The Latest on Pancreatic-Cancer Diagnosis

By Jane Farrell

Pancreatic cancer is the third most common cause of cancer death in the United States, recently surpassing breast cancer, according to an article in the Mayo Clinic News Network.

The article cites statistics that 53,000 new cases of pancreatic cancer are expected by the end of 2016, and an estimated 42,000 deaths occur annually.

“Although we have made great advances in many cancers, pancreas cancer remains one of the most difficult to treat ― often because patients are diagnosed at a late stage,” Dr. Michael Wallace, a gastroenterologist on Mayo Clinic’s campus in Jacksonville, Florida, said in the article.

But, he says, screening advances for high-risk individuals, surgical improvements and new genetic classifications are changing the outlook. “I am optimistic about the future, as we are seeing major areas of progress,” Wallace said, according to the article.

Pancreatic cancer begins in the tissues of the pancreas — an organ in the abdomen that secretes enzymes to aid digestion and hormones to help regulate the metabolism of sugars. All individuals, regardless of gender, race, color or age, can be at risk, Wallace says. Risk is increased by heavy alcohol and tobacco use.

Fewer than one in ten people have a genetic risk factor, Wallace says, but people who have one or more family members diagnosed with pancreatic cancer, especially at an early age, should be monitored.

“This broad group of people may represent up to 20 percent of individuals who are at increased risk, but it is important that we follow them closely, especially since we do have effective screening tests now, including MRI and endoscopic ultrasound,” Wallace said in the article.

Because of advances in MRI technology, doctors can now detect pancreatic cysts, small pockets of fluid that may increase the risk for cancer. “We find cysts in about 40 percent of the population,” Wallace said. “ While most are inconsequential, it is important to distinguish which of them are benign and which we need to either watch, biopsy or even surgically remove.”

The article notes that in 2015, Wallace and a team of colleagues developed a profile of people who would be most at risk of cysts developing into cancer. The study was published in the journal Digestive and Liver Disease.

“Studies such as these allow us to further stratify people into a low-, medium- or high-risk category for their cyst becoming cancerous, based on characteristics, including size and shape. This will hopefully enable us to help diagnose cancer earlier and, in turn, positively impact survival,” Wallace said in the current Mayo News Network article. “Traditionally, only about 5 percent of all patients are diagnosed at an early stage where we can resect their tumor completely with surgery. Now, we are pushing the boundary of who we can get to surgery. Because, if we can get the tumor out, we can cure those individuals.”

Additionally, research related to the genetic classification of tumors can help in the evolving treatment. In the past, genetic information was usually only available from surgical specimens. But, today, thanks to fine needle biopsies, Wallace says, “we’re able to get enough material and look at genetic sequences to see if there is a better medication available when our current options are exhausted. We’re seeing major areas of progress on many fronts for pancreatic cancers. There is hope for this cancer.”

For more information on health issues, visit www.mayoclinic.org.