World Pancreatic Cancer Day
November 16th marks World Pancreatic Cancer Day, a global awareness day to raise awareness for pancreatic cancer, promote research, and provide support for those affected by this disease.
Pancreatic cancer is one of the deadliest cancers, with a 5-year survival rate of just 5%-15% for advanced stages[1].
Raising awareness and supporting research efforts is crucial to improving outcomes for patients.
What is Pancreatic Cancer?
Pancreatic cancer begins when cells in the pancreas start to grow out of control and form a mass called a tumor[2]. The pancreas is an organ located behind the stomach that produces enzymes that help digest food and hormones like insulin that regulate blood sugar levels.
There are two main types of pancreatic tumors[2]:
- Exocrine tumors are the most common and start in the exocrine cells that produce digestive enzymes. Around 95% of pancreatic cancers are exocrine tumors.
- Endocrine tumors are less common and start in the endocrine cells that produce hormones like insulin.
Pancreatic tumors are normally referred to as pancreatic cancer or pancreatic adenocarcinoma. Pancreatic neuroendocrine tumors (NETs) or islet cell tumors are rare.
The exact causes of pancreatic cancer are unknown, but some risk factors include[2]:
- Age – risk increases as you get older
- Smoking
- Obesity
- Family history
- Chronic pancreatitis
- Diabetes
Pancreatic cancer is very challenging to detect early, as the pancreas is located deep inside the body and tumors often do not cause symptoms until later stages[2]. This is why pancreatic cancer is often diagnosed at an advanced stage after the cancer has already spread outside the pancreas, contributing to the low survival statistics.
Signs and Symptoms
In the early stages, pancreatic cancer often does not cause any signs or symptoms. As the cancer grows, some common symptoms may include[3]:
- Jaundice (yellowing skin and eyes)
- Light colored stools
- Dark colored urine
- Pain in the upper abdomen or back
- Unexplained weight loss
- Loss of appetite
- Nausea and vomiting
If you experience any persistent, unexplained symptoms, especially jaundice, it is important to see your doctor as soon as possible for evaluation. Catching pancreatic cancer early dramatically improves treatment options and survival rates.
Risk Factors
While the exact causes are unknown, certain factors are linked to an increased risk of developing pancreatic cancer[4]:
- Age: The risk goes up as you get older, with most people diagnosed over age 55.
- Smoking: Cigarette smokers are 2-3 times more likely to develop pancreatic cancer.
- Obesity: Being overweight increases the risk.
- Family history: Having a first-degree relative (parent, sibling, child) with pancreatic cancer increases your risk. Genetic syndromes like Lynch syndrome also increase risk.
- Chronic pancreatitis: Long-term inflammation of the pancreas due to heavy alcohol use or other factors is associated with increased risk.
- Diabetes: Pancreatic cancer risk is increased in those with type 2 diabetes.
- Certain chemicals: Exposure to certain pesticides, dyes, and chemicals may increase risk slightly.
Knowing your risk factors empowers you to make lifestyle changes to reduce modifiable risks and undergo regular screening if you are at high risk.
Screening and Early Detection
Since pancreatic cancer often does not cause symptoms until later stages, early detection screening is critical to finding tumors when they are small and surgically removable. Unfortunately, there are currently no recommended standard screening tests for the general population.
Some options doctors may use for screening high-risk individuals include[5][6]:
- Endoscopic ultrasound (EUS): A small camera on the end of a flexible tube is inserted through the mouth into the stomach and duodenum. Sound waves create detailed images of the pancreas.
- MRI/MRCP: Magnetic resonance imaging creates 3D cross-sectional images of organs and tissues. MRCP focuses on the pancreas and bile ducts.
- CT scan: Uses X-rays and computer imaging to make detailed cross-sectional images.
- ERCP: Endoscopic retrograde cholangiopancreatography uses an endoscope and contrast dye to image the bile ducts.
- Blood tests: Such as CA19-9 may be used but are not definitive.
Screening is generally only recommended for those at high risk including people with multiple family members affected or genetic syndromes. Discuss your risk and screening options with your doctor.
Diagnosis
If screening or symptoms suggest pancreatic cancer, your doctor will run tests to make an official diagnosis[7][8]:
- Imaging tests: CT scan, MRI, PET scan to visualize the tumor
- Endoscopic ultrasound (EUS) to see inside the pancreas
- Biopsy: Removing a sample of tissue to be examined for cancer cells
- Labs: Testing blood for tumor markers like CA19-9
After a diagnosis is made, additional tests are done to stage the cancer – determine size, location, and spread. These may include chest x-rays, PET scans, or laparoscopy to stage the tumor and determine if it can be surgically removed. Knowing the stage guides treatment decisions.
Getting an accurate, timely diagnosis is key to proper treatment and improved odds. Seek multiple opinions if needed to start optimal treatment as soon as possible.
