When the Oncologist Becomes the Patient: The Progress Made In Pancreatic Cancer Care
- A Utah colorectal cancer doctor was diagnosed with pancreatic cancer at just 37 and his diagnosis reshaped his approach to oncology, reinforcing that patients bring their own expertise and that cancer can strike far earlier than many expect.
- Pancreatic cancer remains one of the hardest cancers to detect and treat, driven by subtle symptoms hard to detect until it reaches late‑stage, combined with a dense stromal barrier that limits drug effectiveness, though early detection dramatically improves outcomes.
- New Phase 3 data for the KRAS‑targeting drug daraxonrasib offer unprecedented survival gains, more than doubling median overall survival for pancreatic cancer patients with KRAS‑mutated pancreatic cancer, a mutation present in ~90% of cases. Though promising, the treatment has not been approved for widespread use by the FDA at this time.
- The results from the clinical trial are considered “unprecedented” according to Dr. Anna Berkenblit, MMSc, Chief Scientific and Medical Officer at The Pancreatic Cancer Action Network (PanCAN).
- Younger‑onset cancers, especially colorectal cancer, continue to rise, prompting earlier screening recommendations and renewed focus on potential drivers such as microbiome changes, diet, microplastics, and antibiotic exposure.
“My father died of cancer at age 49, and that taught me very early that this is not just a disease of the elderly,” Dr. Mark Lewis, director of colorectal oncology at Intermountain Health, told KSTU news.
Read MoreThe experience forced him to confront the disease from the other side of the exam room.
While he did not specify the subtype of pancreatic cancer, the diagnosis itself underscores the challenge: pancreatic cancers are notoriously difficult to detect early and often remain asymptomatic until they reach advanced stages. Pancreatic cancer tumor biology that makes treatment particularly complex.
For Dr. Lewis, the experience has permanently altered his approach to care. It’s one thing to understand cancer as a clinician — and another to live through it as a patient.
Dr. Allyson Ocean of Weill Cornell explains that pancreatic tumors are surrounded by a dense, protective stroma that blocks chemotherapy and radiation from effectively reaching cancer cells.
Conversely, pancreatic cancer cases caught in their early stages notably increase the patient’s chances of survival. Dr. Lewis says he was treated successfully.
Recently, pancreatic cancer physicians and patients have received a major boost of hope after promising Phase 3 RASolute 302 clinical trial results using the cancer drug daraxonrasib.
Daraxonrasib, a drug undergoing clinical trials, is showing promise for pancreatic cancers with KRAS mutations — a mutation found in about 90% of pancreatic cancer cases and historically very hard to treat because the KRAS protein is smooth and lacks the pockets most cancer medicines need to latch onto.
Daraxonrasib more than doubled median overall survival (13.2 vs. 6.7 months), offering new hope for patients who previously had few effective treatment options. The treatment has not yet been approved by the U.S. Food and Drug Administration (FDA), but many oncologists are optimistic it may be approved.
The results from the clinical trial are considered “unprecedented” according to Dr. Anna Berkenblit, MMSc, Chief Scientific and Medical Officer at The Pancreatic Cancer Action Network (PanCAN).
A Growing Cohort of Younger Cancer Patients
Another layer to Dr. Lewis’ cancer diagnosis is the growing cohort of cancer patients younger than 50 being diagnosed, especially in the colorectal cancer sector.
“At the beginning of my career, there were really no patients under the age of 50,” Dr. John Marshall, director of the Ruesch Center for the Cure of Gastrointestinal Cancers at Georgetown University and Chief Medical Consultant at the Colorectal Cancer Alliance, told SurvivorNet.
“Now approximately half of my patients are under the age of 50.”
While colorectal cancer remains most common in people over 55, cases in younger adults have risen by 2.4% each year from 2012 to 2021, according to the American Cancer Society.
This surge prompted updated screening guidelines: average‑risk adults should now begin screening at 45 instead of 50, with earlier testing recommended for those with symptoms or a family history.
This change was recommended by advocacy organizations in 2018 and officially supported by the U.S. Preventive Services Task Force (USPSTF) in 2021.
The new recommendation led to more people getting screened earlier. Since 2018, there has been a 17% increase in colorectal cancer cases for people between the ages of 45 and 49, directly related to the new screening guideline.
WATCH: Deciding When to Operate on Colon Cancer
Researchers are still working to understand what’s driving the rise in younger patients.
Dr. Marshall believes the answer may lie in the gut microbiome — the community of bacteria, viruses, and other microorganisms in the digestive tract. Potential influences include diet, microplastics, and antibiotic exposure, but more research is needed to pinpoint the cause.
Lessons Learned After Becoming a Cancer Patient
Dr. Lewis says he “learned far more by being a patient than I could ever learn from a textbook.”
