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Genetics could help diagnose pancreatic cancer

In March of 2019, the beloved “Jeopardy” host Alex Trebek announced he had been diagnosed with stage 4 pancreatic cancer. He died on Sunday. In September, Ruth Bader Ginsburg died from complications of metastatic pancreatic cancer; and in July civil rights legend Rep. John Lewis died after a battle with pancreatic cancer.

About 95% of people diagnosed with pancreatic cancer die from it, say experts. It’s so lethal because there are usually no symptoms during the early stages. It’s generally not discovered until advanced stages when abdominal pain or jaundice occurs. Unfortunately, there are currently no screening tools.

Men have a slightly higher likelihood of developing pancreatic cancer than women. There is also a noted association with race: African-Americans are more likely to develop pancreatic cancer than whites. 

Researchers are trying to better understand the way in which pancreatic tumors grow and spread. CNN reports: “There is also a lot of research focused on finding better treatments, targeted therapies, immunotherapy, improving surgery and radiation therapy, according to the American Cancer Society…Another line of research is focused on finding biomarkers of pancreatic cancer so that a simple blood or urine test could be developed…The future of medicine to help people with pancreatic cancer will involve genetics, [Dr. Michaela Banck, a medical oncologist in New York] said. This would involve matching a person’s particular type of tumor using genomic information with treatment. ‘What’s going to make real difference in the future is the revolution of the genomic era,’ she said.”

In a poll of 450+ Sermo physicians, 93% said they were discouraged that 95% of people diagnosed with a pancreatic cancer die. However, 91% of physicians said they are hopeful that the recent media coverage surrounding these tragic deaths will bring about more public awareness of this deadly disease. In terms of diagnosing and treating pancreatic cancer, 95% have hope that the future of genetics could make a difference in diagnosing and treating pancreatic cancer. And 93% are encouraged by the research focused on biomarkers—so that a simple blood or urine test could be developed to help diagnose this deadly cancer earlier.

Here’s more of what Sermo doctors have to say on this topic:

This is unfortunately a disease that has had some progress but nowhere the promising results seen in lung cancer and melanoma. It is imperative that all patients diagnosed with pancreas cancer undergo gremlin (blood) and somatic (tissue) sampling for BRACA. In the general population 5-10% and in the Askinazi population a higher percentage will be BRACA positive. This may have value in treatments, eg PARP agents and platinum but more important may lead to genetic testing in relatives of the patient. If they are positive, they can be enrolled in a high risk program where surveillance includes EUS and MRI. It is important to consider evaluation in a high volume pancreas program for evaluation and treatment. The results from Whipple are different in programs where this type of surgery is common, Also, these programs can enroll patients in clinical trials if appropriate. Precision medicina may play a role in the choice of future treatments and hopefully patients will benefit from therapy directed towards “actionable mutations”.

Hematology Oncology

For this terrible disease, the means must be sought to make an early diagnosis and carry out timely surgical treatment and reduce morbidity and mortality.

Pediatrics (excluding surgery)

The situation is very worrying, due to the late diagnosis, and the enormous difficulties in treating and evolved Ca Pancreas, with > 3 cm (vascular neighborhood, heavy chemo, generally palliative, high mortality)

It is urgent to obtain reliable biomarkers, especially in patients who fall under risk factors, as the alternative is echo, with many false negatives, and TAC is expensive to screen.

General Practice (GP)

The media coverage needs to emphasize the risk factors of obesity, smoking and uncontrolled Diabetes so patients are aware of what they are risking by lifestyle habits.

Internal Medicine

Of course, it is discouraging, those of us who suffer from it are fighting a thousand x thousand, I have spent 3 cycles of qpt with little encouraging results, and my hope is in clinical trials but in addition to hope is the desire of research. I may be late but in 2-3 years molecules with very interesting therapeutic potential will appear … and yes, the future in genetics … and also, I see an increase in cases due to improved diagnoses

General Practice (GP)

I would like to underline the important role of the EUS as a diagnostic tool, also knowing the indications for the procedure. There are countries in Latin America where their use is not widely disseminated, mainly because of the lack of knowledge of physicians about the indications.

General Surgery