Understanding Cancer

Pancreatic Cancer 101

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By Henry Ford Health System Staff

After a cancer diagnosis, every individual begins a difficult battle — and a battle against pancreatic cancer can be notoriously tough. In recent years, notable figures who’ve fought the disease include Supreme Court justice Ruth Bader Ginsberg, American legend Aretha Franklin, Apple co-founder Steve Jobs and Nobel laureate Ralph Steinman

To date, pancreatic cancer accounts for less than three percent of all cancer diagnoses, but it also ranks as the fourth deadliest behind lung, colorectal and breast cancer.

“Part of the reason pancreatic cancer is so lethal is because there are few symptoms indicating that the disease is present,” says David Kwon, M.D., who leads surgical oncology at Henry Ford Cancer Institute and the new clinical director of its Pancreas Cancer Center.

But while determining the presence of pancreatic cancer can be hazy, there are plenty of concrete facts to know about this silent disease. Below, Dr. Kwon outlines the basics.

Q: What role does the pancreas play in the body?

A: The pancreas is an organ—located in your abdomen– that plays two significant roles: one, it helps digest food by secreting enzymes and, two, it also regulates blood sugar by releasing hormones like insulin and glucagon.

Q: How can you tell if you have pancreatic cancer?

A: In general, symptoms associated with pancreas tumors can be very vague, which makes it extremely difficult for physicians to diagnose. Common symptoms include dull, aching mid epigastric abdominal pain—pain right underneath the breast bone—that pain radiates toward the back, toward the spine.  Urine color can also change in consistency to something more like dark tea. Bowel movements may become softer and may become pale like clay. Another sign can be jaundice, or yellow, in the eyes, and if this occurs, people may also experience increased itchiness of their skin.  Some patients may notice increasing nausea or vomiting, develop poorly controlled blood sugars, and have unintended weight loss. 

Q: What are the causes of pancreatic cancer?

A: I wish we could pinpoint specific reasons as to what causes pancreas cancer, but there are no one-to-one associations that have been identified.  There are known risk factors that increase the risk for developing pancreas cancer, including tobacco use, a history of diabetes mellitus, a history of pancreatitis, a family history of pancreatic cancer, and inherited genetic mutations (BRCA1/BRCA2, Lynch syndrome, Peutz-Jeghers syndrome, Von Hippel-Lindau syndrome).

Q: How is pancreatic cancer treated?

A: Optimal treatment of pancreas tumors involves a combination of surgery — removal of any cancerous tumors — as well as considerations of chemotherapy and/or radiation. In the past decade, though, the approach to the sequencing of treatment has evolved, and more patients are receiving chemotherapy and/or radiation first, followed by surgery. The results of this approach appear to be associated with overall survival rate that’s superior to the traditional surgery-first approach. More importantly, in the past decade, our chemotherapy regimens have significantly improved, allowing us to combat this deadly disease with higher success rates.

Q: What is the survival rate for pancreatic cancer?

A: Traditionally, the five-year survival rate for all stages of pancreas cancer has been around five percent. The reason that this number is extremely low is that 80 percent of pancreas cancer patients are often diagnosed too late for curative treatment. But we’ve made some incredible strides in the past decade, and the five-year survival rate has almost doubled to approximately 9 percent. We hope this number will continue to climb as we optimize treatment sequencing with surgery and better and more effective chemotherapy. 

Q: How can you reduce your risk of pancreatic cancer?

A: Always see your physician for an annual wellness visit and discuss any health issues you may have been experiencing.  As noted above, if there are any symptoms of nausea or vomiting, unintended weight loss, pain radiating towards the backbone, yellow in the eyes or skin with increased itching, see a physician immediately.  If you think you might be at increased risk for developing pancreas cancer because you have family members who have had the disease, talk with your physician to discuss the possibility of genetic testing.  Moreover, if you have been identified to a genetic mutation, there are tests used to detect cancer earlier, such as magnetic resonance imaging (MRI) or endoscopic ultrasound (EUS). 

Any type of cancer diagnosis is a life-changing event, so be sure to collect all the information and support you need as you embark on your journey to wellness, whether in the form of a second opinion or a team of caregivers.

“It’s extremely important to be treated in a multidisciplinary fashion,” Dr. Kwon says. “Here at Henry Ford, we are an established team of medical oncologists, surgical oncologists, radiation oncologists, nurse navigators, dietitians and psychology support professionals trained in pancreas cancer treatment. We’ll work with you to optimize a treatment plan to ensure the best outcome possible for you or any loved one facing pancreatic cancer.”

Whether you are going through cancer treatment or serve a loved one as a caregiver, there are resources to help you. Visit henryford.com/cancer to learn more.

Dr. David Kwon is a board-certified surgeon and fellowship-trained surgical oncologist specializing in pancreatic and gastric cancer surgery, in addition to cytoreductive cancer surgery for the administration of Hyperthermic Intraperitoneal Chemotherapy (HIPEC). He sees patients at Henry Ford Hospital in Detroit.