New Research Improves Early Detection And Survival For Pancreatic Cancer

There are new and innovative methods to better understand the risk factors for and improve earlier detection of pancreatic cancer. Specifically, researchers can demonstrate that the development of, new biomarkers, novel treatment targets, innovative approaches to screening and surveillance and improved understanding of risk factors can lead to diagnosis of pancreatic cancer at earlier more treatable stages.

“Pancreatic cancer is the fourth-leading cause of cancer death in the U.S., taking 34,000 lives every year,” said Mark P. Callery, MD, MACS, associate professor of surgery, Harvard Medical School, chief, division of general surgery Beth Israel Deaconess Medical Center. “It’s vitally important that we make pancreatic cancer a research priority. Signs and symptoms of the disease may not present themselves until advanced stages, when surgical removal of the cancer is no longer possible.”

The five-year survival rate for pancreatic cancer is only four percent, but if detected at Stage 1, the survival rate can be as high as 33 percent.

Endosonographic Evaluation Improves Survival in Patients with Pancreatic Cancer

Due to a lack of early detection and treatment options, pancreatic cancer is deadly. In fact, a vast majority of patients with pancreatic cancer die because the disease has spread so far that it can no longer be removed. However, a small percentage of pancreatic cancers are caught early enough for a curative surgery to allow removal of the tumor, which may result in improved survival.

Researchers are fervently searching for new, improved technologies that could either detect pancreatic cancer earlier or treat it once it’s detected. Endoscopic ultrasound (EUS) is an expensive treatment, but shows great promise in helping to improve patient outcomes after a diagnosis with pancreatic cancer. Researchers for this study sought to learn about the association between EUS performance and pancreatic cancer survival. To achieve this, investigators reviewed the SEER-Medicare database of patients receiving treatment between January 1994 and December 2002. In all, the records of 4,236 patients with pancreatic cancer were assessed, and broken into two groups — those who received EUS (only 12 percent of the sample) and those who did not (88 percent).

Researchers found that after they controlled for age, race, gender and comorbidities, those who did receive EUS at the time of diagnosis had a longer average survival time (nine months) than those who did not receive EUS (five months).

“Good initial investigation by EUS makes a significant difference for patients with pancreatic cancer,” said Ananya Das, MD, associate chair of medicine, Mayo Clinic, Scottsdale, Arizona. “Though the treatment is expensive and not available everywhere, it has shown to be a marker for better care and treatment planning.”

Dose Dependent Effects of Alcohol and Tobacco on Age of Presentation in Pancreatic Cancer (PC): A Multi-Center, International Study

Smoking tobacco and drinking alcohol have an effect on the age at which a patients present with pancreatic cancer. This multi-center, international study shows that among patients with pancreatic cancer, heavy smokers and drinkers show the youngest onset. While the average age for the onset of pancreatic cancer is in the 70 to 80 year age range, smokers and drinkers show onset as early as in their 50s, and the more tobacco and alcohol consumed, the earlier the onset.

A previous study using insurance data showed that tobacco and alcohol use affected the age of onset of pancreatic cancer but the effect of the amount and length of time of its use was unknown.

This study, using The Pancreatic Cancer Collaborative Registry, a multi-center international patient registry, captured data for the first time on the dose amounts of tobacco and alcohol used by pancreatic cancer patients along with data on the type of alcohol consumed. The registry was queried for patient age at diagnosis, gender, race, diabetic status, family history of pancreatic cancer, and tobacco and alcohol use.

“We found that the more smoking and drinking done by the patient, the younger the onset of the cancer, and that of the two, drinking has a worse effect,” said Michelle A. Anderson, MD, assistant professor of medicine at the University of Michigan. Heavy drinkers (more than three drinks a day) presented with pancreatic cancer 10 years younger than those who did not drink, while heavy smokers* presented seven years younger than those who did not smoke.

Among the different types of alcohol studied (beer, wine and hard liquor), beer was the strongest in lowering the age of presentation. The median age of onset for those who drank only beer was 62.2 years compared with 68.2 years for those consuming other types of alcohol. “This study strengthens the validity of the data showing that these toxins may be important in the pathogenesis of pancreatic cancer,” said Dr. Anderson.

Researchers did not find a synergistic relationship between the use of tobacco and alcohol, meaning that the age of onset was not profoundly worse if the patient used both, although the size of the study may have affected this finding.

Other limitations of the study include the fact that patients were being asked to recall their past use of tobacco and alcohol and a potential for selection bias. Also, because all of the centers using the registry are academic medical centers, the type of patient may be different than the type of patient who would go elsewhere for care.

A heavy smoker is a person with a pack value > 40. Pack values were determined by multiplying the number of years a person has smoked by the pack per day they smoke (e.g. a person who smokes a pack per day for 20 years has a pack value of 20 while a person who smokes half a pack per day for 20 years has a pack value of 10).
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source: Science Daily