Treatment
Treatment options for pancreatic cancer depend on the type, stage, location of the tumor, and overall health of the patient. The 3 main treatment types are[8]:
Surgery
If the cancer is small and confined to the pancreas, surgery to remove the tumor offers the best chance for a cure. Different operations may be done depending on tumor location[8]:
- Whipple procedure: removes head of pancreas, gallbladder, part of bile duct, and small intestine.
- Total pancreatectomy: removes entire pancreas, part of bile duct, gallbladder, spleen, and nearby lymph nodes.
- Distal pancreatectomy: removes body and tail of the pancreas.
Surgery can have significant side effects like difficulty digesting food, diabetes, and more. But it offers the best odds if the cancer has not spread.
Chemotherapy
Chemotherapy uses anti-cancer drugs to kill cancer cells. It may be given alone or alongside surgery or radiation. Chemotherapy is usually given in cycles of treatment followed by rest periods so the body can recover.
For advanced pancreatic cancer, chemotherapy helps shrink tumors and control growth. The drugs gemcitabine and FOLFIRINOX are commonly used. Side effects like nausea, fatigue, and increased risk of infection are common but manageable[8].
Radiation Therapy
Radiation uses high-energy beams to kill cancer cells and shrink tumors. External beam radiation aims beams from a machine at the tumor. Brachytherapy places radioactive seeds inside or near the tumor[8].
Radiation may be used before surgery to shrink the tumor or after surgery to kill remaining cancer cells. It can relieve side effects like pain by shrinking tumors pressing on other organs. Side effects like skin redness, nausea, and fatigue can occur.
Palliative Care
Palliative care provides relief from symptoms and focuses on improving the quality of life for those with serious illness. The goal is to prevent and ease suffering. Palliative care may help manage[9]:
- Pain
- Digestive issues like nausea or appetite loss
- Jaundice
- Depression or anxiety
- Nutrition concerns
- Coordination of care
Palliative care can be provided at any stage, alongside treatments like chemo or radiation, or when treatment is no longer working. Discuss your symptoms with your care team. Palliative care helps you live as fully as possible.
Pancreatic Cancer Survivorship and Support
Living with pancreatic cancer presents many physical and emotional challenges. Seeking support can help you navigate your journey.[10][11]
- Connect with fellow survivors in support groups, online communities, or local in-person meetings. Communicating with others facing the same issues can reduce isolation.
- Consider counseling or mental health support to help process difficult emotions and anxiety related to your diagnosis. This support can improve overall well-being.
- Communicate openly with your medical team and be your own best advocate in your care. Do not hesitate to get second opinions as needed.
- Let family and friends provide support like rides to appointments, meals, or help around the house. Accepting help when you need it allows you to focus on healing
- Consult with a dietitian to manage nutrition, and digestive issues and maintain strength. Eating well can help you better withstand treatments.
- Stay active if possible through gentle activities like walking, yoga, or stretching. Moving your body aids recovery and circulation.
Remember you are not alone in this fight. Connecting with others and embracing available support provides the stamina needed along the journey.
Ongoing Research Bringing New Hope
While pancreatic cancer remains very deadly, new developments are bringing hope for improved treatment and early detection.[12][13]
Research on causes and risk factors continues to inform prevention and who may benefit from screening. Lifestyle factors like smoking are preventable.
Surgical techniques are improving, with newer approaches like robot-assisted surgery leading to better outcomes. Research identifies patients who benefit most from surgery.
Systemic therapies like chemotherapy are being refined. New drugs like gemcitabine have moderately extended survival. Ongoing trials study new drug combinations.
Immunotherapy drugs help the body’s immune system recognize and attack cancer cells. Ongoing research is studying immunotherapy alongside chemo and other new combinations.
Early detection research seeks more accurate, cost-effective screening methods to find pancreatic tumors when small enough to remove surgically. This could dramatically improve survival. Blood tests, breath biomarkers, and imaging techniques are being studied.
While there have not yet been major breakthroughs, steady progress is being made.
Participating in clinical trials brings treatments of tomorrow to patients today. Increased research funding is still desperately needed for this overlooked cancer. Hope remains alive.
World Pancreatic Cancer Day – Take Action!
Observed every year on November 16th, World Pancreatic Cancer Day promotes global awareness and action. Here are ways you can make an impact[14][15]:
- Spread awareness – Share information on social media, host educational events, and display purple ribbons. Increased awareness drives research funding and policy change.
- Support a local advocacy organization – Volunteer, fundraise, or donate to groups working to influence policymakers and provide patient support services. Activism fuels change!
- Participate in community events like fundraising walks/runs, awareness rallies, memorials, galas, and more. Local in-person events directly support patients.
- Contact elected officials to urge them to make pancreatic cancer a priority. Increased research funding and policies that promote early detection access are needed.
- Wear purple on November 16th to spur conversation and display your solidarity with the pancreatic cancer community. Purple represents pancreatic cancer awareness.
- Share your story to put a face on the disease and honor loved ones lost. Connecting through stories builds community power.
Together through heightened awareness and activism, we can push for research advances to turn the tide against this deadly disease. Get involved this World Pancreatic Cancer Day!
