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Chari is a gastroenterologist.
According to the statistics, Scott Nelson and Steve Nelson shouldn’t be alive today.
The Nelsons are brothers who live in Minnesota. They are two of the rare survivors of pancreatic cancer.
Scott’s diagnosis came nearly 2 decades ago. He went to his primary care physician because he was experiencing some mild digestive issues — nothing serious, but concerning. His doctor suggested that he receive an ultrasound. At his follow-up appointment, the technician immediately knew something was wrong and ran out of the room to get the doctor. The doctor returned and said it looked like a tumor on his pancreas. Sure enough, he was right. Scott had pancreatic cancer.
Scott was terrified. Nearly nine in 10 pancreatic cancer patients die within 5 years of diagnosis, and only about four in 10 patients survive the first year. But luckily, Scott was able to receive treatment and beat the odds, thanks to the early diagnosis.
Then, due to Scott’s experience and his family history of cancer, Steve closely monitored his own health and received regular checks for pancreatic abnormalities. One day, his doctor called and told him they’d spotted some dangerous cells. Since the disease hadn’t spread yet, Steve was able to get surgery to remove the cancer.
Both brothers are incredibly grateful for the extra years with their friends and families. Unfortunately, stories like these are exceptionally rare. Each year, more than 50,000 Americans die from pancreatic cancer, at least in part because most people are not diagnosed until the disease is advanced. At that point, it’s often too late for effective treatment.
It doesn’t have to be this way. When pancreatic cancer is diagnosed while the disease is localized, the 5-year survival rate increases to 44%. Earlier detection can save lives.
It is critical that clinicians focus on identifying pancreatic cancer risk factors in their patients and recognize the often-subtle symptoms of disease earlier. With new research and innovation, there are an increasing number of tools available to help healthcare providers do just that. As we commemorate Pancreatic Cancer Awareness Month in November, we need to invest aggressively in these tools and support medical professionals in embracing them.
We can start by being aware of the risk factors for developing pancreatic cancer. For example, a personal or family history of certain types of cancer, obesity, specific genetic mutations, Black and African American heritage, and smoking are relevant factors that should prompt doctors to consider additional testing. In addition, symptoms such as new onset of diabetes in patients over the age of 50 years, changes in weight, and abdominal or mid-back pain may all point toward the developing disease. Even a sudden change in mood should raise red flags.
Rapid progress is being made through technological advances to aid prediction and earlier detection of pancreatic cancer. For example, genetic testing has become more affordable and widely available and can be used to identify individuals who are at higher risk. Novel cancer biomarkers in blood are being developed and tested in clinical trials to detect pancreatic cancer in asymptomatic subjects. Similarly, artificial intelligence (AI) tools have been applied to medical records to predict who may be diagnosed with pancreatic cancer in the near future. AI has also been applied to CT scans to identify cancers not visible to even expert radiologists.
More patients can survive pancreatic cancer. Earlier detection is the key. To save lives and ensure quality of life, pancreatic cancer must be identified before it metastasizes. Earlier detection of the disease requires medical professionals to be well-informed on the risks and nuanced symptoms.
Suresh T. Chari, MD, is a professor of medicine with the University of Texas MD Anderson Cancer Center in Houston. He specializes in pancreatic diseases, and his research focuses on new-onset diabetes for early detection of pancreatic cancer. He is part of a new podcast series from the Kenner Family Research Fund titled, “The First line of Defense: Primary Care Clinicians and Early Detection of Pancreatic Cancer.”
Disclosures
Chari has consulted for companies developing biomarkers and products for early pancreatic cancer detection, including ClearNote, Guardant, and Olympus. He does not own shares of these companies or have intellectual property in any of these products.
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