WRNMMC, Bethesda, Md.  –   November is Pancreatic Cancer Awareness Month, observed to draw attention to the cancer that’s estimated to claim more than 50,000 lives in the United States this year. The National Cancer Institute also estimates there will be more than 64,000 new cases of pancreatic cancer diagnosed in the U.S. during 2023.

The pancreas, which is the organ lying behind the lower part of the stomach, secretes enzymes that aid in digestion and hormones to help regulate sugar metabolism. Pancreatic cancer is often detected late, spreads rapidly, and has a poor prognosis. Up to 10 percent of patients who receive an early diagnosis become disease-free after treatment. For patients who are diagnosed before the tumor grows much or spreads, the average pancreatic cancer survival time is three to three-and-a-half years.

“Currently, most early-stage pancreatic cancers are found incidentally, due to CT scan for unrelated symptoms. This is because pancreatic cancer is typically asymptomatic at very early stages. We currently do not have a great screening marker for pancreatic cancer, but under the [John P.] Murtha Cancer Center’s Cancer Moonshot research, we are investigating potential screening markers for pancreatic cancer. I am the principal investigator on this groundbreaking research, supported by the leadership of Dr. Craig Shriver, the director of the Murtha Cancer Center,” explained Navy Cmdr. (Dr.) Michele Gage, chief of the Division of Surgical Oncology at Walter Reed and associate professor of surgery at the Uniformed Services University of the Health Sciences (USU).

Early signs of pancreas problems, or acute pancreatitis symptoms, may include pain in the upper belly; pain in the upper belly that radiates to the back; tenderness when touching the belly; fever; rapid pulse; upset stomach; and vomiting. But as Gage stated, there are not tell-tale early signs of pancreatic cancer.

“It is most commonly detected by imaging, such as CT scans or MRIs. If causing secondary symptoms, such as abdominal pain or an early feeling of fullness when eating, CT or MRI would be obtained to investigate the cause. We do not have an optimal blood test or screening test which can detect early pancreatic cancer with accuracy.”

She added symptoms for pancreatic cancer depend on its location. “The pancreas is a fish-shaped organ and is described as such – the head, body and tail. In the head of the pancreas, a cancer can obstruct the pancreatic duct or bile duct, leading to pancreatitis and/or jaundice. In the body of the pancreas, patients may experience severe back pain if the adjacent celiac nerves are involved. In the tail of the pancreas, if the cancer is large enough, it may compress the stomach or intestines, leading to discomfort or an early feeling of fullness. Advanced stage pancreatic cancer could also cause systemic symptoms, such as weight loss, decreased energy, and loss of appetite.”

“The majority of patients who develop pancreatic cancer are older than 55. In fact, 90 percent of patients who are diagnosed with pancreatic cancer are over the age of 55, and the average age is around 70 years old. For this reason, older age is considered a risk of pancreatic cancer. Substances or diseases which may results in chronic inflammation of the pancreas, such as smoking, alcohol, diabetes, or chronic pancreatitis, are also believed to be risk factors,” Gage added. According to the NCI, the median age of death form pancreatic cancer is 72.

“While some pancreatic cancers are caused by genetic syndromes or exposure [such as] smoking, it is not uncommon that the cause of pancreatic cancer is unknown in many patients. A universal screening marker would greatly assist in early detection,” said Gage.
She shared that survival of pancreatic cancer is improved with earlier diagnosis.

“Based on SEER [Surveillance, Epidemiology, and End Results] data, the estimated 5-year survival of pancreatic cancer is 44 percent for those who are able to undergo surgery for their early-stage pancreatic cancer. When cancer has spread to the nearby structures or lymph nodes, 5-year survival is approximately 15 percent. When distant metastatic disease is present, for example the cancer has spread to the liver or bones, it is 4 percent. This is why early detection is so important and our research here at the Murtha Cancer Center is working to improve it,” said Gage.

“Pancreatic cancer treatment requires multi-disciplinary care with a surgical oncologist, medical oncologist, and involvement of a radiation oncologist for evaluation of candidacy of surgery, chemotherapy, and radiation,” Gage stated. “The team also involved advanced gastroenterology, pathology, radiology, genetics, nutrition, and more. Our team at the Murtha Cancer Center at Walter Reed is highly skilled in pancreatic cancer care and we take pride in our multi-disciplinary work. I lead our weekly Tumor Board conference, discussing our pancreatic cancer patients and their management with these team members. We believe in world-class care for our service members and their families – they deserve nothing less than the best,” she added.