November is PancreaticCancer awareness month

This year, more than 44,000 Americans will be diagnosed with pancreatic cancer and nearly 38,000 will die of the disease. It is estimated that more than 200,000 patients worldwide die of pancreatic cancer each year. 95% of pancreatic cancers are exocrine tumors because they begin in the cells that produce enzymes for digestion. Less than 5% are endocrine tumors. This disease has claimed the lives of many public figures including actor Patrick Swayze, opera tenor Luciano Pavarotti, and recently, co-founder, chairman and CEO of Apple, Inc., Steve Jobs.

Pancreatic cancer can be difficult to diagnose. Many patients tend to have vague abdominal pain or back pain for a few months before the diagnosis is made. Other symptoms include weight loss, Jaundice (yellowness of skin), and blood clots. Risk factors can include smoking, physical inactivity, chronic pancreatitis and family history. Selected mutations involving breast cancer such as BRCA mutation and hereditary pancreatitis have been associated with familial pancreatic cancer.
For exocrine pancreatic cancer, once it is diagnosed, about 20-25% of cases can be removed with surgery. Surgery is the only potentially curative treatment. Chemotherapy or chemotherapy plus radiation are considered after surgery. For pancreatic cancer that is localized but not able to be removed, chemotherapy or a combination of chemotherapy and radiation can be used. Radiation is helpful in controlling pain from tumor invasion. In metastatic disease, chemotherapy is the mainstay of treatment. Supportive care, nutrition, and pain control are all important in treating pancreatic cancer.

Pancreatic neuroendocrine tumor is a rare form of pancreatic cancer. Surgery to remove the cancer is a common treatment. At this time, there is not a standard treatment for advanced neuroendocrine tumor. Two targeted drugs, Affinitor and Sutent were recently approved by FDA to treat advanced pancreatic neuroendocrine tumor. We would encourage clinical trial participation to help us find better treatment options for this rare tumor.

Lifestyle modifications that can decrease pancreatic cancer risk include intake of diets rich in fruits and vegetables, keeping blood sugar under control, and maintaining a healthy body weight as well as being physically active.