Pancreatic Cancer: Symptoms & Progress
- Tom was diagnosed with pancreatic cancer at 42 years old. And his diagnosis came “out of the blue” after experiencing symptoms of jaundice a condition in which the skin, whites of the eyes and mucous membranes turn yellow because of a high level of bilirubin, a yellow-orange bile pigment, according to the Cleveland Clinic.
- Pancreatic cancer is an aggressive disease that is difficult to detect because symptoms including jaundice and weight loss typically present at a later stage in the cancer's development.
- But clinical trials are currently exploring promising treatment options that could change prognoses as we know them.
- Clinical trials are research studies that compare the most effective known treatment for a specific type or stage of cancer with a new approach. They can give patients access to incredible new therapies, but they're not for everyone and the treatments may very well not work for you.
- To help you explore your clinical trial options, SurvivorNet created the SurvivorNet Clinical Trial Finder an A.I. driven tool that's built on top of clinicaltrials.gov and gives access to more than 100,000+ individual clinical trials, updated daily.
Just before the start of 2018, Tom was feeling great. He had “enjoyed a lovely festive season” and “everything seemed normal.” But as January progressed, he began to show signs of jaundice a condition in which the skin, whites of the eyes and mucous membranes turn yellow because of a high level of bilirubin, a yellow-orange bile pigment, according to the Cleveland Clinic. Tom described it as “a horrible condition” where “you are constantly uncomfortable: hot, sweaty and itchy.”
Read MoreFor treatment, Tom started with an extensive surgery.
“The procedure the team had identified was a pancreaticoduodenectomy, also known as the Whipple's operation,” he explained. “This would include the removal of the gall bladder, part of the duodenum, and the head of the pancreas. Followed by re-stitching and plumbing me back together.
“I could only marvel at the dedication of the amazing surgeons who carried out my operation.”
After that operation came chemotherapy. Thankfully, he found lots of support along the way, and his outlook on life should inspire everyone whether they’ve faced cancer or not.
“One of the most important aspects of my recovery has been the fantastic support I have received from my family and friends,” he wrote. “I have found that some of my friendships have grown and become stronger, as well as new friendships forming.
“Positivity is the only way forward. Life is full of hard knocks, and it is how you respond that matters.”
Understanding Pancreatic Cancer
Pancreatic cancer is an aggressive disease that is difficult to detect because symptoms including jaundice and weight loss typically present at a later stage in the cancer's development. In a previous interview with SurvivorNet, Dr. Anirban Maitra, the co-leader of the Pancreatic Cancer Moon Shot at MD Anderson Cancer Center, explains what he typically sees when patients develop this disease.
"Because the pancreas is inside the abdomen often doesn't have symptoms that would tell you that something is wrong with your pancreas," he says. "By the time individuals walk into the clinic with symptoms like jaundice, weight loss, back pain or diabetes, it's often very late in the stage of the disease."
Detecting Pancreatic Cancer Early Is Crucial
Parents, siblings and children of someone with pancreatic cancer are considered high risk for developing the disease because they are first-degree relatives of the individual. PGVs (pathogenic germline variants) are changes in reproductive cells (sperm or egg) that become part of the DNA in the cells of the offspring. Germline variants are passed from parents to their children, and are associated with increased risks of several cancer types, including pancreatic, ovarian and breast cancers. Germline mutations in ATM, BRCA1, BRCA2, CKDN2A, PALB2, PRSS1, STK11 and TP53 are associated with increased risk of pancreatic cancer.
Jessica Everett, a genetic counselor at NYU Langone's Perlmutter Cancer Center, encourages people in this category to look into possible screening options.
"If you're concerned about pancreatic cancer in your family, start by talking to a genetic counselor to learn more about your risk and what options you have," Everett said.
In addition, note that up to ten percent of pancreatic cancer cases are caused by inherited genetic syndromes. So, if two or more members of your family have had pancreatic cancer, or if you have pancreatic cysts, it's worth asking your doctor to check for pancreatic cancer since you're at high risk.
Progress Being Made
Progress has been made over the last few years in the world of pancreatic cancer treatments. One clinical trial recently found that the drug Onivyde, in combination with chemotherapy in the so-called Nalirifox regimen, helped patients live longer compared with chemotherapy in previously untreated patients with metastatic pancreatic ductal adenocarcinoma (mPDAC), according to Ipsen, the pharmacautical company that bought the drug.
