The Sandler-Kenner Foundation was founded in memory of Michael Sandler and Peter Kenner who succumbed to pancreatic cancer. Since then, the foundation has dedicated its funds on supporting and improving the survivability of pancreatic cancer patients by developing highly sensitive tools for early identification of the disease. They are also committed to increasing the awareness of neuroendocrine and adenocarcinoma pancreatic cancers.
- The studies on pancreatic cancer are limited due to directed focus on advanced symptomatic cancer. The biomarker research is also confined to samples from symptomatic patients. It is critical that the disease is studied early before symptoms manifest in order to make advances in early detection of pancreatic cancer. The disease also has limited options for treatment, and funds are being spent to find treatments that more comprehensive and effective for all the stages of the disease.
- In their efforts to initiate and support the research for early detection of pancreatic cancer, Sandler-Kenner foundation partnered with Mayo Clinic. Mayo Clinic initiated a landmark study in a trial as a novel strategy to screen for pancreatic cancer. The studies were conducted on pancreatic cancer patients at Mayo Clinic and have the potential to provide a practical approach to diagnosing the disease at an early stage to help improve life expectancy.
- The research for pancreatic cancer has not had adequate funding, but various sources, including Sandler-Kenner Foundation have continued to raise funds which with time will see pancreatic patients extend their lives with innovative treatments. Sandler-Kenner Foundation still provides funding for a wider scope of more in-depth research to help change the diagnostic and treatment approaches of the disease. Though slow, new developments are evolving in all areas of pancreatic cancer.
Much time is spent on developing new methods of diagnosis and treatment of pancreatic cancer. Research is making great strides in new advances that will lead to more lifesaving developments in the treatment, prevention, and detection of this disease. With the dedication of researchers and adequate funding to support their work, more promising developments will come up to ensure that more defined ways of improving the approach to pancreatic cancer are devised.
Although cancer ranks fourth in the cause of cancer mortality rates in the U.S, there has not been a standard screening test to detect it early and save lives. The pancreas is located deep inside the body and it’s not easy to see or feel early tumors during physical examinations. It also presents no symptoms until the cancer has advanced and spread to other organs in the body. Individuals at high risk of the disease include those with a strong family history of pancreatic cancer, those with Lynch Syndrome and those with mutations in the BRCA1 and BRCA2 genes.
Here are some of the tests carried out on patients with pancreatic cancer:
- Blood tests – At times, the levels of some proteins in the blood rise when an individual has pancreatic cancer. Such proteins, known as tumor markers, can be detected using blood tests. The CA 19-9 and carcinoembryonic antigen (CEA) are tumor markers that are closely associated with pancreatic cancer. The CA-19-9 don’t always go up when one has pancreatic cancer and if they go up, the cancer is found when it’s already advanced. Sometimes, the tumor markers go up even when pancreatic cancer is not present. Blood tests can be ordered for patients showing symptoms but can’t be used to screen for pancreatic cancer. Blood tests are only effective in people who already have pancreatic cancer to tell whether the cancer is progressing or if the treatment is working.
- Genetic testing – These are only done on people with an increased risk. These are individuals with a family history of pancreatic cancer or other cancers, which might be due to a specific genetic syndrome. Some genes can be tested to look for pancreatic cancer early when it can be easily treated. Endoscopic ultrasound has helped doctors to detect pancreatic cancer in such situations.
- CT scan – A CT scan or any other type of scan that focuses on the pancreas may be recommended although these tests have not been proven to be effective at picking up early-stage cancers or pre-cancers.
There’s no standard screening program or test for detecting pancreatic cancer early. Only people at high risk for the disease can be considered for screening. Researchers are working to discover means of detecting the disease earlier, especially in people with no family history of the disease.
Metabolic syndrome, type 2 diabetes, and obesity are all linked to pancreatic cancer. Even though the most commonly known risk factor, smoking, has been declining, cases of pancreatic cancer are still on the rise. That’s why researchers work tirelessly to seek explanations for other causes and find ways to detect and prevent it while it’s still curable. In some cases, pancreatic cancer is discovered early by accident during surgery or when scanning for another reason.
