Medicine still does not fully understand the biology of pancreatic cancer. Why does it kill so quickly, even before disease is spread? Why does he relapse so often? – admits Dr. Leszek Kraj from the Oncology Clinic of the Medical University of Warsaw. Currently, pancreatic cancer is the seventh cause of death from oncological diseases, and in nine years it may be in second place.
- Pancreatic cancer is one of the most dangerous cancers. – In the case of this cancer, the number of deaths is almost equal to the number of cases – says Dr. Leszek Kraj from the Department of Oncology of the Medical University of Warsaw.
- Only 10 to 20 percent. pancreatic cancer patients are eligible for surgery – the risk of relapse after surgery is high anyway
- – Unfortunately, we still do not understand the biology of this cancer – admits the doctor. – We also do not know exactly why it kills so quickly, the mystery is also significant cancer wasting
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Medexpress: About 4 die every year from pancreatic cancer. Poles. What is the cause of so many deaths? Are there any trends in the patient population in recent years?
Dr Leszek Kraj, Department of Oncology, Medical University of Warsaw: Compared to other cancers, the prognosis is poor. Unfortunately, in the case of pancreatic cancer, the number of deaths is almost equal to the number of cases. Five-year survival rates are only 8-9 percent. sick. We detect it most often in the form of a disease that is already disseminated or advanced locally. Only 10 to 20 percent. patients are eligible for surgery, and the risk of relapse after surgery is still high. As a result of the pandemic and difficult access to healthcare, there are many more advanced cases than before.
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Global trends indicate that in 2030 this cancer will become the third or even the second cause of death from oncological diseases, although today it ranks 5th – 7th. This is because we treat other cancers better and better, and although more people suffer from them, fewer and fewer die. According to statistics, the same number of people died from pancreatic cancer in 2018 as from breast cancer, although six times as many people suffer from the latter.
Usually, talking about cancer is not easy. Can we be optimistic about the treatment of pancreatic cancer?
Unfortunately, we still don’t understand the biology of this cancer. Why it kills so quickly, even before it can spread, annihilating its host. For example, in the case of a very aggressive melanoma, if we cut it early with an appropriate margin, 90 percent. we are sure that this is the end of the treatment. Meanwhile, in the case of pancreatic cancer, we excise the tumor within healthy organs, and it recurs most often anyway.
We also don’t know exactly why it kills so quickly. After all, the pancreas is a non-critical organ without which one can live today. There are patients who have their pancreas removed for various reasons. They are given digestive enzymes and supplemented with insulin.
Then why is cancer developing in such an organ so dangerous? After all, we see patients from the so-called pancreatic neuroendocrine neoplasms. Even if significant pancreatic involvement or distant metastases are then observed in these patients, we are able to treat them for years. In the case of classic pancreatic adenocarcinoma, which is the most common type of pancreatic cancer, it is virtually impossible.
A big puzzle for us is also a significant cachexia, i.e. neoplastic cachexia that often accompanies this cancer. Why do patients with a tumor size of 3-4 cm often lose several kilograms of body weight?
Can we talk about prophylaxis in the case of pancreatic cancer?
We know the risk factors for this cancer. These are cigarette smoking, alcohol abuse, chronic pancreatitis, physical inactivity, obesity. But we are unable to propose any secondary prophylaxis to patients at risk. Currently, we do not have tools for the early detection of this cancer during screening, as is the case with colorectal or breast cancer.
If you want to take care of your pancreas, undergo preventive examinations. At Medonet Market you will find Pancreatic Tests – a blood test package in which you can determine the level of amylase, lipase, and also CA 19-9. As part of the package, you can donate a blood sample at one of over 500 facilities in Poland or at your own home.
Fortunately, it is a relatively rare cancer, and yet we have several million smokers, obese or excessively alcohol-consuming people in our country. About 4 – 5 thousand people suffer from pancreatic cancer. people per year, while other cancers a total of 170 thousand.
Patient Hears Pancreatic Cancer Diagnosis – What Next? What options does she have today?
The first option considered, as with other cancers, is surgery. Physically getting rid of this tumor, if technically feasible, offers a chance of a complete recovery. But only 10 to 20 percent are eligible for such treatments. sick.
If the cancer is advanced, systemic treatment is used – chemotherapy. In the first line of treatment, we have three basic regimens at our disposal today, which we select depending on the patient’s condition. Recently, data on the so-called maintenance therapy for patients with BRCA1 and BRCA2 mutations. It is about drugs from the group of the so-called PARP inhibitors (olaparib).
In advanced pancreatic cancer, we can still talk about an unmet medical need.
We lack therapeutic options in the second line of treatment. Liposomal irinotecan, a chemotherapeutic drug packed in liposomes (irinotecan in this case), penetrates better into tumor tissues. The liposomes build up within the tumor and slowly release the drug, keeping it active for a longer period of time. The combination of this drug with 5-Fluorouracil resulted in an increase in median survival by approximately two months in patients treated in the second line of treatment. It seems little. However, in the case of pancreatic cancer, unlike, for example, breast or prostate cancer, extending the median survival by two months in the absence of other therapeutic options is a significant advance. In Poland, this therapy is not reimbursed yet.
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