How Long Can You Have Pancreatic Cancer Without Knowing It
What is pancreatic cancer?
When Steve Jobs died on Oct 5th of this yr, global attention turned to his cause of death – pancreatic cancer. Many people had questions: Would his fate have been unlike if he hadn't elected for culling treatments in the early days of his diagnosis? If someone of his wealth couldn't crush this affliction, can anyone? What many people may non know is that the eight years Jobs lived with his cancer diagnosis were significantly longer than the typical pancreatic cancer patient can expect to survive. This fact has much, if non all to do with the particular type of pancreatic cancer that Jobs had.
There are two parts of the pancreas: the endocrine pancreas and the exocrine pancreas. The erstwhile secretes hormones like insulin that assist control blood sugar levels, while the latter secretes digestive enzymes that help suspension down the nutrient you lot eat. Steve Jobs roughshod into the 1% of patients whose pancreatic cancer is of endocrine origin, and these patients have meliorate prognoses because cancers of the endocrine pancreas are less aggressive. The other 99% of pancreatic cancer patients take exocrine tumors, most usually in a class chosen an adenocarcinoma, and their prognosis is not and so good: these tumors have a five-year survival rate of less than 5% compared to a 50 to lxxx% survival rate for endocrine tumors [1]. Why is the outlook for adenocarcinomas so poor? Information technology has everything to do with what happens before a patient ever makes a trip to the doctor.
How is pancreatic cancer detected?
You lot've been feeling abdominal hurting and throwing up for a few days, but you assume it's only a nasty tum virus. However, when you start to notice that the whites of your eyes are looking a chip yellow, you make up one's mind to go in to run into your doctor. The diagnosis: you have pancreatic cancer; your primary tumor is already quite large and has more than likely spread to other parts of the body – and yous're one of the luckier ones. The power to detect pancreatic tumors can depend on which part of the pancreas the tumor originates from. When a pancreatic tumor is well-nigh the common bile duct, a buildup of bile in the claret tin can cause the yellow-tinged skin characteristic of jaundice. The unanticipated benefit of this symptom is that it brings attention to the fact that a tumor may be nowadays. People with pancreatic tumors originating elsewhere on the pancreas can go much longer before having any clue that something is wrong with them.
Because at that place are few, if whatever, symptoms in the early stages of pancreatic cancer, few patients are diagnosed early on, when surgery could be more than useful because the cancer has not yet spread. Additionally, at that place are no general screening tools to take hold of pancreatic cancer early, in contrast to the regular mammograms used to notice breast cancer in women, for example. Fifty-fifty with some sort of early on screening, pancreatic cancer tin can still go undetected past most imaging methods because of its location deep in the abdomen, beneath the liver and behind the stomach; it is known as "the subconscious organ."
Figure 1. The pancreas is effectively "subconscious" by other organs, making pancreatic tumors difficult to detect past many imaging methods.
How is pancreatic cancer treated?
A year or 2 agone, the standard treatment for pancreatic cancer was chemotherapy, a very non-specific way of killing chop-chop dividing cells in the trunk. While the targets of chemotherapy include the fast-growing cancer cells, other tissues similar hair and the lining of the gut are also harmed, which makes for unpleasant and potentially serious side effects for the patient. Most of the electric current and pending treatments for pancreatic cancer are much more focused on the specific biology of pancreatic tumors. Today, patients are ofttimes given Tarceva, a drug that inhibits a growth-promoting molecule produced by the tumor. Combined with standard chemotherapy, Tarceva can significantly extend the life of patients [2].
A growing number of pancreatic cancer treatments in clinical trials work by helping our immune organization specifically target and destroy cancer cells. These therapies utilize antibodies – molecules that are naturally produced by the immune organization and demark to specific cells, marking them for destruction. The National Cancer Institute is attempting to engineer an antibody that binds pancreatic cancer cells, causing them to exist recognized and killed by immune cells [3]. This antibody could be combined with standard chemotherapy to create a more than potent effect against the cancer.
Another potential therapy in development for pancreatic cancer is the apply of viruses to selectively target and kill cancer cells. The concept behind this therapy is that researchers tin modify viruses to recognize molecules found exclusively in cancer cells. When such a virus is administered, it infects cancer cells and causes them to die, leaving normal tissues unharmed and spreading only to tumors. Clinical trials accept been done in humans with virus-based therapies in recent years, and the results are promising [4].
Can nosotros notice pancreatic cancer before?
All the same, the difficulty in detecting pancreatic cancer in its early stages remains at the center of why this disease is so deadly. Ane way to address this problem is by using improved imaging techniques, an area that has seen promising breakthroughs in recent years. I such applied science involves the use of a elementary endoscopy, in which a thin tube with a calorie-free at the end is passed into the upper office of the small-scale intestine to see inside the body. This approach is based on the principle that a tumor in one part of the pancreas would change the construction of the entire organ. Considering the caput of the pancreas is in contact with the upper intestine, an endoscopy could detect a meaningful change in pancreas construction early on in the cancer. An experiment showed this technique to be effective in identifying 19 out of 20 early-stage pancreatic tumors in patients.
Another cutting-edge imaging method under consideration takes advantage of a biomarker for early-stage pancreatic cancers. A biomarker is any biological substance that tin can be used to indicate a particular biological state; for example, a protein that is significantly more abundant in the blood of people with pancreatic cancer would be a biomarker for the disease. Identifying biomarkers for early-phase pancreatic cancers is an area of active study because they could brand detecting these cancers much easier. Doctors could simply draw a blood sample and have an indication that a patient may have pancreatic cancer, at a fourth dimension when the tumor is however operable. Fascinatingly, researchers at UCLA showed last year that they could detect biomarkers in saliva that were significantly different between people with pancreatic cancer and people who were only at risk for it [five]. This noninvasive engineering science could be platonic for screening at-adventure groups for pancreatic cancer, including people with chronic pancreatic inflammation and those with recent-onset diabetes.
The terminal few years accept seen large strides in enquiry to understand what sets pancreatic cancer apart, and to change how this disease is diagnosed and treated. These advances all provide hope for a futurity, perhaps only a few short years away, in which pancreatic cancer is not so silent a killer – or not as much of a killer at all.
Kristin Rose is PhD candidate at Harvard Medical School.
References:
- "Pancreatic cancer survival past stage," American Cancer Gild, October twenty 2010, <http://www.cancer.org/Cancer/PancreaticCancer/DetailedGuide/pancreatic-cancer-survival-rates>
- Malcolm J. Moore et al, "Erlotinib Plus Gemcitabine Compared With Gemcitabine Solitary in Patients With Advanced Pancreatic Cancer: A Phase III Trial of the National Cancer Found of Canada Clinical Trials Group," Periodical of Clinical Oncology, May 20 2007, Vol 25, pgs 1960-1966
- Elizabeth Landau, "Why pancreatic cancer is so deadly," CNN Health, October 6 2011, http://world wide web.cnn.com/2011/10/06/health/conditions/pancreatic-cancer-steve-jobs/index.html
- Ta-Chiang Lu, "Clinical trial results with oncolytic virotherapy: a century of promise, a decade of progress," Nature Reviews Clinical Oncology, February 2007, Vol 4, pgs 101-117
- Lei Zhang et al, "Salivary Transcriptomic Biomarkers for Detection of Resectable Pancreatic Cancer," Gastroenterology, March 2010, Vol 138, pgs 949-957
Source: https://sitn.hms.harvard.edu/flash/2011/issue107/
0 Response to "How Long Can You Have Pancreatic Cancer Without Knowing It"
Post a Comment