Here’s how to lower the risks of pancreatic cancer:
• Be attentive to the symptoms – You should be able to know the symptoms and the major risk factors of pancreatic cancer. Some risk factors like gender, age, family history, and race are beyond anyone’s control. But others like obesity and smoking can cause type 2 diabetes and chronic pancreatitis due to abuse of alcohol can increase the risk.
• Quit smoking – Once you quit smoking, your pancreatic cancer risk will decrease with time. It’s never too late to quit smoking.
• Maintain a healthy body weight – If you are obese or overweight, you are at high risk of developing pancreatic cancer. Make smart diet choices by avoiding red meats and choosing poultry and fish. Also, incorporate fruits and vegetables into your diet. Stay physically active by exercising regularly.
• Check your levels of vitamin D – Vitamin D consists of protective qualities against the development of pancreatic cancer. As an antioxidant, vitamin D can destroy cancerous cells. A diet rich in vitamin D such as fish and egg yolks is recommended.
• Get regular medical check-ups – You should visit the doctor regularly to help identify any concerns such as yellowing of the skin and eyes, itchy skin, and discoloured urine.
• Working with chemicals – Exposure to some chemicals may increase the risk of pancreatic cancer. When working with chemicals, ensure that you follow the guidelines for safe use.
It is important to be aware of the factors associated with developing pancreatic cancer. If you have several factors that are controllable, you should make lifestyle changes right away. Exercising, losing weight, eating healthy and quitting smoking can prevent your chances of developing pancreatic cancer.
Type 2 diabetes is known to be an early indicator of pancreatic cancer, and according to scientists, this cancer is among the deadliest forms of cancer that exists. Patients with diabetes carry a double risk of cancer. The survival rate of pancreatic cancer is five years. Physicians advise that diabetic patients exercise caution to prevent further complications like pancreatic cancer with these diet changes.
- Eat healthy carbohydrates – Digestion of sugar and starch breaks down into blood glucose. Eat healthy carbs like whole grains, legumes, and low-fat dairy products
- Fiber-Rich foods – Eat plant foods that ease and absorb digestion. Fiber moderates how the body digests hence controlling the blood sugar.
- Eat fish – Tuna, cod, and halibut have less saturated fat and cholesterol than meat and poultry. Fish such as mackerel, sardines, and bluefish are rich in omega-3 fatty acids, which promote a healthy heart and lowers blood sugar.
- Eat Good fats – monounsaturated fats and polyunsaturated fats help lower cholesterol levels. Avocadoes, peanut oils, canola, and walnuts have beneficial fats in a diabetic patient
A majority of pancreatic cancer patients have shown to have diabetes three years before the cancer diagnosis. A surgical procedure is carried out to remove tumors. Half of the patients with recent on-set diabetes do develop diabetes postoperatively.
Researchers found out that association of latest-onset diabetes with pancreatic cancer was more evident in African Americans and Latinos.
The study suggests that patients with on-set diabetes who later develop pancreatic cancer represent a higher risk predictor and might participate in the development of tests required for early diagnosis and treatment. Initial treatment and management of diabetes can significantly lower the risk of developing cancer of the pancreas.
Dr. Gregory Echt explains the research findings on the link between pancreatic cancer and new-onset diabetes. The study was funded in part by the Sandler-Kenner Foundation which was initiated by Dr. & Mrs. Gregory Echt.
Pancreatic cancer is a lethal malignancy and represents the fourth leading cause of cancer-related death in the United States. The symptoms of pancreatic cancer manifest in a patient according to the location of the tumor in the pancreas. Most of the malignancies of pancreatic cancer are found inside the head of the pancreas while about 25% of them occur in the tail or body of the pancreas. They present different symptoms relating to their location in the pancreas.
