Seven years ago, Matt Wilson went to an ambulance. He had abdominal pain, which he assumed was a kidney kidney. It was not. His CT scan showed an abnormal site, later diagnosed as an early pancreatic cancer. This accidental discovery may have saved his life. Pancreatic cancer usually grows quietly, without symptoms, and successful treatment is a rarity.
Thursday is a day of consciousness about pancreatic cancer, hoping that awareness of the disease will help save lives.
What is pancreatic cancer?
Pancreas, an organ in the abdomen, is responsible for the secretion of digestive enzymes and hormones that regulate metabolism. Pancreatic cancer is the third leading cause of cancer death in the United States – it can even overcome lung and colorectal by 2020. The risk of developmental life span in developing this cancer is 1 in 63 for men and 1 for 65 for women; the risk is increasing over the years. Almost 90 percent of diagnosed individuals older than 55 years. Other risk factors include family history of cancer, obesity, smoking, diabetes, and diet in red and processed meat. A diet that includes lots of fruits and vegetables can work to reduce the risk.
Why is it so deadly?
Most people diagnosed with, including Matt Wilson, initially show only vague symptoms: abdominal or back pain, unintentional weight loss, fatigue, recent diagnosis of diabetes or jaundice (yellowing of the skin and eyes). Because these symptoms relate to many diseases, cancer is often diagnosed too late for significant treatment. There is a scary survival rate of 9 percent for 5 years after diagnosis. Only 55,440 people are diagnosed this year, and 44,330 will die.
Are there different types?
There are two main types of pancreatic cancer: endocrine and exocrine tumors.
The most common and most aggressive form is an exocrine tumor. It is an adenocarcinoma that begins in the pancreatic and glandular cells that produce enzymes. These cells have a thick layer to protect them from the digestive enzymes they produce. But this thick layer also reduces the effects of chemotherapy.
Only a few cases of pancreatic cancer – about 1% – are endocrine tumors. They affect cells that produce insulin and glucagon, the hormones that control our blood sugar. These cancers have a significant increase in survival 5 years after the diagnosis of about 50 to 80 percent.
The gold standard treatment option is a surgical procedure known as Vhipple. This technique was coined by Dr. Allen Wipple in 1935 at the Columbia-Presbiterian Hospital in New York. Doctors remove many digestive organs: gallbladder, gallbladder, part of the stomach and head of the pancreas. Unfortunately, this procedure is only possible in about 20 percent of patients; can not work with patients who have been diagnosed with cancer at a later stage. Other treatment options include chemotherapy, a range of drugs designed to kill cancer cells. This can be done after Vhipple or together with radiation for those who are not eligible for surgery. Treatment is difficult because it is difficult to diagnose pancreatic cancer when the tumor is small. When enlarging and obstructing the pancreatic canal or producing abnormal levels of the hormone, it is often too late for surgery.
Pancreatic transplantation, another treatment option, has recently been caught. That's what Steve Jobs used, in part, to fight his illness. However, doctors warn that steps taken to prevent the body from dismissing the new pancreas can allow the remaining cancer cells to grow, which means a high risk of cancer return.
"The oncologist will probably have to rely on the science and art of medicine to help the patient determine the treatment that is the best choice for them," Dr. Linn Matrisian, chief scientist for the pancreatic network, told ABC News.
Can not we show pancreatic cancer the way we work for breast cancer?
International cancer pancreas screening consortium recommends that people with hereditary pancreatitis, those with first-degree relatives who are diagnosed or persons with BRCA1 / 2 mutations should be examined by doctors closer when they come to the office with an unclear abdominal pain. Unfortunately, there are no other instructions.
What's on the horizon?
Matt, an ER patient, had an operation that removed part of his pancreas, spleen and more than 20 lymph nodes. Serious recovery and the discovery of a new reason mean that Matt now separates his time as a university professor and advocates others with the same diagnosis. It is now part of the pancreatic network.
Organizations such as the Pancreatic Nursing Network are constantly working to claim additional resources to find out what can act against this aggressive cancer. They also research biomarkers for a blood test that could diagnose it early. At this point, tests remain unreliable, but maybe further research may open new doors. Drug therapy targeting specific DNA mutations can help create drugs that penetrate the tumor cells better. But, unfortunately, these screening tools will take years to develop.
Dr. Sumir Shah, MD is an Emergency Medical Officer at the Nevilleork presbyterian Medical Center Kueens / Veill Cornell in New York and a member of the ABC Nevs Medical Unit.