Pancreatic cancer: That’s what makes it so treacherous

Pancreatic cancer is medically referred to as pancreatic carcinoma and is not one of the common types of cancer. But no other is so insidious: those affected and their doctors only become aware of pancreatic cancer when it is too late for a cure.

And while survival rates for most types of cancer have increased significantly in recent years, five years after diagnosis for pancreatic patients, it is still only eight percent. The average life expectancy after diagnosis is only two to three years, and patients often only have months.

Pancreatic cancer strikes 17,000 people each year

The reason: There have been hardly any medical advances for pancreatic cancer, such as the survival rates for other types of tumors have risen steadily in recent decades.

As if that wasn’t depressing enough, the number of people affected in industrialized countries is constantly increasing. In Germany, around 17,000 people develop pancreatic carcinoma every year, and the same number die from the cancer every year. According to the European Association of Gastroenterologists (UEG), the number of deaths increased by five percent between 1990 and 2016. Experts blame our modern lifestyle for the increase in diseases in industrialized countries.

These are risk factors for pancreatic cancer

lifestyle: Smoking, obesity, a diet rich in fat and meat, excessive alcohol consumption are risk factors for pancreatic cancer. However, the connection is not quite as clear as with smoking and lung cancer. Conversely, you should avoid alcohol and nicotine and eat a balanced diet, for example along the lines of the Mediterranean diet.

inflammation: The influence of chronic pancreatitis on the risk of pancreatic carcinoma is clear.

Diabetes: Diabetes is not a direct precursor to pancreatic cancer in the way polyps are to colon cancer. But diabetes often precedes the diagnosis of cancer. In an interview with Die Welt, Volker Ellenrieder, Director of the Department of Gastroenterology and Endocrinology at the University Medical Center in Göttingen, said that diabetes might even be an early detection feature. It has been found that when pancreatic cancer is diagnosed in a patient in their mid-50s, they have often been diagnosed with diabetes a few years earlier.

predisposition: Genetic factors play a role, especially hereditary forms of chronic pancreatitis. If one or two close relatives have pancreatic carcinoma, it makes sense to seek medical advice.

Lack of early detection: A kind of risk factor is also the fact that there are no early detection methods for pancreatic cancer, unlike breast or colon cancer. In the future, research will focus on blood tests (“liquid biopsy”). So far, however, no approach has been so mature that reliable early cancer detection can be read in the blood.

This is how pancreatic cancer manifests itself

In the early stages of the disease, pancreatic cancer causes no or only unspecific symptoms such as loss of appetite or a Feeling of pressure in the upper abdomen, which can also have other causes. Also persistent back painthat cannot be explained by tension or poor posture can be a clue.

Significant symptoms like

• strong pain
• significant weight loss or
• jaundice

only occur when the disease is more advanced.

Diagnosis of pancreatic cancer

Doctors usually discover the malignant tumor late and often by chance during another examination of the abdomen. If pancreatic carcinoma is suspected, the general practitioner first performs a physical examination with a Ultrasound of the abdomen through. For further research like a Computed Tomography and a endoscopic examination the general practitioner will refer you to a suitable specialist, or to a cancer center if necessary.

One Biopsywhich secures the diagnosis for many other types of cancer, is for pancreatic cancer not useful. Because removing tissue from the pancreas is difficult and not without risk.

Therapy of pancreatic cancer

If tests performed suggest pancreatic cancer and the tumor has not spread, doctors may recommend immediate surgery at a certified pancreatic cancer center.

1) Operation

If the tumor is detected early enough for surgery to be an option, there is a chance of complete recovery. Surgery is almost always followed by supportive chemotherapy for six months. Sometimes chemotherapy prior to surgery is also intended to shrink a tumour. After the pancreas is removed, the patient must replace the vital enzymes and hormones (such as insulin) produced there with drugs.

2) chemotherapy

In most patients, the disease is so advanced at the time of diagnosis that the tumor can no longer be operated on. It has then grown into the surrounding tissue or has already formed metastases. The standard treatment here is chemotherapy with the aim of prolonging survival and improving quality of life.

3) Personalized cancer therapy

Pancreatic cancer often does not respond to standard chemotherapy. Valuable time is wasted until that is clear. Therapy that is precisely tailored to the respective tumor can help to overcome this dilemma. Because of the cancer’s genetic fingerprint, oncologists can target promising drugs rather than those to which the cancer will not respond anyway.

4) Experimental therapies

At the centers specializing in pancreatic cancer, new therapeutic approaches are being used as part of studies. Certain new drugs can supplement chemotherapy or achieve success in patients who are not affected by the usual cell toxins. Patients can participate in such studies if their disease makes them suitable.

Die immunotherapy, on which the high hopes against cancer are currently resting, has so far failed in pancreatic cancer. Because unlike most other types of cancer, the immune system does not recognize pancreatic cancer. Researchers must first find out how an immune response can be evoked.

Good palliative care is important for the quality of life of patients with a poor prognosis. This includes the clarification of symptoms associated with the tumor, but also support for the family, social and psychological situation of the patients and their relatives. In addition to the important and often necessary pain therapy, she also takes into account aspects such as nutrition and exercise.