ASGE And The Pancreatic Cancer Action Network Partner To Raise Awareness About Pancreatic Cancer

Main Category: Pancreatic Cancer
Also Included In: Cancer / Oncology
Article Date: 25 Nov 2008 - 0:00 PDT

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The American Society for Gastrointestinal Endoscopy (ASGE) and the Pancreatic Cancer Action Network are teaming up this November to raise awareness about pancreatic cancer, educating patients about the disease and the resources that are available for them.

Pancreatic cancer is the fourth leading cause of cancer deaths in the U.S. In 2008, an estimated 37,680 Americans will be diagnosed with pancreatic cancer and 34,290 will die from the disease. Seventy-five percent of pancreatic cancer patients die within the first year of their diagnosis and only five percent survive more than five years. Unfortunately, it is one of the few cancers for which survival has not improved substantially over the past 25 years. Men are 20 percent more likely to get pancreatic cancer than women and the majority of cases occur in people over the age of 65. The incidence rate among African Americans is 40 to 50 percent higher than other ethnic groups.

"While the statistics on pancreatic cancer are sobering, it is important for patients to know that treatment does exist for pancreatic cancer. Clinical trials can provide important treatment options beyond what is currently available," said Mark B. Pochapin, MD, chair of ASGE's Public and Member Outreach Committee and member of the Pancreatic Cancer Action Network's Medical Advisory Council. In addition, advanced technologies are allowing for the diagnosis of pancreatic cancer at earlier, more treatable stages.ASGE and the Pancreatic Cancer Action Network encourage patients and their families to become educated about the disease, to ask their doctor about treatments and to reach out for support. The organization's Patient and Liaison Services program and Survivor Caregiver Network can be accessed at www.pancan.org to help patients diagnosed with this disease.

About Pancreatic Cancer

The pancreas is a gland deep in the abdomen, behind the stomach, that is part of the digestive and endocrine systems. The pancreas makes juices that help with digestion (enzymes) as well as important hormones such as insulin that control the level of sugar in the bloodstream. Pancreatic cancer is difficult to diagnose early, as the symptoms are often minor or non-existent until the tumor has extended outside the pancreas. Once outside the pancreas, the tumor invades a number of adjacent organs and is usually not amenable to surgical resection. There are no reliable early diagnostic tests for pancreatic cancer.

Scientific research is in the basic stages. Advancing pancreatic cancer research into the 21st century is dependent upon the increase of basic science research. Pancreatic cancer risk factors need to be identified and verified before research about prevention methods can begin. Recent research studies indicate that approximately 10 percent of pancreatic cancer cases are familial and another 30 percent are thought to result from cigarette smoking. Some other risk factors scientists are currently studying include: diabetes, chronic and hereditary pancreatitis (inflammation of the pancreas), obesity, physical activity, and diet.

"Screening for pancreatic cancer in relatives of affected people is not often done in the United States," said Pochapin. "However, families with many cases of pancreatic cancer or close relatives of people who developed pancreatic cancer at an early age should seek the advice of a specialist such as a gastroenterologist or oncologist, as there are specific genetic syndromes that may increase susceptibility for pancreatic cancer."

Symptoms and Detection

Since the pancreas is near the drainage tubes for bile and digestive enzymes, a mass in the pancreas can block the flow of these substances into the small intestine. This can cause the skin and eyes to turn yellow (jaundice) and the stool to turn pale. It can also cause pain, weight loss, nausea, vomiting, and itchy skin. The symptoms of pancreatic cancer can be confused with those of benign diseases such as arthritis (back pain), gallstones (jaundice) or chronic pancreatitis (pain, diarrhea, weight loss). Unfortunately, by the time most patients develop symptoms, the cancer is usually advanced and difficult to treat.

A variety of tests are used to detect and understand the extent or stage of the disease. It is important to detect pancreatic cancer at its earliest and most treatable stage. Precise staging helps determine what treatment course is best and what alternatives (such as participation in a clinical trial) might be appropriate.

