The Rise of Pancreatic Cancer

[PeterRS]

Yesterday I wrote an article under Theatre, Movies etc. about the 10 year anniversary of the death of actor Alan Rickman. He died of pancreatic cancer aged 69. If you are a man, do you realise you are one of almost 500,000 who will contract the cancer this year? And are you aware that unless it is caught early and has not spread to other organs, your chance of surviving for five years is just 13.3% according to the National Cancer Institute?

I'm not a doctor but I do know something about this cancer. Just over five years ago, my doctor at King Chulalongkorn Hospital in Bangkok had me undergo a full abdominal CT scan for a totally unrelated issue. From the scan, she noticed a small cyst on my pancreas. She understandably wanted to know what might be underneath that cyst. She explained that if one was 5mm or less, normally she would not bother. But mine was slightly larger at just over 6mm. So she had me do an MRI scan. This showed nothing abnormal underneath, but she said she wanted 5 annual scans just to make sure. I have now completed 4.

I had heard about quite a number of prominent people dying of this insidious cancer, but before my experience I had no idea even where that organ sits in the body. In fact it is behind the stomach. One reason for so many deaths is that it is frequently misdiagnosed when first visiting a doctor. Many consider it could be a stomach complaint or a mild back ache. So it is frequently caught too late. Hard to detect and hard to cure! That is why Alan Rickman and so many others have died, often much too early. These include Steve Jobs, Luciano Pavarotti, Aretha Franklin, Patrick Swayze, Joan Crawford, Sir Rex Harrison, Henry Mancini . . . That all these were rich and famous did not prevent them from undergoing checks before the cancer became too advanced. Steve Jobs was aware of his diagnosis but he chose not to be operated on. Why, I have absolutely no idea. But he soon realised he had made the wrong decision.

I am not listing links simply because some deal only with the USA or other specific countries and others worldwide. Just type in pancreatic cancer and it will throw up all manner of links. From what I have read - and I trust doctors will correct me if this is incorrect - there is nothing one can do to prevent the onset of pancreatic cancer. Generally thought to affect only older people, the really worrying fact is that worldwide rates of this cancer are rising, especially now among younger people. In the USA the rate for those under 50 is around 2 per 100,000 (figure from the Dana Farber Cancer institute).

[Riobard]

See “The Rise of Obesity”, brought to you anywhere and in your face. Independent risk factor along with smoking. As obesity contributes substantially to the variance in pancreatic cancer incidence, not that the selected above public figure examples necessarily represents the well established logistic regression analysis for incremental BMI and belt size circumference, then the latter isn’t something that just happens randomly in a significant proportion of cases. Plus there are other benefits to not being obese. Put that in your pipe and smoke it, but really, don’t smoke. Feed the world.

Impending downvotes brought to you by mindless self-indulgent troll-marketed dessert buffets as well as troll waist and waste of spaces. 

[PeterRS]

As a doctor, I would have expected you to write more succinctly and clearly on what is an extremely serious subject. You highlight obesity. You are correct, thank you. You sort of suggest giving up smoking. You are correct. Thank you. You do not mention diet and you do not mention other lifestyle issues. Alcohol intake is another. As I stressed, age is one. A look at the Mayo Clinic page on pancreatic cacer offers considerably more than your post.

https://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/symptoms-causes/syc-20355421

[unicorn]

Some people are not aware that "cancer" is not a disease, but rather a collection of many hundreds of different diseases, all with different behaviors and different ways to treat. Even "pancreatic cancer" isn't a single disease, but I will comment on pancreatic adenocarcinoma, by far the most common (the beta cells, which produce insulin, for example, can also become cancerous, although that's very rare, and there are also pancreatic neuroendocrine carcinomas). Pancreatic adenocarcinoma (which I'll call PA for short) is one of the fastest-growing cancers that exists, and therefore cannot be screened for (similar to the fast-growing ovarian cancers). Although on occasion it is caught early from CT scans done for another reason, 80% of the time it's found after it's spread, in which case the prognosis is almost always measured in months, not years. Smoking doubles the risk. Diabetes mellitus is also a major risk factor. A somewhat small percentage seem to be genetic. The biggest risk factor is repeated episodes of pancreatitis (most commonly from alcohol), which greatly increases the risk. I once had a patient who'd had pancreatitis so many times his pancreas had basically turned into a pile of chalk. I already had to treat him with insulin and with the oral digestive enzymes the pancreas normally produces, so I consulted with an oncologist and asked if it would be a good idea to have his pancreas taken out as a precaution, but was advised that even in this case, it wasn't advisable (the surgery has a high risk of complications). High consumption of processed, red, or grilled meat have been associated with a higher risk of pancreatic cancer, but this has been proven as causative by randomized clinical trials, as far as I'm aware. 

[unicorn]

I just reviewed my post, and realize I wrote in the last sentence "...this has been proven..." when I meant to say "...this hasn't been proven...". 😉