Pancreatic cancer is a very serious condition because it often doesn’t present with any symptoms until it is at an advanced and less treatable stage. Like all cancer types, pancreatic cancers are more treatable with more favorable outcomes when caught early. However, late diagnosis means that patients face lower survival rates and fewer treatment options, making the disease much more complicated to manage.
In light of these facts, screening for pancreatic cancer before symptoms emerge is an increasing healthcare priority. This article will discuss the importance of detecting pancreatic cancer early before discussing different screening methods, guidelines, and the role of lifestyle and preventative measures in reducing the incidence of this disease.
Several characteristics of pancreatic tumors make them challenging to detect in the early stages. First, these tumors rarely present with symptoms at early stages. Second, the internal location of the pancreas at the back of the abdomen (retroperitoneal) makes the use of imaging techniques like ultrasound more challenging. Finally, computed tomography (CT) scans and magnetic resonance imaging (MRI) techniques are not effective in detecting small pancreatic lesions that characterize early-stage pancreatic cancers.
Early-stage pancreatic tumors have more treatment options than late-stage tumors. For instance, surgical techniques, including total and distal pancreatectomy, can be employed to remove the entire tumor and associated tissues. However, this option may not be available in later-stage cancers where the cancer has spread to distant sites.
The 5-year survival rates for pancreatic cancer are 44 percent for localized tumors, 16 percent for regional tumors, and 3 percent for distantly metastasized tumors. These rates are relatively low compared to other cancer types. By comparison, the 5-year survival rates for breast cancer are 99 percent for localized tumors, 86 percent for regional tumors, and 31 percent for distantly metastasized tumors. Lack of early detection and treatment options undoubtedly play a role in the poor prognosis of pancreatic cancers.
Several methods are used for screening pancreatic cancers, including imaging techniques, biomarker testing, and genetic screening.
Several blood biomarkers may offer a non-invasive and more practical alternative to imaging for screening pancreatic cancer.
A marker known as carbohydrate antigen 19-9 (CA19-9) is thought to be elevated in individuals with pancreatic cancer. However, measuring its levels is not sufficient to diagnose the disease. Despite this, it is sometimes used to track the tumor progression and response to therapy. Blood biomarkers are an exciting prospect for cancer screening. However, they may have limited utility in the early stages of cancer when tumors are very small, as is the case in pancreatic cancer.
Specific genetic markers can indicate an increased risk of developing pancreatic cancer. A high incidence of pancreatic cancer within a family likely suggests an inherited genetic component to the disease. Thus, individuals with a family history of pancreatic cancer should seek genetic testing to determine if they are carrying a high-risk genetic variant. Important genes in pancreatic cancer include BRCA2 (which plays a role in other cancers like ovarian and breast cancers) and PALB2.
There are different guidelines for pancreatic cancer screening depending on an individual’s level of risk.
Individuals with a genetic predisposition are considered to be at a higher risk of developing pancreatic cancer. For these individuals, the American Society for Gastrointestinal
Endoscopy (ASGE) recommends EUS or MRI screening, depending on patient preference and other factors.
They also provide guidelines on the age at which to start screening, depending on the specific genetic predisposition. For instance, they recommend starting screening at age 50 or 10 years earlier than the youngest relative with pancreatic cancer for individuals with variants in BRCA2, BRCA1, and PALB2 genes.
Currently, no guidelines recommend general screening for pancreatic cancer in asymptomatic adults. This is because the harms of screening for pancreatic cancer are thought to exceed the benefits in this population. Furthermore, some imaging methods are considered impractical for general screening programs.
Several new technologies are on the horizon for pancreatic cancer screening. Liquid biopsies, which analyze factors found in bodily fluids like blood, can be used to detect cancer markers. These markers include CA19-9, as mentioned above, but also include circulating tumor cells and circulating tumor DNA.
Research suggests that measuring the levels of various metabolites (by-products of metabolism) may also help screen pancreatic cancer. The search for new markers of pancreatic cancer is an ongoing area of research.
New imaging techniques also hold promise in improving the detection and accurate diagnosis of pancreatic cancer. Contrast-enhanced ultrasound (CEUS) is an advanced imaging technique that is better at distinguishing different types of pancreatic cysts and tumors than other methods.
Lifestyle plays an important role in pancreatic cancer risk. Excess body weight, diabetes, and consumption of tobacco, red meat, and alcohol may increase risk.
Thus, health-conscious individuals can make informed decisions in their daily lives to reduce risk. Many of these tips can reduce the risk of other diseases in addition to pancreatic cancer:
In addition to these measures, individuals should be aware of symptoms and understand their personal risk of pancreatic cancer. Symptoms of pancreatic cancer can include:
It’s important to note that all of these symptoms can arise for other reasons, and so do not always mean that pancreatic cancer is present. Consult with a healthcare professional if you have particular concerns.
Early detection of pancreatic cancer is critical due to its typically late presentation and aggressive nature. Screening methods like imaging tests, blood biomarkers, and genetic testing can significantly improve survival rates by identifying the disease at a more treatable stage. Screening is specifically recommended for individuals at high risk due to genetic predisposition. Additionally, lifestyle modifications such as maintaining a healthy diet, quitting smoking, and reducing alcohol consumption can lower the risk of developing pancreatic cancer. By staying informed about risk factors and symptoms, individuals can proactively manage their health and seek timely medical advice.
Consult with your healthcare provider if you are concerned about symptoms or your risk of developing pancreatic cancer. Remember: Screening increases the chances of finding cancer early and can significantly improve survival.
If you want to be proactive about your health, why not book an Ezra full-body MRI? Our annual scan catches potential cancer earlier, leveraging AI through the screening process to make it more efficient, affordable and faster.