After a physical examination and some basic blood tests, most patients get scanned with a CT (computerized tomography) or "CAT" scan. CT scans and MRI (magnetic resonance imaging) provide a detailed view of the pancreas and neighboring organs. A very important test, usually performed after a CT or MRI scan, is endoscopic ultrasound (EUS). EUS allows specially trained doctors known as endoscopists to obtain highly detailed pictures of the pancreas and to get a biopsy of any abnormalities seen. This type of biopsy is known as fine needle aspiration, or FNA. This technique uses a thin, flexible camera (combined with a tiny ultrasound device) that is passed gently through the mouth and into the stomach.

A recent study in GIE: Gastrointestinal Endoscopy, the scientific journal of the ASGE, showed that EUS and EUS-FNA is 99.1 percent accurate in diagnosing pancreatic neoplasms (abnormal growths or tumors) in patients who were referred for endoscopic ultrasound (EUS) because of CT and/or MRI reports of two common, though somewhat ambiguous findings - enlargement of head of pancreas or dilation of the pancreatic duct. EUS and EUS-FNA have become valuable tools in the diagnostic evaluation of patients with suspected pancreatic cancer. Another test that may be required is known as endoscopic retrograde cholangiopancreatography (ERCP). During this test a small camera (scope) is used to inject a dye into the ducts that drain bile and the pancreatic juices. It also allows doctors to insert a small tube (stent) if needed to relieve a blockage.

Treatments

Treatments are generally decided based on the stage of the cancer. Currently, surgery offers the only potential for a cure. It is estimated that only 15 percent of pancreatic cancer cases are caught early enough for surgery. Most patients will have a recurrence within two years.

The most commonly used surgical procedure to remove tumors in this stage is called the Whipple procedure, named after the doctor who developed the technique in 1935. A Whipple procedure treats cancer of the head of the pancreas (the widest part) and generally involves removing most of the pancreas and part of the small intestine, bile duct and stomach. Surgery may be followed by chemotherapy or a combination of chemotherapy and radiation. If the tumor has spread into surrounding tissue or organs and cannot be removed by surgery, then the treatment becomes medical and focused on the control of the disease and optimal symptom relief with a chance for increased survival.

An estimated 52 percent of pancreatic cancer patients are diagnosed with late stage pancreatic cancer that has spread to distant organs or sites. Chemotherapy alone, without surgery or radiation, is the recommended treatment for patients at this stage. The goal of treatment in this case is palliative care - optimal relief of symptoms and improvement in quality of life. Unfortunately, only two percent of pancreatic cancer patients who are diagnosed at this stage will survive for more than five years.

For more information on endoscopic procedures for pancreatic cancer and to find a physician in your area, log on to http://www.asge.org. To learn more about the Pancreatic Cancer Action Network, please visit http://www.pancan.org.

About the Pancreatic Cancer Action Network

The Pancreatic Cancer Action Network is the only national organization creating hope in a comprehensive way through research, patient support, community outreach and advocacy for a cure. The organization raises money for direct private funding of research -- and advocates for more aggressive federal research funding of medical breakthroughs in prevention, diagnosis and treatment of pancreatic cancer. The Pancreatic Cancer Action Network fills the void of information and options by giving patients and caregivers reliable, personalized information they need to make informed decisions. We create a sense of hope and community so no one has to face pancreatic cancer alone. The organization helps support individuals and communities all across the country to work together to raise awareness and funds to find a cure for pancreatic cancer.

About the American Society for Gastrointestinal Endoscopy

Founded in 1941, the mission of the American Society for Gastrointestinal Endoscopy is to be the leader in advancing patient care and digestive health by promoting excellence in gastrointestinal endoscopy. ASGE, with nearly 11,000 members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit http://www.asge.org and http://www.screen4coloncancer.org for more information.

About Endoscopy

Endoscopy is performed by specially-trained physicians called endoscopists using the most current technology to diagnose and treat diseases of the gastrointestinal tract. Using flexible, thin tubes called endoscopes, endoscopists are able to access the human digestive tract without incisions via natural orifices. Endoscopes are designed with high-intensity lighting and fitted with precision devices that allow viewing and treatment of the gastrointestinal system.

American Society for Gastrointestinal Endoscopy
http://www.asge.org