“America mourns the loss of one of the greatest heroes of American history: Congressman John Lewis,” House Speaker, Nancy Pelosi announced Friday, confirming Lewis’ death from stage 4 pancreatic cancer. Lewis served in the U.S. House of Representatives for Georgia’s 5th congressional district from 1987 until his July 17 death.
RELATED: U.S. Rep John Lewis, 79, Casts First House Vote Since Pancreatic Cancer Diagnosis
Read MoreLewis’s Cancer Journey: “A Fighting Chance”
Lewis announced his pancreatic cancer diagnosis on Dec 20, 2019. In his statement, Lewis said that while he was “clear-eyed about the prognosis, doctors have told me that recent medical advances have made this type of cancer treatable in many cases, that treatment options are no longer as debilitating as they once were, and that I have a fighting chance."
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“Not many of us get to live to see our own legacy play out in such a meaningful, remarkable way,” former President, Barak Obama shared in his Instagram post (below) honoring Lewis, whose own page brought heartfelt tributes, thanking him for his fearlessness:
“We appreciate everything you have done for our communities, for our children,” therealteacherboss wrote. “May your soul rest well as you have completed your mighty works!”
RELATED: The Love Is Real for U.S. Rep. John Lewis as He Turns 80 Amid His Pancreatic Cancer Battle
“Thank you for fighting for me. RIP,” dontroos shared. And t_feld wrote, “Job well done thou good and faithful servant. Rest in power â¤ï¸””
"Because the pancreas is inside the abdomen, it often doesn't have symptoms that would tell you that something is wrong," Dr. Anirban Maitra, co-leader of Pancreatic Cancer Moon Shot at MD Anderson Cancer Center, told SurvivorNet in a previous interview.
Who is at Risk for Pancreatic Cancer?
At higher risk of developing pancreatic cancer are those with two or more family members who had pancreatic cancer, those with an abnormality in germline DNA and those with cysts in their pancreas, according to Dr. Anirban Maitra, co-leader of Pancreatic Cancer Moon Shot at MD Anderson Cancer Center.
Detecting pancreatic cancer in its early stages opens up treatment options significantly. Because the disease is often diagnosed so late — as it was for Rep. Lewis — Dr. Maitra pointed out that only about 20% of people diagnosed with pancreatic cancer are eligible for surgery.
Stage 4 Pancreatic Cancer
Unfortunately, late-stage diagnoses like Lewis’ are relatively common for pancreatic cancer, which means that the disease has often become difficult to treat.
"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,” said Dr. Maitra.
Each year in the United States, about 53,000 patients get pancreatic cancer, and unfortunately, most will die from this disease within a few months to a year or so from the diagnosis. When the disease is caught early, when the tumor is only in the pancreas, the five-year survival rate is 37% but in stage 4 pancreatic cancer, the five-year survival rate drops to 3%, according to the Pancreatic Action Network.
Dr. Maitra pointed out that a large issue lies in screening methods, which, unfortunately, still need to be improved. Testing everyone for the disease, Dr. Maitra said, would lead to too many false positives.
U.S. Rep. John Lewis made a final appearance nearly six weeks ago at Black Lives Matter Plaza in Washington, D.C.
Advances in Pancreatic Cancer Treatment
While the disease still has a poor prognosis (it is the only major cancer with a five-year survival rate under 10%), recent years have brought advances in treatment.
One of the biggest developments in cancer research this year involved pancreatic cancer: A clinical trial showed, for the first time, that a class of drugs called PARP inhibitors may be effective in treating pancreatic cancer.
RELATED: Big News for PARP Inhibitors: They Can Work for Pancratic Cancer, Too
PARP inhibitors work by preventing cancer cells that have been damaged often during the course of chemotherapy from naturally healing themselves, and have shown significant promise in treating ovarian cancer and breast cancer. However, a study presented at the American Society of Clinical Oncology (ASCO) Annual Meeting in June revealed that one of these PARP inhibitor drugs, called olaparib (Lynparza), may work for pancreatic cancer as well.
The drug extended the amount of time that patients with advanced stages of pancreatic cancer who had mutations of the BRCA gene could live without the cancer getting any worse (a measurement doctors call "progression-free survival"). The drug was actually just officially granted full Food and Drug Administration (FDA) approval in December 2019.
Updated Radiation Guidelines
A new set of guidelines released late last summer from the American Society for Radiation Oncology (ASTRO) clarified when and how radiation should be used to treat pancreatic cancer. The guidelines are the first to address pancreatic cancer treatment with "stereotactic ablative radiation therapy," or "stereotactic body radiation therapy (SBRT)."
"SBRT," which is the type of radiation therapy that Justice Ruth Bader Ginsburg received and the type of radiation that the ASTRO guidelines address in pancreatic cancer for the first time can administer very high doses of radiation to a precise location in the body. The way this works is through a number of separate high-intensity beams of radiation targeting a tumor from different angles.
"It's a very focused form of radiation that's used to treat small tumors… that have not spread to nearby lymph nodes or other parts of the body," Dr. Billy Loo, an associate professor of Radiation Oncology at Stanford University's Stanford Cancer Institute, explained to SurvivorNet in a previous conversation.
Immunotherapy For Pancreatic Cancer
Another study this year showed some promising results for using immunotherapy or the process of activating a patient's own immune system to recognize and attack cancer cells to treat pancreatic cancer. The study, funded by the Parker Institute for Cancer Immunotherapy and released in April, combined two immunotherapy drugs with chemotherapy and found some patients experienced either shrinking of tumors, or a slowing of the progression of tumors.
Dr. Otis Brawley, a medical oncologist and epidemiologist at John Hopkins University, says restoring trust is crucial to improving treatments outcomes for patients of diverse backgrounds.
Up until this unique combination of drugs was tested, immunotherapy for pancreatic cancer hadn't historically worked well.
"Up until now, immunotherapy hasn't had a big role," Dr. Allyson Ocean, Medical Oncologist at Weill Cornell Medicine and NewYork-Presbyterian, told SurvivorNet at the time. "Now this study is combining two immunotherapy drugs with frontline standard chemotherapy, and we're seeing response rates that are significantly better than what was published with other chemotherapies alone."
Immunotherapy does not work for all patients with advanced pancreatic cancer, but the advances presented in this study and others throughout 2019 are giving those facing this disease a lot of hope.
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