Changing the outlook for pancreatic cancer

Pancreatic cancer
Axial CT image with i.v. contrast. Macrocystic adenocarcinoma of the pancreatic head. Credit: public domain

Pancreatic cancer often is hidden and doesn't cause symptoms until it has spread. It is a leading cause of cancer deaths in the world.

November 19 is World Pancreatic Cancer Day, but the entire month of November is meant to bring awareness to this disease.

Advances in screening and early detection for high-risk people, minimally invasive surgical innovations and new genetic classifications are changing the outlook for pancreatic , says Dr. Michael Wallace, a Mayo Clinic gastroenterologist.

Some of the benefits include:

  • Thanks to advances in MRI technology, doctors today can identify pancreatic cysts, small saclike pockets of fluid that may increase the risk for cancer.
  • Patients with large tumors now can take advantage of improved chemotherapy to shrink the tumors prior to surgery. The goal is to get the tumor out and improve patients' chances of survival.
  • Today, thanks to fine needle biopsies, physicians can get enough of the cancerous material and look at genetic sequences to see if there is a better medication available when current options are exhausted.

In addition, for a small number of pancreatic cancer cases, one clue can help doctors find the tumor early, while it's still curable. That clue is an unexpected diagnosis of diabetes. In these cases, the pancreatic cancer is actually causing the diabetes, Dr. Wallace says.

And the key feature is that the diabetes appears where you wouldn't expect it—such as in someone who is maintaining or losing weight, someone who gets diabetes at an older age, or someone who uses tobacco.

Dr. Wallace and colleagues are focused on early detection. Here is a sampling of their research:

They identified key markers of early cancer in the "juice" secreted by the pancreas into the intestine where it can be sampled with standard endoscopy, and potential in a stool (i.e. Cologuard) test. This test was developed by the same team that developed Cologuard, now a widely used method of screening for colon cancer.

Another study demonstrated that screening for early pancreatic cancer is a cost-effective way to prevent in high-risk people.

They are developing artificial intelligence tools to classify early cancers in cystic lesions.

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