Early clinical detection remains a considerable challenge in pancreatic cancer. Early diagnosis of pancreatic cancer presents several challenges, primarily due to the nature of the disease and its symptoms. Pancreatic cancer is often diagnosed at stage IV and unfortunately, the onset of clinical symptoms in patients usually indicates advanced disease. It is obvious that when identification of cancer care is delayed, there is a lower chance of survival, more complex problems associated with treatment may arise, and increase the costs of care. Early diagnosis is important to improve cancer outcomes including pancreatic cancer by providing care at the earliest possible stage. Let’s find out more about pancreatic cancer:
What is pancreatic cancer?
Pancreatic cancer occurs when abnormal cells in the pancreas grow and form a tumor. It affects your pancreas. The pancreas is a gland in your abdomen that helps in digestion. Around 3% of all cancers in the United States are caused by pancreatic cancer. It ranks as the 10th most common cancer in men and 8th most common in women.
What are the Symptoms of Pancreatic Cancer?
Unfortunately, there are not any early signs of pancreatic cancer. Symptoms usually appear as the tumor begins affecting other organs in the digestive system. Pancreatic cancer often presents with vague and non-specific symptoms in its early stages, such as
- Jaundice (yellowing of your skin).
- Dark urine (pee).
- Light-colored stool (poop).
- Upper abdominal pain.
- Middle back pain.
- Itchy skin.
- Nausea and vomiting.
- Gas or bloating.
- Lack of appetite.
- Blood clots.
- Weight loss.
- New-onset diabetes.
Why Is Pancreatic Cancer Difficult to Diagnose at the early stage?
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- Doctors use several tests to diagnose pancreatic cancer, but there is no standard, single test. Unlike some other cancers where screening tests like mammograms for breast cancer or colonoscopies for colorectal cancer are effective, there is no routine screening test for pancreatic cancer that is highly accurate and cost-effective for the general population. This means that pancreatic cancer is often diagnosed at later stages when symptoms become more evident.
- The pancreas is located deep within the abdomen, making it difficult for doctors to see or feel any tumors during a physical examination.
- Diagnostic tests are not always effective in identifying small lesions in early-stage cancers.
- Medical, emotional, and financial challenges in Broad screening.
Then, how it could be diagnosed?
- Imaging tests
- CT (computed tomography) scans.
- MRI (magnetic resonance imaging).
- PET (positron emission tomography).
- Endoscopic ultrasound (EUS).
- Blood tests
- A pancreas blood test: It can detect tumor markers. A tumor marker is a substance that may indicate the presence of cancer.
- Staging laparoscopy: The surgeon creates a few small incisions (cuts) in your abdomen and inserts a long tube with a camera on the end. This allows them to see inside your abdomen and look for abnormalities.
- Genetic testing: Some people with pancreatic cancer have mutations in genes BRCA1 and BRCA2. A mutation is a change in the DNA sequence and an alteration in the genes of a cell.
Can Pancreatic Cancer Be Caught Earlier?
Pancreatic cancer is often diagnosed at stage IV due to the lack of a standard diagnostic tool or early detection method. Patients whose disease is detected in the early stages have better outcomes. This is due to access to more treatment options, including surgery.
The Pancreatic Cancer Action Network strongly recommends you see a surgeon who performs a high volume of pancreatic surgeries (more than 15 per year) to determine eligibility. PanCAN was the first organization dedicated to comprehensively fighting pancreatic cancer. For more than two decades, they have grown a nationwide movement tackling the disease from all angles.
The Pancreatic Cancer Action Network, other advocacy organizations, and the scientific community are working to find pancreatic cancer earlier through:
- Awareness of symptoms
- Efforts to improve imaging
- Developing biomarkers (biological clues) that could help doctors diagnose, monitor, and treat the disease
- Efforts to improve how people at high risk are found and monitored
Who has the higher risk of Pancreatic Cancer?
Family history is a major risk factor for pancreatic cancer. If you are a first-degree relative of someone diagnosed with pancreatic cancer, you may have an increased risk of developing pancreatic cancer. Your family member with pancreatic cancer is strongly recommended to undergo genetic testing for inherited mutations.
Some other factors can increase pancreatic cancer risk:
- Long-standing diabetes
- Chronic and hereditary pancreatitis
- Smoking
- Race (ethnicity): African-American or Ashkenazi Jew
- Age: over age 60
- Diets high in red and processed meats
- Obesity
Are any Early Detection Methods Exist for Pancreatic Cancer?
- Surveillance programs: In a surveillance, early detection, or screening program, doctors actively check people who are at risk of getting pancreatic cancer. Surveillance programs usually use imaging tests to monitor patients.
- Regular imaging scans: CT scans, MRIs and X-rays
- Blood-based tests: Use of FDA-approved blood-based biomarker
What is the role of Bio Markers to detect Pancreatic Cancer?
Biomarkers are measurable substances found in the body that can differ in amount between a healthy person and someone with a disease, aiding in disease detection. They can be found in various samples in the body such as blood, tissue, urine, and saliva. As per the report published in December 2021, the only approved serum marker for pancreatic cancer diagnosis in the US is carbohydrate antigen 19-9 (CA 19-9).
How to fight with Pancreatic cancer?
A pancreatic cancer diagnosis can be shocking and life-changing. Your healthcare provider can offer guidance and support. Joining a support group or talking to a counselor can help improve your mental and emotional well-being. There are also several resources available to help you and your family cope with the diagnosis.
This news is a creative derivative product from articles published in famous peer-reviewed journals and Govt reports:
References:
1. Mizrahi JD, Surana R, Valle JW, Shroff RT. Pancreatic cancer. The Lancet. 2020 Jun 27;395(10242):2008-20.
2. Park W, Chawla A, O’Reilly EM. Pancreatic cancer: a review. Jama. 2021 Sep 7;326(9):851-62.
3. Pancreatic Cancer Action Network – Research, Patient Support, Resources. (2024, February). Pancreatic Cancer Action Network. https://pancan.org/
4. Pereira SP, Oldfield L, Ney A, Hart PA, Keane MG, Pandol SJ, Li D, Greenhalf W, Jeon CY, Koay EJ, Almario CV. Early detection of pancreatic cancer. The lancet Gastroenterology & hepatology. 2020 Jul 1;5(7):698-710.
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