You may not be as familiar with November being National Pancreatic Cancer Awareness month, as say, that October was Breast Cancer Awareness Month, but that doesn’t mean that pancreatic cancer is overshadowed by pink ribbons (the pancreatic cancer ribbon is a purple ribbon.)
In contrast, support and awareness for pancreatic cancer are growing rapidly, and there are many people and organizations dedicated to both raising awareness and raising funds to support research for the treatment of pancreatic cancer.
Let’s take a look at what we know about pancreatic cancer—the symptoms, the risk factors, and treatment options, and then talk about what you can do to get support if you’re living with the disease, or become an advocate, or you want to make a difference for those living with pancreatic cancer.
The pancreas is a fish-shaped organ that lies behind the stomach, deep in the body. It measures about six inches long and is less than two inches wide. The pancreas is made up of exocrine glands (which make pancreatic enzymes that break down food in the intestines) and endocrine cells (which make hormones like insulin that help balance the amount of sugar in the blood).
Pancreatic cancer starts when the exocrine gland cells or the endocrine cells form tumors, which can spread throughout the body. Cancers formed by the exocrine cells are much more common.
When pancreatic cancer spreads, the cancer cells may also be found in nearby lymph nodes, the liver, the lungs or in fluid collected from the abdomen.
Facts About Pancreatic Cancer
- 43,093 Americans will die of pancreatic cancer in 2017 (22,300 men and 20,790 women.) Pancreatic is the 4th most common cause of cancer-related deaths in men and causes a similar number of deaths in women.
- 53,670 Americans will be diagnosed with pancreatic cancer in 2017.
- Pancreatic cancer is responsible for three percent of cancers in the United States and seven percent of cancer-related deaths.
- The 5-year survival rate for stage IA pancreatic cancer is 14 percent, but only around one percent for stage IV disease. Unfortunately, the majority of people are diagnosed when the disease is already in the advanced stages.
- The earlier pancreatic cancer is caught, the better chance a person has of surviving five years after being diagnosed.
- Pancreatic cancer is most frequently diagnosed among people 65-74 years of age.
- There is not a screening test for pancreatic cancer, but people with significant risk factors may talk to their physicians about doing screening ultrasounds.
Compared to other cancers, pancreatic cancer is relatively rare—coming in at number nine for the number of estimated new cases in 2017. However, the chances of survival from pancreatic cancer are poor, as the population distribution of people who die of the disease is similar to that of the people who are diagnosed. The average survival time from diagnosis of pancreatic cancer is low.
A reason for such a poor survival rate is partly because the disease is difficult to detect early and even more difficult to treat.
The symptoms of pancreatic cancer are often very similar to that of many other illnesses and don’t always show until the disease has progressed to an advanced stage.
Although researchers are unsure as to what exactly causes pancreatic cancer, the following risk factors of the disease have been identified:
- African Americans have higher rates of pancreatic cancer incidence and mortality than any other racial or ethnic group.
- Pancreatic cancer incidence and mortality rates are slightly higher in men than in women.
- Cigarette smoking is a significant risk factor (smoking increases the risk of many cancers, not just lung cancer)
- A family history is an important risk factor
- Personal history of diabetes – At the current time it’s uncertain which comes first, diabetes, or pancreatic cancer, though there are arguments for each scenario
- Chronic inflammation of the pancreas (pancreatitis)
- BRCA2 gene mutation – Women who test positive for a BRCA2 gene mutation (on breast cancer screening) also have an increased risk of developing pancreatic cancer, ovarian cancer, and lung cancer.
Early symptoms of pancreatic cancer may be vague, such as abdominal pain and nausea. Symptoms such as jaundice often occur when the condition is advanced. Possible signs and symptoms include:
- Yellowing of the skin and eyes (jaundice)
- Abdominal pain
- Unintended weight loss
- Loss of appetite
- Itchy skin (the itching can be very intense)
- Unexpected onset of diabetes
- Changes in stool and urine colour
All of these symptoms warrant a thorough medical evaluation. If you are experiencing any of the symptoms of pancreatic cancer, see your doctor. Even if they are not related to pancreatic cancer, in the end, they do warrant a medical evaluation. Keep in mind that you may need to keep asking questions, and request a second opinion if you aren’t getting answers. The symptoms above are your body’s signal that something is wrong. It’s important to listen.
