Pancreatic Cancer: Common Questions, Answered

• We all know someone who has been affected by pancreatic cancer and, in 2019 alone, it is estimated that over 56,000 people will be diagnosed with the disease. Pancreatic cancer is often diagnosed in later stages; this, combined with the aggressive nature of the disease, makes it extremely challenging to treat.

  Recently, Sanjay S. Reddy, MD, FACS, a surgical oncologist and co-director of the Marvin and Concetta Greenberg Pancreatic Cancer Institute at Fox Chase Cancer Center, and Namrata (Neena) Vijayvergia, MD, a medical oncologist at Fox Chase Cancer Center, sat down with 6abc for a live webchat on their Facebook page to answer questions about pancreatic cancer.

  Below are some of the questions posed, and the answers given by our physicians:

  What is pancreatic cancer?

  Pancreatic cancer is a cancer of the pancreas, which is a gland located behind the stomach. Different organs in your body can develop rogue cells that escalate and can become malignant (cancerous). There are a couple different areas where these malignancies occur in the pancreas—the head, the body, and the tail. Diagnosis and treatment can depend on the area where the tumor is located.

  What is the function of the pancreas?

  The pancreas secretes the digestive juices that help break down the food you eat. In addition, and most importantly, it also secretes insulin, which is the body’s sugar regulator. By secreting insulin and other hormones, the pancreas maintains the balance of sugar in your body. This is the gland’s main function.

  Why is pancreatic cancer often diagnosed late?

  The pancreas lies deep within the abdominal cavity and, because of this, tumors are not easily felt. Also, pancreatic cancer symptoms are often subtle and not always obvious right away. Some symptoms include dark urine, abdominal bloating, clay-colored stools, sudden weight loss, a diabetes diagnosis at a later age, and abdominal pain. These symptoms may be ignored or confused for other conditions until they become very problematic.

  Tumors in the head of the pancreas are typically diagnosed earlier than tumors in the tail because they often block the bile duct and cause people to become jaundiced. This symptom, painless jaundice, is one that people often recognize quickly and seek treatment for. Tumors in the tail of the pancreas are often diagnosed at a later stage because they typically do not cause symptoms until later on in the disease process.

  It is important to familiarize yourself with pancreatic cancer symptoms and to see a doctor if you notice symptoms that aren’t going away.

  You can learn more about the symptoms of pancreatic cancer here.

  What are some of the risk factors for pancreatic cancer?

  The most common risk factors for pancreatic cancer are smoking, alcohol consumption, obesity and pancreatitis (inflammation of the pancreas). However, it is important to keep in mind that these are risk factors, not necessarily causes. There are many people who have these risk factors who won’t develop this disease.

  What is the relationship between pancreatitis and pancreatic cancer?

  While the link between the two diseases isn’t entirely understood, we know that the inflammatory process of pancreatitis has a connection to the development of pancreatic cysts and pancreatic cancer. However, while pancreatitis is a risk factor for pancreatic cancer, having the illness does not mean you will develop cancer.

  Can you be screened for pancreatic cancer?

  There is no routine screening tool for pancreatic cancer. There is hope that in the future we will be able to develop specific biomarkers to help detect this disease early, but for now, paying attention to subtle symptoms is the best we can do.

  If you have a parent who is diagnosed with pancreatic cancer, what is your risk and should you receive genetic testing?

  A very small fraction of pancreatic cancer cases are hereditary, but there are a number of known genetic syndromes linked to pancreatic cancer, such as those associated with BRCA gene mutations and Lynch syndrome. People with a strong family history of pancreatic cancer, particularly those who also have a family history of breast/ovarian cancer and colorectal cancer, are advised to see a genetic counselor and consider genetic testing. New guidelines from the National Comprehensive Cancer Network (NCCN) recommend that everyone diagnosed with pancreatic cancer receive genetic testing to see if there is a genetic cause for their disease. If so, there are treatment options available for advanced disease that can target hereditary pancreatic cancer. This information can also benefit an individual’s loved ones, as it is advised that the family members of those with hereditary pancreatic cancer receive genetic testing as well.

  Learn more about family history and pancreatic cancer risk.

  Is pancreatic cancer more prominent in men or women? Is there a common age when it occurs?

  The occurrence rates for pancreatic cancer in men and women are equal, and age is not a determinant for the disease.

  Why is pancreatic cancer so deadly?

  The biology of the cancer and the fact that pancreatic cancer is often found in later stages are two reasons for poor survival outcomes. Pancreatic tumors are typically surrounded by a protective sheath that prevents cancer treatments from penetrating them. This fibrous stroma makes treating the disease challenging. A sizable amount of modern pancreatic cancer research is focused on determining the best ways to break this shield and effectively deliver therapies to tumors.

  Are there clinical trials for pancreatic cancer?

  Pancreatic cancer is an aggressive disease. Clinical trials are the way forward—they pave the way to finding a cure. There are many open clinical trials for pancreatic cancer that investigate potential treatment options, including new surgical techniques, combination treatments (such as chemotherapy and radiation), and immunotherapy for advanced disease. Pancreatic cancer patients are encouraged to discuss potential trials with their care team.

  What should patients look for when seeking care for pancreatic cancer?

  It takes a true multidisciplinary approach to treat pancreatic cancer effectively, and the combination of surgical, radiation, and medical oncologists is an important component for effective care. Finding a comprehensive cancer center that offers this multidisciplinary approach, as well as research in the area of pancreatic cancer, can make a significant difference in a person’s outcome.

  What should you do if you are diagnosed with a pancreatic cyst?

  We see a significant number of pancreatic cysts at Fox Chase, and the diagnosis itself can be scary. Many times, pancreatic cysts are found when individuals are being evaluated for something entirely unrelated. For example, a routine scan for a possible kidney stone.

  While a pancreatic cyst can be a worrisome finding, it’s important to know that a majority of pancreatic cysts are benign. They do, however, need further workup with imaging (either an MRI or CT scan) under the care of a specialist. Sometimes, these cysts have high-risk or concerning features such as a large size, a thickened wall, or a nodule. If this is the case, the cyst may be biopsied.

  If their pancreatic cyst is benign, individuals will typically need follow up every six months to a year. If the cyst is worrisome, it may need to be surgically removed.

  Why is pancreatic cancer awareness important?

  If pancreatic cancer is found early, individuals have a better prognosis. It’s important to be aware of the symptoms and risk factors for pancreatic cancer, and to discuss any symptoms or abnormalities with a doctor.

  You can view the full Facebook Live chat here.