Pancreatic Cancer Warning Signs
Karen Kieran, a retired nurse from Naperville, Illinois, started to suffer severe back pain in 2016 and gradually lost 40 pounds. In 2017, she was diagnosed with stage IV pancreatic cancer.
“I never dreamed I would ever get cancer,” Kiernan said in an interview with the Pancreatic Cancer Action Network. “I always took care of myself, and there was no history of cancer in my family. The diagnosis came as a complete shock.”
The American Cancer Society (ACS) estimates that 64,050 new cases of pancreatic cancer will be diagnosed in the United States in 2023, and 50,550 will die from the disease. The ACS also reports that more than 90 percent of cases develop in the exocrine tissue of the pancreas, which makes enzymes that help digest food.
Pancreatic cancer is often called a “silent disease” because the warning signs are so subtle that they are often overlooked. What’s more, some of the signs and symptoms are also experienced in other health conditions. So, by the time of diagnosis, people are often in the later stage of the disease.
Some of the signs and symptoms to look out for include:
- Abdominal pain in the mid to upper abdomen that often radiates to the back
- New diagnosis of diabetes or worsening of existing diabetes or worsening blood sugar levels, especially with weight loss
- Darkening of urine
- Light-colored stools
- Jaundice (yellowing of the skin and whites of the eyes)
- Nausea and vomiting
- Loss of appetite and unintentional weight loss
Some lifestyle behaviors, such as drinking alcohol, being overweight, and smoking, can increase the risk of pancreatic cancer, according to the ACS. About 25 percent of pancreatic cancers are thought to be caused by cigarette smoking while people who are obese (with a body mass index of 30 or higher) are about 20 percent more likely to develop pancreatic cancer, the ACS reports.
Other risk factors cannot be changed, such as having a family history of pancreatic, breast, and ovarian cancer. Since about 10 percent of pancreatic cancers are thought to be hereditary, health experts recommend that people with a family history talk with their doctor about whether they should be screened for the disease.
New Developments in Detecting and Treating Pancreatic Cancer
1. Molecular Profiling
After Kieran was diagnosed with pancreatic cancer, she said her sister told her about molecular profiling, an innovative method that uses a sample of tissue, blood, or other body fluids to determine the molecular and genetic makeup of a tumor. Doctors can use this information to target treatment for the patient. So, Kiernan asked her doctors to collect a tissue sample from her tumor that could be used for molecular profiling.
As a result of this technique, Kieran received a targeted therapy in 2018 with Keytruda (pembrolizumab), a medication that treats melanoma, cervical cancer, stomach cancer, and other types of cancer. After taking Keytruda, Kieran said she started gaining some weight and was able to do some of the things she once did before she was diagnosed with cancer. While her journey hasn’t been easy, Kieran told AARP in 2022 that she is “truly in remission now.”
In an interview with AARP, Dr. Michael Pishvaian, director of the Gastrointestinal, Developmental Therapeutics, and Clinical Research Programs at the Johns Hopkins Kimmel Cancer Center, estimates that more than half of all pancreatic cancer patients are now having their tumors tested. Because of this, Dr. Pishvaian said he thinks “we are starting to see more progress and traction in testing every pancreatic cancer patient’s tumor.”
“This is definitely something patients can take some measure of control over,” Dr. Pishvaian said. “They should generally feel more comfortable and be more aggressive in asking their doctor for this.”
For years, pancreatic cancer was treated with traditional therapies, such as surgery, radiation therapy, and chemotherapy. Now, breakthrough screening techniques such as molecular profiling are giving pancreatic cancer patients more hope for surviving the disease and doctors the ability to detect pancreatic cancer sooner.
2. Using Other Cancer Drugs To Treat Pancreatic Cancer
By discovering the different mutations in tumors, doctors have been able to target treatment by using medications initially approved by the U.S. Food and Drug Administration (FDA) for one type of cancer but were later approved by the FDA to treat pancreatic cancer. In 2020, for example, the FDA expanded Keytruda’s approval for use in certain patients with pancreatic cancer.
In addition, in 2019, the FDA expanded the approval of Lynparza (olaparib) to treat metastatic pancreatic cancer. The FDA initially approved the medication to treat breast cancer in people with a mutation in their BRCA gene (a gene that fights cancer) or DNA-repairing genes (genes that repair other damaged genes).
The FDA’s approval followed the release of a 2019 study published in The New England Journal of Medicine that found patients with a BRCA mutation who took Lynparza for metastatic pancreatic cancer had no new tumor growth, nor did their cancer spread for twice as many months as patients who did not receive the drug. However, the study reported that there was no difference in long-term survival past 18 months.
3. Using AI To Detect Tumors
Researchers say pancreatic cancer is often missed in its early stages because the pancreas is located within the abdomen, behind the stomach. Some studies suggest that CT scans miss pancreatic tumors 30 percent of the time.
“We should be able to do better,” Dr. Elliot Fishman, a professor of radiology and radiological science at the Johns Hopkins School of Medicine in Baltimore, told AARP. Dr. Fishman enlisted the help of artificial intelligence (AI) to teach the computer to read CT scans to detect more tumors in the early stages so they could be surgically removed. AARP reports that Dr. Fishman has used AI to screen several thousand pancreatic cancer patients since February 2022 and has been able to detect tumors with 90 percent accuracy.
4. Using Image-Guided Radiation Therapy
Doctors are now using magnetic resonance imaging (MRI) guidance to precisely target tumors with radiation and avoid other organs, such as the stomach and intestines.
Norman Kravetz, a Boynton Beach, Florida, resident, told AARP that he was diagnosed with stage 3 pancreatic cancer in 2019. He had six months of intensive chemotherapy followed by one week of MRI-guided radiation therapy at the Dana-Farber Brigham Cancer Center in Boston.
After six months of chemo and one week of the new radiation treatment, Kravetz said his tumor had shrunk so much that he was able to have surgery to remove it in early 2020.
“Everything is back to normal,” Kravetz told AARP in 2022. “I go to the gym five to six times a week. …I am healthy and feel great. [The doctors] call me the miracle guy.”
Dr. Shubham Pant, associate professor in the Department of Gastrointestinal Medical Oncology at the MD Anderson Cancer Center in Houston, believes that a few of these innovative therapies will help “double the rate of survival in the next five years.”’