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Cancer of the pancreas is challenging to treat, and survival rates historically have been low as a result. Yet new treatments on the horizon offer an exciting opportunity to help patients live longer, fuller lives after diagnosis.
The pancreas is a pear-shaped organ in the abdomen between the stomach and the spine that produces enzymes and hormones to aid in digestion. The American Cancer Society estimates that more than 66,000 people in the U.S. will be diagnosed with pancreatic cancer in 2024.
Although it is rare, pancreatic cancer is among the deadliest. It is the third leading cause of cancer death in the U.S. While 44% of people with localized pancreatic cancer survive five years after diagnosis, the overall five-year survival rate for all stages is just 12-13%. Most often, pancreatic cancer has spread and is stage IV by the time it is diagnosed.
Though several factors make pancreatic cancer difficult to treat, new research shows promise, delivering immune-boosting and genetic therapies that could make a real difference for patients.
Risk factors, symptoms, and challenges of pancreatic cancer.
Most patients with pancreatic cancer don’t have clear risk factors, though there are a few things we know increase your risk:
- Breast cancer
- Close family members with pancreatic cancer
- Conditions such as chronic or hereditary pancreatitis or congenital syndromes such as familial adenomatous polyposis, a digestive disease
- Obesity
- Smoking
Screening programs for pancreatic cancer are usually reserved for people with a significant family history. If your close family member (parent or sibling) had or has pancreatic cancer, talk with your doctor about screening to assess your risk and genetic counseling to plan ongoing care.
One of the reasons pancreas cancer is difficult to treat is that its symptoms are vague until it is advanced. Talk with your doctor if you have symptoms such as:
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Change in urine or stool color
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Fatigue
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Jaundice (yellowing of the skin or whites of the eyes)
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Pain in the back or upper abdomen
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Weight loss or loss of appetite
Pancreas cancer moves quickly, spreading to other parts of the body in a matter of months. Approximately 80-90% of patients are diagnosed with pancreatic ductal adenocarcinoma (PDAC) when it has spread beyond the pancreas.
Even after we find it, pancreatic cancer can be difficult to treat. It is tucked away in the abdomen where surgery can be risky. Most PDAC tumors form a dense, fibrous layer called a desmoplastic barrier that can prevent chemotherapy from reaching the target. And pancreatic cancer often doesn’t respond to current targeted therapies and immunotherapy like other cancers.
Despite these challenges, new research suggests that genetic therapies and new ways to deliver treatment could make a real difference.
Related reading: Research Examines Whether a Blood Test Can Provide Early Detection of Cancer.
Genetic therapy advances in pancreas cancer treatment.
Targeting the KRAS gene mutation.
About 95% of people with PDAC, the most common type of pancreatic cancer, have a mutation in the KRAS gene that is important in pancreas cancer development. Researchers have been looking for a therapy to target this gene for a long time.
Recently, new drugs have been developed that target a very specific mutation of KRAS. Lumakras™ has been approved for patients with non-small cell lung cancer that shares a mutation with many pancreatic cancers. Research has shown that combining KRAS-inhibitor drugs with other treatments such as immunotherapy could make an impact for pancreas cancer.
Nano-particle drug delivery systems.
Researchers at the University of Massachusetts Amherst and UMass Chan Medical School recently published a study that demonstrated an exciting new treatment method.
The researchers sought to deliver two drugs (tramentinib and palbociclib) to promote blood vessel development in the tumor so immunotherapy and chemotherapy treatments can be more effective. To get past the desmoplastic barrier, they tucked the immunity-triggering agonists in a nanoparticle that can sneak through into the tumor’s tough outer barrier.
The treatment shrunk PDAC tumors in eight out of nine mouse models—and tumors in two models disappeared altogether.
Related reading: Advanced, Team-Based Treatment for Liver Tumors, Cancerous or Not.
Advanced pancreatic cancer treatment at MedStar Georgetown Cancer Institute begins with research.
Patients who get pancreatic cancer care at MedStar Georgetown Cancer Institute benefit from our full team of specialists, including medical oncologists, radiation oncologists, and surgeons. Every patient gets a personalized treatment plan created by this multidisciplinary team.
Through clinical trials, patients can get leading treatments before they’re widely available and contribute to research that could save lives for future patients. I encourage my patients to give serious consideration to enrolling in trials for which they’re qualified.
If you have a family history of pancreatic cancer, talk with your doctor about your risk factors and whether you might benefit from genetic counseling. Keep an eye out for symptoms such as unintended weight loss or back pain that could signal something more serious.
Pancreatic cancer is challenging, but the future looks bright. With continued investment and participation in research, advances that will make pancreas cancer much more treatable could be just around the corner.