Early detection is possible for pancreatic cancer

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Pancreatic cancer has a bad reputation. It's a terrible disease, but most people do not realize that there are ways that early detection can help.

When the host of "Jeopardy!", Alex Trebek, announced last week that he had Stage 4 pancreatic cancer, many people have badumed that it was an automatic death sentence.

do not Mr. Trebek.

"I plan to beat statistics of low survival rates for this disease," he said in a video. "The truth says, I must. Under the terms of my contract, I have to host "Jeopardy!" For another three years. "

He was trying to stay positive. But the more widespread dark outlook is affecting even some doctors. It was not so long ago, an American Cancer Society officer stated that there was no standard screening test for life-saving pancreatic cancer, pointing out that CT scans, which could help detect early cancers, carry unique risks..

However, some less risky steps can help you avoid pancreatic cancer.

First, know your risk. Insist that your doctor has a thorough and intelligent family history. If more than one member of your family has had pancreatic cancer, you should have your DNA examined in what we call a germ line test. The cost of germline testing has dropped in recent years. If it is not covered by insurance, the cost to the charge is now about $ 250. A blood sample will tell you if a relevant mutation is present in all the cells of the body.

This will tell you if your risk of contracting the disease is high enough for you to have annual pancreas screening, usually covered by insurance – a M.R.I. or a special type of endoscopy called endoscopic ultrasound, also called an EUS.

If you have one of the BRCA genes suggesting a higher risk of pancreatic cancer, you should consider other tests; Another sign of higher risk is the presence of melanoma and pancreatic cancer in a family.

We have tended to underestimate the importance of genes in conferring risk. Too many people misunderstand genetic testing. They think that mutations in the BRCA gene are only common in people of Jewish descent and only concern bad and ovarian cancers. In made, BRCA mutations are present in many ethnic groups and greatly increase the risk of not only bad and ovarian cancer. cancers but also pancreatic cancer.

In the N.Y.U. pancreatic cancer clinic that I head, we perform DNA tests on the germline of all patients with pancreatic cancer, and we found that 15 percent had a germ line mutation that probably contributed to their risk of developing the disease. Knowing that this helps us to adapt the treatment and to identify siblings and children who may be at higher risk.

For half of patients with pancreatic cancer who come to my clinic, I can not identify a known risk factor. Risk factors that we can control include smoking, alcohol consumption, obesity and type 2 diabetes, which doubles the risk.

At the present time, pancreatic cancer is a relatively rare disease but the third leading cause of cancer death, as few people survive. We aim to change that. We know we can help people at risk, but the challenge is greater if most people think that prevention and early detection are impossible.

Screening of high risk individuals is a proven value. New studies show that if you filter somebody and find somethingthe chances of you having surgery are 80 to 90%. Most of those who do not receive help until the onset of symptoms are unable to undergo life-saving surgery. Without surgical resection, there is little hope for long-term survival. For all patients, the five-year survival rate is only 9%.

But new chemotherapy regimens have helped patients live longerand some patients with metastatic pancreatic cancer during clinical trials on drugs have had a long-term survival.

Of course, we still need more ways to find this cancer sooner and better clinical trials to bring new and more effective treatments to patients. Pharmaceutical companies are trying to find new drugs for this disease, but they will often not pay for tumor biopsies at the beginning, middle and end of the trials. These biopsies are the only way to know why some drugs work and others do not.

C & # 39; a thought cancer that few people wanted to study, a cancer that until recently did not receive a lot of research funding. Cases of high-profile patients such as Mr. Trebek helps to draw attention to the disease, but it is also important to remember cases like that of justice Ruth Bader Ginsburg, who was operated on for pancreatic cancer in 2009. She apparently would not have any symptoms, but her cancer was discovered during a routine scan.

People at increased risk need to know that screening and genetic testing can help them save their lives.