Pancreatic Cancer: Overview and Promising New Therapies
Pancreatic cancer is rarely diagnosed before spreading to other organs. Thankfully, researchers are developing promising new therapies that can be used to treat it. The American Cancer Society predicts that about 64,050 people in the United States will be diagnosed with pancreatic cancer in 2023. This aggressive cancer, which accounts for about 7% of all cancer deaths, is slightly more common in men than women.
What is pancreatic cancer?
The pancreas is an organ that lies behind your stomach and helps your body function properly. It produces hormones such as insulin that help regulate blood sugar and enzymes that break down food. Pancreatic cancer may affect how the pancreas works.
When the cells in your pancreas grow abnormally and uncontrollably, they can form a tumor and cause pancreatic cancer. The tumor can grow anywhere, but about 70% of pancreatic cancers are located in the head of the pancreas.
What are the signs of pancreatic cancer?
Pancreatic cancer rarely causes any early signs and symptoms. Unfortunately, the symptoms typically appear once the tumor has grown significantly or spread to other tissues and organs.
Symptoms of pancreatic cancer may include:
- Pain in your upper belly
- Pain in the middle of your back
- Tiredness
- Lack of appetite
- Weight loss
- Gas or bloating
- Nausea and vomiting
- Dark-colored pee
- Light-colored stool
- Itchy skin
- Yellowing of the skin (jaundice)
- Sudden-onset diabetes
Most of these signs and symptoms are not specific. However, if you have recently developed diabetes or pancreatitis (inflammation of your pancreas, which tends to be very painful), your healthcare provider may suspect pancreatic cancer.
Who is at risk for pancreatic cancer?
Some factors that increase your risk of pancreatic cancer include:
- Smoking tobacco
- Being very overweight (obese)
- Diabetes, especially newly diagnosed diabetes
- Chronic inflammation of the pancreas (pancreatitis)
- Older age
- A family history of pancreatic, ovarian, or colon cancer
How is pancreatic cancer treated?
Chemotherapy
Chemotherapy uses drugs in the form of pills or intravenous injections that kill cancer cells. You may receive it before or after surgery or as a standalone treatment.
Radiation therapy
Radiation therapy involves the use of high-energy X-rays to kill cancer cells. Your provider may combine it with chemotherapy before or after surgery. You may receive radiation therapy if you don’t qualify for surgery.
Targeted therapy
Targeted therapies are drugs directed against specific molecules that cancer cells need to survive and spread. It is often combined with radiation therapy and other treatments. Common drugs include erlotinib, olaparib, larotrectinib, and entrectinib.
Surgery
Your provider may recommend surgery if your cancer is limited to the pancreas and can be entirely removed. In other cases, if the cancer has spread or your provider cannot be certain surgery will be able to remove the cancer entirely, there is little to no benefit.
Emerging therapies for pancreatic cancer
Researchers are working on a blood test that could pick up early pancreatic cancer in the general population and developing better imaging methods to pick up tiny tumor cell deposits. Moreover, they are investigating new potential drugs and better ways to combine the existing drugs.
Cancer vaccines
Researchers are investigating vaccines designed to help your body fight against cancer. They help your immune system recognize substances found only in cancer cells, also known as tumor-associated antigens, and destroy those cells.
Neoadjuvant chemotherapy
This form of chemotherapy may be given to you before surgery to shrink the tumor, as well as to kill cancer cells that have escaped from the tumor and would continue to grow as you recover from surgery.
Adjuvant chemotherapy
Cancer research is also focused on improving the standard adjuvant chemotherapy. You may receive this form of chemotherapy after surgery to kill the remaining cancer cells.
Targeted therapies
Researchers are investigating Ras-directed therapies which target altered forms of growth-controlling Ras genes, and olaparib, which targets alterations in the BRCA1 or BRCA2 gene.
Stroma-modifying drugs
The stroma is a type of tissue that surrounds and protects a tumor. Researchers are investigating drugs that help break down stroma so that other therapies can more effectively reach cancer cells and eliminate them.
Immunotherapy
Immunotherapy can help your body fight cancer by stimulating or suppressing your immune system. The researchers are investigating pembrolizumab, new immunotherapy drug combinations, combinations of immunotherapy drugs with radiation therapy, stromal modifying agents, and other targeted drugs, and cell therapies such as T cells and natural killer cells altered in the lab to kill cancer cells.
For many years, treatment options for pancreatic cancer have been limited, and often with little long-term success. Through careful research, and the willingness of many patients and providers to participate in clinical trials, many new therapies are emerging that have the potential to change outcomes and improve the lives of patients with pancreatic cancer.