“Pancreatic cancer symptoms vary with the location of the malignancy. Malignancies within the tail or body of the pancreas present symptoms such as back pain while those within the head present symptoms of jaundice, weight loss, steatorrhea and acholic stools,” explained Dr. Echt, Founder and Chairman of the Sandler-Kenner Foundation.
According to research findings funded in part by the Sandler-Kenner Foundation, new-onset diabetes mellitus (DM2) in adults can be an indication of the presence of pancreatic cancer as seen in the facts below:
- New onset diabetes is DM2 that was diagnosed within 36 months.
- About 80% of pancreatic cancer patients have developed hyperglycemia and DM2.
- For long-standing DM2, a diagnosis that has been longer than 36 months, there is a risk that a patient will develop pancreatic cancer according to epidemiological studies.
- The role of DM2 as a potential screening test for pancreatic cancer is under investigation.
- Pancreatic cancer and DM2 both share common risk factors such as obesity, family history, and age.
- Of the more than 2000 patients who underwent a study after being diagnosed with diabetes for pancreatic cancer development, 0.85% of them were found to have pancreatic cancer in three years’ time.
- Another study conducted on high-risk patients (African American) showed that 32% of them developed diabetes. Some of them developed pancreatic cancer while others were found to have new-onset diabetes after diagnosis.
- Pancreatic cancer has been found to be associated with diabetes in patients between the ages of 65 to 75 years. It was concluded that new onset diabetes is an indication for pancreatic cancer manifestation. There is a high prevalence of DM2 in pancreatic cancer patients as compared to other patients with lung, colorectal, prostate and breast cancer.
“The role of DM2 in screening pancreatic cancer is still being investigated,” continued Dr. Echt,”But medical practitioners need to consider it as both sequelae and risk factor for pancreatic cancer when evaluating patients with new onset and long-standing diabetes.”
While there has been some progress in the treatment of pancreatic cancer over the past couple of decades, it’s still one of those cancers that are difficult to cure.
When looking at the life expectancy and prognosis of pancreatic cancer, we typically concentrate on the five-year survival rate, which basically refers to the percentage of individuals still alive once five years elapse after being diagnosed with pancreatic cancer.
Why five years? Well, five years are used as a benchmark as it’s a great indicator that the disease has responded to treatment. These rates don’t only refer to persons who survive five years later, some people live well beyond the five years.
Here are the most recent statistics from the National Cancer Institute on pancreatic cancer survival rates:
- Overall, pancreatic cancer’s five-year survival rate is 7.2 percent
- For pancreatic cancers that haven’t spread past the pancreas (localized cancers), the survival rate is at 27.1 percent.
- For those cancers that have affected other parts near the pancreas (regional cancers), the survival rate is at 10.7 percent
- For those cancers that have spread further (metastatic or distant cancers), the survival rate is 2.4 percent.
Although these statistics give an outlook of the general population, they may not always consider the details of your specific case. This is because personal factors such as family history, age, and behaviour can considerably affect your prognosis.
Survival by stage
The survival rate may vary with each stage of this cancer. Typically, pancreatic cancer grows fast and may have a poor prognosis. The earlier it’s diagnosed and treated, the higher the chances of curing it.
If it’s diagnosed at an advanced stage, the tumor may be hard to remove through surgery, making it more difficult to treat.
A small study conducted on adults with common pancreatic cancer reveals that high-risk breast cancer patients with BRCA1 AND BRCA2 gene mutations have the lowest rates of survival compared to those without the mutations. The same study also discovered that the BRCA! and BRCA2 patients would survive better with platinum-based chemotherapy than those who used other kinds of drugs.
The research findings highlighted the potential for harmonizing targeted therapies to groups of patients with pancreatic cancer based on their genetic makeup.
The survival rates and therapies for patients who have pancreatic ductal adenocarcinomas (PDAC) are very poor at the moment, and such a finding that tailors better treatment for some of the patients is received with enthusiasm. Surgical removal of the tumor is currently the standard care for PDAC, but only a fraction of patients are eligible for the operation since most of the cancers don’t show symptoms and are not diagnosed until they have already metastasized.