Treatment options for pancreatic cancer depend on the stage of the disease. For early stage cancers, surgery offers a chance to cure the disease (or at least increase the chance of long-term survival.)
Unfortunately, most people are diagnosed when the disease is already advanced (stage 4) and has spread to a point at which surgery is not possible.
Options for advanced pancreatic cancer include chemotherapy to attempt to slow the disease, and radiation therapy (which is often used as a palliative therapy to reduce the symptoms of the disease.)
In recent years, two new approaches to treating cancer have been developed which offer promise improving survival. These include targeted therapies, in which a tumour is directly targeted by a drug based on genetic changes and signally pathways present in the cancer cell. and immunotherapy, an exciting new treatment approach for cancer. Simplistically, immunotherapy works by boosting your own immune system’s ability to fight cancer. Unlike many treatments, immunotherapy has resulted in long-term control for some people with even the most advanced cancers.
Your doctor is a good source of information for testing and treatments available for cancer of the pancreas, but studies tell us that learning as much as you can about your cancer yourself is also helpful. Take a moment to learn about how to research your cancer online. Ask for a second opinion, preferably at one of the larger National Cancer Institute-designated cancer centers. Become involved in one of the pancreatic cancer support communities. Learn about clinical trials, and ask if any of these would be fitting for you. There are currently people living with pancreatic cancer only because of clinical trials. That said, these studies are not for everyone. Thankfully, there are now free clinical trial matching services available in which trained researchers can help you learn whether or not there is a trial for your particular molecular type of cancer anywhere in the world. (Sometimes people with cancer “discover” treatments that even their community oncologist was not aware of.) Most of all, be your own advocate in your cancer care. It makes a difference.
If you’re living with pancreatic cancer, you’ve likely already noticed that there are fewer ribbons out there than for, example, breast cancer. Yet this doesn’t mean that there isn’t support for those with other types of cancer. You may have a pancreatic support group in your community. Even if not, there are active pancreatic support communities available online. Not only do these communities give you a way to get in touch with people facing the same challenges you are, but they are an excellent way to learn about the latest research on the disease.
There are also communities (such as an active twitter chat group) designed for people with any type of advanced cancer.
If you are in the midst of coping with pancreatic cancer, you may wish to leave the raising awareness topic to those who are not coping with the disease. Many people with advanced cancers feel almost guilty that they are not doing anything to raise awareness or funding to study new treatments. But your goal, with pancreatic cancer, is to take care of yourself first. We know that cancer fatigue can make it difficult to do anything but care for yourself.
On the other hand, if you are a long time survivor of pancreatic cancer (and out of treatment) or have a loved one with the disease, advocates are desperately needed to spread the word about the symptoms of the disease, what can be done as far as screening for those who may be at risk, and to raise funding to further study the disease. Since people respond to people and faces rather than numbers, sharing your story can be a very effective way to raise awareness.
Some of the organizations dedicated to supporting those with pancreatic cancer, and raising funds for pancreatic cancer research include:
- The National Pancreatic Cancer Foundation
- The Pancreatic Cancer Action Network
- The Pancreatic Cancer Alliance
- The Lustgarten Foundation
- The Hirshberg Foundation for Pancreatic Cancer Research
- The National Pancreas Cancer Foundation
- The World Pancreatic Coalition
This is only a small taste of some of the organizations available that are dedicated to supporting people with pancreatic cancer. In addition to these organizations, there are Facebook groups and even twitter chats focused specifically on pancreatic cancer. Even if you are very short on time, there is something you can do. Contact one of these organizations and ask what you can do to help, even if you only have 15 minutes a month to spare.