Submitted by Fedricker D. Barber, PhD, ANP-BC, AOCNP, University of Texas MD Anderson Cancer Center, Houston, TX
Did you know that November is Pancreatic Cancer Awareness Month and that November 21, 2019 is World Pancreatic Cancer Day? Pancreatic cancer is one of the deadliest cancers worldwide and is one of the leading causes of cancer mortality in developing countries (World Health Organization, n.d.). In 2018, approximately 458,000 people were diagnosed with pancreatic cancer, and an estimated 456,280 people are expected to die from this disease by 2020 (World Health Organization, n.d.). Currently, there is no cure for pancreatic cancer and there are no screening tests to detect this disease, therefore, education and awareness are key to preventing pancreatic cancer.
The incidence rate for pancreatic cancer varies, for example, the highest incidence rate was in North America (50,745) and Europe (128,045) in 2018 (World Health Organization, n.d.). Whereas, the lowest incidence rate was in Africa (15.458) in 2018 (World Health Organization, n.d.). Generally, pancreatic cancer is more prevalent in men than in women and is a disease of older adults, with a median age of onset of 71 years (Ilic & Ilic, 2016; McGuigan et al., 2018; McWilliams et al., 2016).
Researchers are making progress in understanding the causes of pancreatic cancer, however, the precise cause is unknown. Epidemiological data suggests that family history of pancreatic cancer, smoking, obesity, diabetes mellitus, and chronic pancreatitis are associated with pancreatic cancer (Ilic & Ilic, 2016; McWilliams et al., 2016). Additionally, alcohol use > 26 grams daily has been identified as a risk for pancreatic cancer (Ilic & Ilic, 2016; McWilliams et al., 2016).
Unfortunately, clinical manifestations of pancreatic cancer usually do not occur until the cancer has invaded other organs (McGuigan et al., 2018). Common symptoms include: unexplained weight loss, epigastric pain that radiates to the back, jaundice, anorexia, abdominal bloating, clay-colored stools, nausea, and fatigue (McGuigan et al., 2018).
The major factor impacting survival and outcomes in patients with pancreatic cancer is the tumor stage. For instance, the 5-year survival rate for patients with pancreatic cancer is 6% worldwide, however, with localized disease, the 5-year survival rate is 37% versus 3% for stage IV disease (McGuigan et al., 2018).
Treatment for pancreatic cancer varies depending on the stage of the disease. Surgical resection such as pancreatico-duodenectomy or total pancreatectomy potentially can cure pancreatic cancer (McGuigan et al., 2018). Other treatment options such as chemotherapy and chemo-radiotherapy have been showed to increase overall survival (71%-76%), however, patients tend to have recurrent disease within two years (McGuigan et al., 2018).
Given that there is no reliable screening test available to detect pancreatic cancer, education and awareness is key to prevention and early diagnosis.
Ilic, M., & Ilic, I. (2016). Epidemiology of pancreatic cancer. World J Gastroenterol, 22(44), 9694-9705. doi:10.3748/wjg.v22.i44.9694
McGuigan, A., Kelly, P., Turkington, R. C., Jones, C., Coleman, H. G., & McCain, R. S. (2018). Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes. World J Gastroenterol, 24(43), 4846-4861. doi:10.3748/wjg.v24.i43.4846
McWilliams, R. R., Maisonneuve, P., Bamlet, W. R., Petersen, G. M., Li, D., Risch, H. A., . . . Lowenfels, A. B. (2016). Risk Factors for Early-Onset and Very-Early-Onset Pancreatic Adenocarcinoma: A Pancreatic Cancer Case-Control Consortium (PanC4) Analysis. Pancreas, 45(2), 311-316. doi:10.1097/mpa.0000000000000392
World Health Organization. Cancer tomorrow. (n.d). Retrieved from http://gco.iarc.fr/