During the study:
- Noncancerous tissue from 658 patients was analyzed. The patients had sporadic PDAC and had undergone operation between the year 2000 and 2015. Out of the 658, twenty-two of them (3%) had the BRCA 1 and 2 mutations in their DNA. The patients were matched by age and structural tumor locations to 105 of the other patients who had no mutations. The mid-range age was 61 years for both groups, and 62 (49%) of them were male.
- Every patient in the control and mutation groups underwent a CT scan every four to six months during the first two years following the removal of the tumor, and yearly after the removal. The overall survival time from diagnosis to death was calculated.
- The disease-free survival was also calculated from the time of surgery to the date of recurrence or stopped at the last follow-up date.
- The pancreatic cancer patients who had the BRCA 1 and 2 mutations had an overall worse survival average of 20.2 months vs. 27.8 months, and a disease-free survival averaging 8.4 months versus 16.7 months than the patients without the mutations.
- The patients who underwent platinum-based chemotherapy after surgery had better survival rates overall than those who took other treatment options or received no chemotherapy at all.
- Out of the 22 patients with BRCA 1 and 2 mutations, 10 went through platinum-based chemotherapy, eight received alternative chemotherapy, and four did not receive any chemotherapy after surgery. Their survival rates averaged 31 months, 17.8 months and 9.3 months respectively.
Researchers compliment the findings, which they view as a step forward in precision medicine techniques that will match patients to better treatment options. They’re looking forward to find ways of sequencing tissue from pancreatic cancer patients to help in defining the biological patterns and other patterns that will help in improving the treatment decisions. This will go a long way in reducing the soaring mortality rates of pancreatic cancer.
Pancreatic cancer, compared to other cancers, has a low profile. But then it is the third leading cause of cancer mortalities in the United States according to the American Cancer Society. Its mortality rates increase each year. Pancreatic cancer is deadly because it doesn’t have early screening tests and has no cure as well. Experts say the nature of the disease makes it difficult to research.
Pancreatic cancer has numerous challenges which call for more funding to help in research that will ensure availability of better screening and treatment options.
Some of these challenges are that:
- Pancreatic cancer is rapidly lethal. The disease does not behave like other cancers, so the treatment approaches used on other cancers don’t work well on pancreatic tumors.
- Not many pancreatic cancer survivors can create awareness campaigns and publicize fundraising events to help combat the disease. This is because most of them die within a short period of diagnosis. It is difficult to find and retain pancreatic cancer patients for clinical trials and further research because of its metastasizing speed.
- There’s little time for the patients and their families to absorb the diagnosis before the patient succumbs to the disease.
- Pancreatic cancer has been underfunded and understudied because it is a little bit of a Catch-22 for scientists and clinicians studying it. The best thing a doctor can offer a pancreatic cancer patient is optimism and hope.
- The resistance mechanism in pancreatic cancer is that it decreases the supply of blood instead of increasing it the way other cancers do.
- Clinical staging system of pancreatic cancer is not clear-cut. Even when caught at early stages, the disease requires complicated surgery (Whipple procedure), and after surgery, the l0-year survival rate is less than 10%. The disease ends up metastasizing because even the early tumors will have already spread. They get to the bloodstream and find ways to survive in other body organs including at the microscopic level.
- Pancreatic cancer does not trigger the immune system, making it difficult to detect through lab tests.
Recent discoveries have made the disease more understandable. Researchers have begun to look for more ways to out-think the tricky disease cells using immunotherapy techniques and molecular biology. Techniques are underway to help target particular aspects of the tumor cell of the pancreas that will prime it to be receptive to drug therapies used in other cancers.
Research reports that patients with locally advanced pancreatic cancer have longer overall survival when they undergo surgical resection after neoadjuvant therapy. The development of advanced systematic treatments of radiotherapy and chemotherapy, patients with non-metastatic locally advanced pancreatic cancer have an increased chance for surgery and improved survival.
