Continuing this week’s spontaneous theme (we didn’t make the claims and write the stories) of runaway enthusiasm for various screening tests by some researchers and journalists, HealthDay news service has reported on a study published in the Oct. 28 issue of the journal Nature that they say “provides new insight into the genetics of pancreatic cancer.” In the story, they let one of the researchers get away with saying, almost unchallenged:
“What’s important about this study is that it’s objective data in support of why everyone should be screened for pancreatic cancer.”
Mind you, this was a study that looked at tissue from just seven patients. The story continued with its breathless enthusiasm for the pancreatic cancer screening idea:
“In the future, new imaging techniques and blood tests will offer hope for early detection, the study noted. And just as people have a colonoscopy when they turn 50, “perhaps they should have an endoscopy of their upper gastrointestinal organs that includes an ultrasound of the pancreas,” said (the researcher).”
The very end of the story included some skepticism from Dr. Len Lichtenfeld of the American Cancer Society. Read more »
KERRI walks to the center of the living room and sits down on the couch, across from SIAH, who is sitting in the corner, staring aimlessly at the wall.
KERRI
Oh Siah, I just received an email! About a chocolate shake with glucose-reducing powers! And how, if I purchase the family pack of chocolate powder mix, I’ll get a free personal blender and I will also be cured of my diabetes!
SIAH
(blinks) Meow?
KERRI
I know! Diabetes cures apparently are everywhere. Even in my spice rack, because it seems that just a spoonful of cinnamon, added to every meal and smeared on my face like Noxema, will help me achieve good blood sugar control. Man, if only I had known that these diabetes cures were there the whole time!
I’m not sure what the hell happened to you, but you’ve taken it upon yourself to stop working. You did have that job for about six years, where you got up early every day and produced my insulin, but apparently that was too much for you. You were laid off or fired or something. Don’t blame it on that virus again. I think you just slept through the alarm and were let go and you just don’t want to admit it.
All you do is sit around, hiding out behind my stomach, reading smut novels and watching reruns of The Facts of Life. Sure, you push out the occasional juices and you can sound important when you talk about “trypsinogen” and “chymotrypsinogen,” but you and I both know that you don’t do much. It’s not even like you empty the dishwasher or anything. The least you could do, after I’ve been testing blood sugar levels and bolusing all day long, is have dinner on the table when I come home. Is that too much to ask? Read more »
*This blog post was originally published at Six Until Me.*
Several years ago I was urgently paged by a patient who had discovered a lump at the bottom of his chest. He came straight over to my office, fairly certain he had cancer. The lump turned out to be a normal part of his sternum (breastbone), a small piece of cartilage called the xiphoid. Now that’s the kind of diagnosis I like to make. Read more »
Patrick Swayze, the popular actor perhaps known best for his role in the 1987 hit movie “Dirty Dancing,” died today of pancreatic cancer. My thoughts are with his family in this time of grief.
Pancreatic cancer is among the more deadly forms of cancer. I asked GI oncologist, Heinz-Josef Lenz, M.D., professor of medicine and professor of preventive medicine in the Division of Medical Oncology at the Keck School of Medicine at the University of Southern California, to explain why that’s so.
Dr. Val: Why is pancreatic cancer so much more deadly (i.e. less treatable) than many other forms of cancer?
Dr. Lenz: Unfortunately we don’t have very effective drugs for pancreatic cancer, which makes it one of the deadliest cancers of all. The median survival is about 8 months with metastatic disease. Even when the tumor is successfully removed there is a very high risk for tumor recurrence. We need more funding to better understand the risk for pancreatic cancer and identify and develop more effective therapies.
Dr. Val: Can you describe the typical course of metastatic pancreatic cancer?
Dr. Lenz: Unfortunately, the 5 year survival rate for pancreatic cancer is only 15 to 20%. The average survival after diagnosis is 12 to 19 months. The best predictor of long term survival is if the tumor is found and removed before it reaches 3 cm in size. Patients with metastatic pancreatic cancer are usually treated with a combination chemotherapy consisting of gemcitabine, tarceva, xeloda or oxaliplatin. However the response rates are (despite using aggressive combination therapies) low. Large clinical trials recently did not show any benefit from erbitux or avastin, again demonstrating that pancreatic cancer therapy is a difficult clinical challenge.
Dr. Val: Are certain populations at higher risk than others for pancreatic cancer?
Dr. Lenz: Age is the most important risk factor for this cancer. It is most common in individuals over age 50 and increases in frequency with age. Black men and women are slightly more likely to get pancreatic cancer (though the reasons for this are unclear), and men are slightly more likely than women to get the cancer. Other risk factors are smoking, diabetes, and obesity.
Dr. Val: If you suspect that someone is “high risk” for pancreatic cancer, what tests should he/she have?
Dr. Lenz: Patients with a genetic predisposition for breast cancer known as BRCA are also at higher risk for pancreatic cancer. There is also a familial form of pancreatic cancer. These high risk families are being followed up with specific screening plans. However there is not a reliable test for pancreatic cancer. Imaging with CT or MRI can miss pancreatic cancer and there is no reliable blood marker. The most common used is CA 19-9, which can be used for monitoring and diagnosis but is not elevated in all patients.
Dr. Val: What if the cancer is caught very early? Does that increase likelihood of survival?
Dr. Lenz: Absolutely. The best chance of survival is when the cancer is limited to the pancreas, and is surgically removed before it reaches a size of 3 centimeters. There are certainly people who have been cured this way, but unfortunately it’s very rare to catch the cancer at such an early stage since it usually has no symptoms until it’s quite advanced.
***
There is a wonderful advocacy group for those whose lives are touched by pancreatic cancer: PanCAN. One of PanCAN’s founders, Paula Kim, is a friend of mine and was inspired to create the organization after her dad was diagnosed with pancreatic cancer in 1999. At that time there was very little advocacy for this deadly disease. PanCAN helps people with pancreatic cancer find help and support.
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