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Why is pancreatic cancer so deadly?



The cause of his death was not immediately announced. Trebek revealed in March 2019 he had been diagnosed with stage 4 pancreatic cancer, triggering a round of support.

About 95% of people with pancreatic cancer die from it, experts say. It is lethal because in the early stages, when the tumor can be best treated, there are often no symptoms. It tends to be detected at an advanced stage when abdominal pain or jaundice is possible. Currently, there is no general screening tool.

As people age, the risk of developing pancreatic cancer increases. Most patients are over 45 years old, and nearly 90% are over 55 years old. The mean age at diagnosis was 71.

Men are slightly more likely to develop pancreatic cancer than women, in part due to increased tobacco use in men. In the past, when men smoke more popular than women, the gender gap was wider. Currently, the risk of developing this disease in life is about 1

in 63 for men and 1 in 65 for women.

There is also a noted association with race: African Americans are more likely to develop pancreatic cancer than whites. Doctors don’t know why but speculate that higher rates of men smoke and have diabetes, and women who are overweight, may contribute to that association.

What are the different types of pancreatic cancer?

The pancreas is an elongated organ located deep in the abdomen and is an integral part of both the digestive and endocrine systems. It secretes hormones to regulate the body and digestive enzymes to break down food.

There are two types of pancreatic cancer: endocrine tumors and endocrine tumors.

Exocrine tumors are the majority of pancreatic cancers, and the most common form is called adenocarcinoma, which begins in the glandular cells, usually in the ducts of the pancreas. These tumors tend to be more active than neuroendocrine tumors, the type that the Apple Inc. co-founder of Apple Inc. Steve Jobs is acquired, but if found early, they can be effectively treated with surgery.

According to research, diabetes after the age of 50 can be an early sign of pancreatic cancer

Pancreatic neuroendocrine tumors account for only 1% of all pancreatic cancers. They can be benign or malignant, but the distinction is often ambiguous and sometimes only clear when the cancer has spread beyond the pancreas.

Five-year survival rates for neuroendocrine tumors can range from 50% to 80%, compared with less than 5% for adenocarcinoma.

Dr Steven Libutti, pancreatic cancer specialist and director of the Montefiore-Einstein Cancer Care Center in the Bronx, says more advanced tumors have a higher risk of recurrence and can spread to liver.

Treatment options

According to the National Cancer Institute, pancreatic cancer can usually only be controlled with surgical excision and only when detected before it has spread. Palliative care can help improve a patient’s quality of life if the disease has spread.

Two drugs approved in 2011 may be of benefit to patients with pancreatic neuroendocrine tumors. They are thought to suppress the blood supply and metabolism of tumor cells. “ It’s going well last year, ” said Dr. Michaela Banck, a New York oncologist who treats patients with neuroendocrine tumors. .

Everolimus, marketed by Novartis as Afinitor, has received approval from the US Food and Drug Administration for the treatment of pancreatic neurocrine tumors and the prevention of transplant rejection. However, the potential side effects are very serious: lung or breathing problems, infection, and kidney failure, which can lead to death.

Blood tests offer hope to find cancer before symptoms develop

Sunitinib malate, marketed by Pfizer as Sutent, is prescribed to treat pancreatic neuroendocrine tumors, as well as kidney and GIST cancer, a rare type of cancer of the bowel, esophagus, or stomach. As with everolimus, there are risks to consider: It can cause liver problems and death.

Jobs underwent surgery to remove his tumor in 2004 and died in 2011. His seven-year survival after treatment matched the average viability of the tumor types. Hey hey, Libutti said.

If pancreatic cancer is detected early, that may increase the survival rate, but it also depends on how aggressive the specific tumors are in the patient. If surgery leaves extremely small aggressive tumor cells, they can cause cancer recurrence.

Dr. Maged Rizk, director of the Center for Chronic Abdominal Pain at Cleveland Clinic, which specializes in digestion and liver, said Jobs also underwent a liver transplant in 2009, which was “cutting edge tool” when the Widespread nerve tumors.

Can implants help?

Because it is so rare, there is not a lot of evidence to support transplantation as a cure; Doctors say this procedure may prolong life, but immunosuppressants may allow any remaining cancer to grow faster. And a study in Europe showed that the majority of patients who received a liver transplant for this type of tumor had a relapse.

But many pancreatic cancers are detected at a later stage because when the tumor is small, it usually does not produce symptoms. As they develop, adenocarcinomas can clog the ducts from the liver and cause severe back pain. Nerve endocrine tumors sometimes produce insulin, so a patient’s first symptom may be low blood sugar. But most tumors don’t produce hormones, Libutti said.

Newly found 'organ' may be the largest in your body

Having two rare genetic syndromes – type 1 multiple endocrine tumors (MEN1) and Von Hippel-Lindau syndrome (VHL) – increase the risk of pancreatic endocrine neuroendocrine tumors. However, other than that, it’s still unclear whether having a family member with pancreatic cancer increases a person’s risk.

Pancreatic cancer caused the family of former President Jimmy Carter to face many difficulties. He lost his father and all of his siblings, brother Billy and sisters Ruth Carter Stapleton and Gloria Carter Spann.

The future of treatment

Researchers are working to better understand how pancreatic tumors grow and spread, Libutti said. There’s also a lot of research focused on finding better treatments, targeted therapies, immunotherapy, improving surgery and radiotherapy, according to the American Cancer Society.

“There are a number of agents being considered in clinical trials that focus on possible pathways that allow pancreatic cancer to evade normal processes,” Libutti said.

Another line of research focuses on finding the biomarkers of pancreatic cancer so that a simple blood or urine test can be developed. Unlike screening for other diseases such as colon cancer, breast cancer and prostate cancer, there is no conventional way to see if a patient has a tumor in the pancreas.

The future of medicine to help people with pancreatic cancer will be genetics, Banck said. This would involve matching a person’s specific tumor type using genomic information with treatment.

“What will make a real difference in the future is the revolution of the genetic era,” she said.

CNN’s Jacqueline Howard contributed to this report.


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