Pancreatic Cancer Online Resources & Help
Here are some online resources for pancreatic cancer patients and their families:
Pancreatic Cancer Action Network: This organization offers free, personalized information and resources for patients and families, including case managers who can answer questions and provide support. Contact them at 1-877-272-6226 or visit their website at https://pancan.org
National Pancreas Foundation: This foundation provides support and education for patients, caregivers, and healthcare professionals. Visit their website at
https://pancreasfoundation.org/patient-resources/helpful-links/ for a list of helpful links.
Online and Telephone Support Groups – Pancreatic Cancer Action Network: For people who do not have an in-person pancreatic cancer group locally or who prefer to stay at home, telephone support groups as well as online support groups and message boards are great options.
Get a list of online support groups, online message boards, and telephone support groups for pancreatic cancer patients and their families at
IdentifyEPI: This website provides links to educational resources and patient support for pancreatic conditions such as chronic pancreatitis, cystic fibrosis, pancreatic cancer, and more. Visit their website at https://www.identifyepi.com/pancreatic-disease-resources
Pancreatic Cancer Action: This website provides helpful information and links to support from the moment symptoms first appear, clinical trials, coping, and bereavement. Visit their website at https://pancreaticcanceraction.org/help-and-support/
The Bottom Line
Pancreatic cancer remains an extremely deadly and challenging disease, with vague symptoms leading to late diagnoses in most patients. However, building awareness empowers the public to reduce risks and recognize symptoms early.
Supporting research funding and clinical trials brings hope for improved treatments on the horizon. Until screening tests are developed, the best course of action is to reduce modifiable risk factors.
Promptly consulting a doctor if digestive symptoms develop allows for early detection and surgery when possible.
Continued progress combating this overlooked disease relies on everyone’s help spreading the word this World Pancreatic Cancer Day and throughout the year!
References:
[1] Puckett, Y., & Garfield, K. “Pancreatic Cancer.” StatPearls, updated 26 Sep. 2022, StatPearls Publishing, 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518996/
[2] “Pancreatic Cancer Treatment.” National Cancer Institute, Cancer.gov, 5 May 2023, www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq.
[3] “Signs and Symptoms of Pancreatic Cancer.” Cancer.org, 2018,
www.cancer.org/cancer/types/pancreatic-cancer/detection-diagnosis-staging/signs-and-sympto ms.html.
[4] “Pancreatic Cancer Risk Factors.” Cancer.org, 2013,
www.cancer.org/cancer/types/pancreatic-cancer/causes-risks-prevention/risk-factors.html.
[5] Yang, Jinshou et al. “Early screening and diagnosis strategies of pancreatic cancer: a comprehensive review.” Cancer communications (London, England) vol. 41,12 (2021): 1257-1274. doi:10.1002/cac2.12204
[6] “Can Pancreatic Cancer Be Found Early?” Cancer.org, 2018,
www.cancer.org/cancer/types/pancreatic-cancer/detection-diagnosis-staging/detection.html.
[7] “Pancreatic Cancer Diagnosis.” Hopkinsmedicine.org, 3 June 2019,
www.hopkinsmedicine.org/health/conditions-and-diseases/pancreatic-cancer/pancreatic-cancer diagnosis.
[8] “Pancreatic Cancer – Diagnosis and Treatment – Mayo Clinic.” Mayoclinic.org, 2023, www.mayoclinic.org/diseases-conditions/pancreatic-cancer/diagnosis-treatment/drc-20355427.
[9] “Palliative Care.” Hirshberg Foundation for Pancreatic Cancer Research, 14 Oct. 2020, pancreatic.org/pancreatic-cancer/supportive-care/palliative-care/.
[10] “Pancreatic Cancer – Survivorship.” Cancer.net, 9 Feb. 2016,
www.cancer.net/cancer-types/pancreatic-cancer/survivorship.
[11] “Support & Survivorship – Pancreatic Cancer – Cancers We Treat – Wilmot Cancer Institute – University of Rochester Medical Center.” Rochester.edu, 2023,
www.urmc.rochester.edu/cancer-institute/cancers/pancreas/support-survivorship.aspx.
[12] “Advances in Pancreatic Cancer Research.” National Cancer Institute, Cancer.gov, 31 Aug. 2023, www.cancer.gov/types/pancreatic/research.
[13] “Pancreatic Cancer – Latest Research.” Cancer.net, 26 June 2012,
www.cancer.net/cancer-types/pancreatic-cancer/latest-research.
[14] Reynolds, Kristin. “5 Ways to Take Action on World Pancreatic Cancer Day.” Pancreatic Cancer Action Network, 19 Nov. 2020,
pancan.org/news/5-ways-to-take-action-on-world-pancreatic-cancer-day/.
[15] “World Pancreatic Cancer Day.” Hirshberg Foundation for Pancreatic Cancer Research, 19 Oct. 2023, pancreatic.org/event/world-pancreatic-cancer-day/.
