Understanding Pancreatic Cancer
- There is hope to have pancreatic cancer, which actress Olivia Williams is managing, detected quicker than ever before, according to new research published in the journal Angewandte Chemie last month.
- The new findings have revealed a new method, which is a “selective detection of specific antibodies in blood samples,” could result in a more accurate diagnosis.
- Pancreatic cancer is a type of cancer that forms in the pancreas. It is more challenging to treat because symptoms usually don’t present themselves until the cancer has spread or metastasized. Symptoms may include weight gain, back pain, and jaundice.
- Early-stage pancreatic cancer tumors don’t appear on imaging scans, and people typically don’t experience symptoms until the disease has progressed. The pancreas’ location in the abdomen makes it harder to find tumors.
- Treatment options for pancreatic cancer may include surgery, radiation, chemotherapy, and targeted therapy.
The research article, which was published on June 27, 2024, notes that current clinical biomarkers are too “insensitive and unspecific for earlier detection screenings,” so the new findings have revealed a new method that could result in a more accurate diagnosis.
Read More“As a consequence, antibodies directed against the tumors (tumor-associated autoantibodies) are formed, circulating in the blood at very early stages of the disease—which makes them useful for early detection.”
The new findings were developed by an international team, including Roberto Fiammengo and Giovanni Malerba at the University of Verona in Italy, in addition to Alfredo Martínez at the Center for Biomedical Research of La Rioja in Spain and Francisco Corzana at the Universidad de La Rioja.
They created a way to do diagnostic testing for pancreatic cancer by searching “special tumor-associated autoantibodies.”
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The researchers decided to use “autoantibodies directed against the tumor-associated form of mucin-1 (TA-MUC1).”
“Mucin-1 is a heavily glycosylated protein (a protein with sugar components) that occurs, for example, in glandular tissue. In many types of tumors, including pancreatic cancer, it is found in significantly elevated concentrations,” the report explains.
“In addition, the pattern of glycosylation is different from the normal form. The team’s goal was to detect autoantibodies that are directed specifically against TA-MUC1 and are a clear indicator of pancreatic cancer.”
They ultimately found that the “specific autoantibodies displayed” in the research were “significantly better” when it came to correct positive/false positive ratios, when compared to current clinical biomarkers used in pancreatic cancer detection.
Olivia Williams’ Cancer Journey
Actress Olivia Williams, revealed to The Independent earlier this year that she’s been bravely battling pancreatic cancer for over the past six years and continuing regular treatment.
“My cancer is not cured. It is being managed,” Williams said. She is a staunch advocate for cancer awareness and advocating for yourself because it took her approximately four years to be diagnosed with pancreatic cancer after a string of doctors misdiagnosed her.
“It was clear my doctors thought I was delusional,” she previously told Vogue Magazine.
The actress was misdiagnosed with depression, lupus (a condition where the immune system mistakenly attacks the body’s tissues), and irritable bowel syndrome (IBS). IBS is a “group of symptoms that occur together, including repeated pain in your abdomen and changes in your bowel movements like diarrhea and constipation,” the National Institutes of Health explains.
“It had taken more than ten doctors, across three continents, four years to track it down, but finally, I had a diagnosis…I don’t blame the doctors for not spotting the cancer earlier. No right-minded GP orders a CT scan for an actress allergic to Champagne,” Williams said.
Eventually, in 2018, Williams underwent a CT scan to discover she had a tumor in her pancreas. She was diagnosed with a rare type of pancreatic cancer called vasoactive intestinal polypeptide (VIP) carcinoma.
Williams underwent a surgical procedure called a pancreatectomy (removal of all or part of the pancreas) and a splenectomy (removal of the spleen) for treatment. Following surgery, she started taking pancreatic enzyme replacement therapy (PERT), the Pancreatic Cancer UK says.
“I’m probably much more at risk of being knocked off my bicycle because there are insufficient bicycle lanes in London than I am to die of this cancer,” Williams said. “I have a soapbox to stand on and something worth saying, which is, ‘Don’t cry for me because I’ve got cancer – help people live with cancer.’ Because that’s the new normal, and there are so many people who are doing it alongside me.”
Learning about 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.
Additionally, 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 in Pancreatic Cancer
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 pharmaceutical 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 “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 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 tool for you. The SurvivorNet Clinical Trial Finder: an A.I. driven tool for patients to find clinical trial options for treatment.
The tool 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.
“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.”
Being Proactive About Your Health
It’s always a good idea to get into see your doctor if you have any concerning lingering symptoms that may be bothering you for more than a couple of weeks.
It’s also imperative to get regular checkups and screenings even when you are seemingly in perfect health. The more proactive you are about your health, the more of a chance you can stay ahead of a potential diagnosis. In general, the earlier you catch your cancer, the better the prognosis.
“Don’t just leave it to the doctors to tell you what’s going to happen … yes you have to listen to them, but take your health into your own hands,” survivor Amy Armstrong previously shared with SurvivorNet.
Questions for 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?
Contributing: SurvivorNet Staff
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