The experience reshaped how he practices.
“When we’re together in the exam room, there are two experts,” he tells patients.
“There’s the oncologist who’s read the studies and treated many people — and there’s the patient, who is the expert on their own body.”
He’s not the only oncologist whose perspective changed after facing cancer himself.
Dr. Adan Rios, a non‑Hodgkin lymphoma specialist at Memorial Hermann Hospital in Houston, spent four decades treating patients before receiving his own diagnosis.
“I was diagnosed with head and neck cancer about five years ago,” Dr. Rios tells SurvivorNet.
WATCH: How an Unexpected Diagnosis Can Shift Your Perspective
Despite years of managing similar cases, the reality of treatment hit differently. His seven‑week course of radiation and chemotherapy was more grueling than he anticipated.
“Even though I had treated patients with head and neck cancer and knew how difficult the treatment was, I was not prepared for the actual experience,” Dr. Rios says.
Looking back, he describes the experience as transformative.
“I don’t know if it is fortune or opportunity to have gone through this, but we have benefited immensely. You never want to repeat it, but it gives you a very different texture for what the meaning of life is,” Dr. Rios said.
Expert Resources for Pancreatic Cancer Patients
- Big News for PARP Inhibitors: They Can Work in Pancreatic Cancer, Too
- Detecting Pancreatic Cancer Early Is Crucial
- Von Hippel-Lindau Syndrome: Pancreatic Cancer
- For Advanced Pancreatic Cancer Patients Running Out of Treatments, a New Pathway Offers Renewed Hope Thanks to the FDA Granting ‘Compassionate Use’ Access to Daraxonrasib
- New Targeted Drug Could Double Survival For Some With Advanced Pancreatic Cancer: What To Know About Daraxonrasib
Why Daraxonrasib Helps Meet an Unmet Need So Desperately?
Pancreatic cancer is notoriously difficult to detect early, often remaining silent until it has advanced. Its biology also makes it challenging to treat.
“Around eighty percent of pancreatic cancer patients already have advanced disease by the time they’re diagnosed, severely limiting treatment options,” explains Dr. Anirban Maitra, Co-Leader of the Pancreatic Cancer Moon Shot at MD Anderson Cancer Center.
“Just twenty percent of patients have their cancer caught early enough to make them a candidate for surgery, the only way pancreatic cancer can be cured.”
WATCH: A Potential New Era Of Targeted Therapy For Pancreatic Cancer
A drug called daraxonrasib is being hailed as potentially “game‑changing” for patients with Kirsten rat sarcoma viral oncogene homolog (KRAS)‑mutated pancreatic cancer — a gene mutation present in roughly 90% of cases and historically considered nearly untreatable.
“It’s a very smooth protein. It doesn’t have places for drugs to grab onto,” Dr. Nicholas Hornstein of Northwell’s Lenox Hill Hospital told SurvivorNet.
Daraxonrasib works differently. Acting as a kind of “molecular glue,” it binds the KRAS gene to another protein, locking it in an inactive state. This mechanism may allow it to work across multiple KRAS mutations, potentially benefiting a wider group of patients who carry the KRAS gene.
The Phase 3 RASolute 302 clinical trial tested daraxonrasib against standard chemotherapy in patients with previously treated metastatic pancreatic cancer.
For clinicians, the implications are significant.
“If I have an 81‑year‑old who doesn’t look like a candidate for chemotherapy, now I have an option that isn’t chemo,” Dr. Hornstein said.
Who Can Benefit From Daraxonrasib?
The patients included in the phase 3 study had metastatic PDAC that was refractory (non-responsive) to prior treatment, but Dr. Berkenblit predicts that the drug may have uses in earlier-stage disease as well.
“If the FDA approves the drug after reviewing the efficacy and safety data, the initial population would be patients with previously treated metastatic pancreatic cancer. That’s just the beginning,” Dr. Berkenblit explains.
Initially, patients would need to meet certain requirements to get daraxonrasib, including:
- Measurable metastatic disease
- An acceptable performance status allows them to conduct most daily activities
- Well-functioning organs
Again, in the trial, Daraxonrasib was compared to the standard chemotherapy.
Questions to Ask Your Doctor
If you are facing a pancreatic cancer diagnosis, you may have questions but are unsure how to get the answers you need. SurvivorNet suggests asking your doctor the following to kickstart your journey to more solid answers.
- What type of pancreatic cancer do I have?
- Has my cancer spread beyond my pancreas?
- If so, where has it spread, and what is the stage of the disease?
- What is my prognosis?
- What are my treatment options?
- What side effects should I expect after undergoing treatment?
- Will insurance cover my recommended treatment?
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