Locally advanced pancreatic cancer accounts for 30% of newly diagnosed pancreatic cancers and is surgically unresectable because of involvement of adjacent vessels. The current guidelines recommend that patients with good performance status be given non-operative treatment. Studies suggest that patients with locally advanced pancreatic cancer (LAPC) can be cured if given resection after induction chemotherapy.
The research was carried out on 415 patients with LAPC to confirm if surgical resection after neoadjuvant therapy was associated with improvement in survival rates compared to aggressive non-operative management. Thirteen patients underwent surgical exploration based on the response of tumor to neoadjuvant therapy, and to another 103 patients who had no signs of the progression or metastases of local disease after four months of neoadjuvant therapy.
- Eighty-four patients achieved the resection of the primary tumor (72% of patients eligible for exploration and 20% of all LAPC patients). Resection was aborted intraoperatively in 12 patients who showed occult abdominal metastatic disease and in 20 patients because of local extension of the tumor. In 89% of the cases, resection margins showed negative for tumor (R0).
- After resection, 40 patients developed recurrence of the disease, 13 patients with most commonly local recurrence and nine patients had distant liver metastases.
- The median survival during diagnosis was 35.3 months for the group under resection and 16.2 months for the 331 patients who were treated with radiation therapy and chemotherapy.
- The overall survival rates were significantly higher in the resected group at one year (96%) and three years (50%) than in the non-resected group which had 74% at one year and 11% at three years.
The overall results showed that the patients had comparable survival after the neoadjuvant therapy and surgery to those with the initially resectable disease which was a significant improvement. However, LAPC patients under neoadjuvant therapy treatment need to be monitored and repeatedly assessed to identify those who can be taken to surgery. Doctors concluded that aggressive neoadjuvant therapy could help in reducing tumor and making surgery feasible.
Pancreatic cancer accounts for almost three percent of all cancers and is considered deadly due to its low survival rate. The disease at its early stages rarely shows any symptoms, and there are no specific screening tools to identify pancreatic cancer. Even after undergoing surgery, 30% of pancreatic cancer still goes undetected, leaving a possibility for the cancer to recur five years after surgery.
Here’s information about the rising rates of pancreatic cancer:
- Pancreatic cancer was the fourth leading cause of cancer mortality in the U.S.
- Currently, pancreatic cancer is the third leading cause of cancer deaths, and even with the rising survival rates, it’s expected to become the second leading cause.
- The incidence of pancreatic cancer has risen by approximately 0.5% each year for more than a decade. This is according to the National Cancer Institute.
- The rise in mortality rank of pancreatic cancer can be partly explained by the advances in treating other cancer types particularly prostate, breast and colon cancer. Immunotherapy has still not worked for pancreatic and liver cancer.
- Over three-quarters of new pancreatic cancer patients are aged between 55 and 84 years old, meaning that the aging population is the main contributor.
- Smoking is the most significant contributor to the development of pancreatic cancer. Even though smoking rates have dropped in the U.S., it will be 30 to 40 years before we experience a proportionate drop in the rates of pancreatic cancer.
- The increase in type 2 diabetes and obesity have contributed to the rise in pancreatic cancer. According to Robert A. Wolf, MD, obesity has overtaken smoking as the primary cause of the increase in pancreatic cancer.
- Pancreatic tumors metastasize quickly unlike many other cancers which can be cured if detected early. Liquid biopsies and precision medicines are hot areas of oncology, but pancreatic cancer is difficult to treat effectively.
- Some doctors believe that patients will be helped by precision medicine therapies, especially the 10% who have hereditary pancreatic cancer. The current blood tests cannot specify though.
- Prevention can combat the rising rates of pancreatic cancer. According to some doctors, 30% of pancreatic cancer can be prevented by better diets, more exercise, no smoking and cutting back on obesity.