As Guardian Media continues with our cancer awareness campaign for the month of October, we turn our focus to pancreatic cancer.
What is Pancreatic Cancer
Pancreatic cancer is caused when abnormal cells in the pancreas grow exponentially and form a tumor.
The pancreas has two types of cells, exocrine cells and endocrine cells, both with different functions. Most pancreatic cancers are considered to be exocrine tumors that start in the exocrine cells responsible for making the pancreatic enzymes that aid in digestion.
According to the American Cancer Society, for all stages combined, the one-year relative survival rate for the disease is 20 per cent and the five-year rate is seven per cent.
It has the highest mortality rate among all cancers as it is notorious for showing almost no signs or symptoms until it reaches stage four.
“Where the pancreas is located, it’s very difficult to understand or recognise that it’s starting to grow abnormally until it gets too big because of where it’s located,” Dr Asnate Le Blanc of the T&T Cancer Society explained in an interview with Guardian Media.
“We don’t have a screening test for pancreatic cancer yet,” she said.
One of the hardest cancers to detect
Elaborating on the problematic nature of the disease during an interview at her home, founder of the John E Sabga (JES) Foundation for Pancreatic Cancer Natalie Sabga, explained that “once you are diagnosed, you’re mostly in stage four. You will always find it early by accident....85 per cent (of patients) find it in stage four and at that point, it is too late so time is of the essence.”
Compounding this, she said: “Survivorship is not very good in T&T because of limited access, limited treatment options. You know, we have one of the topline drugs available in T&T which is Gemcitabine. However, in America, they use that in combination with a drug called Abraxane which we do not have in T&T. Then we have the other top-line treatment that they use here called folfirinox and a lot of times you have to be a candidate for that so a lot of times people get diagnosed and they’re elderly and they have a lot of other medical issues - they won’t be a candidate for that because it’s strong.”
Risk factors for pancreatic cancer
According to the JES foundation’s website, there are several risk factors for the disease.
Individuals who have inherited a genetic mutation linked to pancreatic cancer, or with more than one immediate relative (parent, sibling, child) who has had pancreatic cancer, or one that developed the disease before the age of 50, are at a higher risk. “Other risk factors include: diabetes (risk increased with long-term, 5+ years) chronic pancreatitis (often linked to individuals with high alcohol consumption), smoking (smokers are 2 times more likely to develop), race and ethnicity (people with African descent appear to have a higher risk over those with Asian, Hispanic, or Caucasian descent), age (chances increase with age, most being 60+), gender (small number of men more than women), diet (while still unclear, diets high in fruits and vegetables seem less likely) obesity (20 per cent increased chance),” the website said.
Despite the challenges in detection of the disease, Dr Le Blanc recommends that those who may be at risk have annual checkups and most importantly, “if you could, have the same physician because they can see how you’re going, they can see the pattern and understand.”
But once the disease is detected, Sabga strongly advised that patients seek out doctors who specialise in treating the disease.
“It’s better if you go to an expert. That is number one. Number two, they have to be their own advocate....You want to know all the answers, all the questions, ask the questions, educate yourself.”