"The prognosis for people diagnosed with pancreatic cancer is extremely poor and we plan to submit these new findings to the regulatory authority as, if approved, we believe this regimen could offer up an important new treatment option for people living with an aggressive and hard-to-treat cancer," Howard Mayer, Executive Vice President and Head of Research and Development for Ipsen, said. "We thank the patients who participated in the study, their families and their healthcare teams."
The drug is currently approved in the U.S., Europe, and Asia in combination with fluorouracil and leucovorin as a treatment for mPDAC after disease progression and following gemcitabine-based therapy.
Another example of progress being made comes in the form of immunotherapy, a type of cancer treatment that uses your own immune system to fight cancer.
"Up until now, immunotherapy hasn't had a big role," Dr. Allyson Ocean, a medical oncologist at Weill Cornell Medical Center, previously told SurvivorNet.
Dr. Allyson Ocean explains why pancreatic cancer is so hard to treat.
A clinical trial led by researchers at the Perelman School of Medicine at the University of Pennsylvania, and sponsored by the Parker Institute for Cancer Immunotherapy, found "a combination of chemotherapy with an immunotherapy meant to unleash the anticancer capacity of the immune system was effective against one of the hardest targets in cancer care, pancreatic cancer," said Penn Medicine.
"The researchers found that in 34 patients with advanced pancreatic cancer randomized to receive the immunotherapy nivolumab with two chemotherapy drugs, nab-paclitaxel and gemcitabine, had a one-year survival rate of 57.7 percent, significantly greater than the historical average of 35 percent with chemotherapy alone," the institution said.
Dr. Benjamin Musher, the director of medical oncology at the Dan L Duncan Comprehensive Cancer at Baylor St. Luke's Medical Center, recently said there were currently multiple "home-grown clinical trials testing novel immunotherapies in all stages of pancreatic cancer studies underway at Baylor St. Luke's." But only about 5 percent of patients with pancreatic cancer participate in such studies.
"We know that we are not going to improve outcomes without more patients enrolling," Musher said.
In addition, there are immunotherapy clinical trial innovations being made to allow for multiple immunotherapeutic approaches to be tested and compared to one or several standard-of-care options within trials. In other words, "investigational treatments can be added or dropped from the trial over time, depending on preclinical and clinical evidence."
"We're encouraged by the trend toward more innovative clinical trial designs to improve the drug development process and ultimately lead to better patient outcomes," PanCAN Chief Science Officer Lynn Matrisian said in a recent article from the Pancreatic Cancer Action Network.
Clinical trials, in general, are research studies that compare the most effective known treatment for a specific type or stage of a disease with a new approach.
Dr. Beth Karlan, a gynecologic oncologist with UCLA Health, previously told SurvivorNet that clinical trials can play an important role for some patients' treatment, but they also serve a larger purpose.
Clinical Trials Can be Life-Saving for Some
"Clinical trials hopefully can benefit you, but it's also providing very, very vital information to the whole scientific community about the effectiveness of these treatments," Dr. Karlan said. "We need everyone to be partners with us if we're ever going to truly cure cancer or prevent people from having to die from cancer."
That being said, there is no guarantee you'll receive more effective treatment than the standard of care, and clinical trials certainly aren't right for everyone. You should always talk with your doctor(s) before getting involved in one. Some risks to consider are:
- The risk of harm and/or side effects due to experimental treatments
- Researchers may be unaware of some potential side effects for experimental treatments
- The treatment may not work for you, even if it has worked for others
But if you've already decided that a clinical trial is right for you or you're just beginning to explore your treatment options, you should know that SurvivorNet has a new tool for you. Introducing the SurvivorNet Clinical Trial Finder: an A.I. driven tool for patients to find clinical trial options for treatment.
The tool, which launched earlier this month, is built on top of clinicaltrials.gov a database maintained by the U.S. government that compiles privately and publicly funded clinical trials conducted around the world and gives access to more than 100,000+ individual clinical trials, updated daily.
To use the SurvivorNet Clinical Trial Finder, simply answer some basic questions using our custom-designed chat feature and we'll send customized clinical trial options within your region right to your email. In simplifying the search, we hope to offer multiple opportunities for clinical trial sponsors and clinical research organizations to engage with patients.
"Clinical trials are critical to the development of new therapies, and as we live through this extraordinary revolution in genomics, immunotherapy and targeted therapy, it's clear that one of the most pressing needs for patients, clinical trials sponsors, and researchers is simply a better way to find patients," SurvivorNet CEO Steve Alperin said. "Even one percent more people successfully enrolled in clinical trials can change the world."
Contributing: Shelby Black, Teaganne Finn
Learn more about SurvivorNet's rigorous medical review process.