Looking for early warning signs of pancreatic cancer

An early cancer in the pancreas does not cause a lesion that can be felt, and it rarely causes symptoms that could prompt definitive medical treatment until it has escaped the borders of the pancreas and spread elsewhere.

But scientists are studying one possible early warning sign: a link between pancreatic cancer and newly developed type 2 diabetes. Diabetes also originates in the pancreas, which contains specialized cells that produce the hormone insulin that regulates blood sugar. And while it’s not yet known which comes first, diabetes or cancer, some research suggests that the recent development of type 2 diabetes may herald the existence of cancer in this organ.

New developments in cancer research

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Progress in the field. In recent years, advances in research have changed the way cancer is treated. Here are some recent updates:

Chemotherapy. A quiet revolution is underway in cancer treatment: a growing number of patients, especially those with breast and lung cancer, are sparing the dreaded treatment in favor of other options.

Leukemia. After receiving a new treatment called CAR T-cell therapy more than a decade ago, two patients with chronic lymphocytic leukemia saw the blood cancer disappear. Their cases offer hope for people with the disease and create some new mysteries.

esophageal cancer. Nivolumab, a drug that unleashes the immune system, was found to extend survival times in patients with the disease who participated in a large clinical trial. Esophageal cancer is the seventh most common cancer in the world.

An early 2005 study of 2,122 residents of Rochester, Minn., by Dr. Suresh T. Chari, now a gastroenterologist at the University of Texas MD Anderson Cancer Center, found that people were six years old within three years of being diagnosed with diabetes. up to eight times more likely than the general population to develop pancreatic cancer. He, along with colleagues at the Mayo Clinic, also identified a gene called UCP-1 that may predict the development of this cancer in people with diabetes.

More recently, Dr. Maxim S. Petrov, professor of pancreatology at the University of Auckland School of Medicine, conducted a September 2020 study in New Zealand of nearly 140,000 people with type 2 diabetes or pancreatitis, or both, who were followed for more than up to 18 years. The findings revealed that those who developed diabetes after a bout of pancreatitis were seven times more likely to develop pancreatic cancer than others with type 2 diabetes.

In 2018, the National Cancer Institute launched a study enrolling 10,000 people ages 50 to 85 with newly diagnosed diabetes or elevated blood sugar levels. Participants will donate blood and tissue samples, and researchers will follow them in hopes of finding clues to early detection in those who develop pancreatic cancer.

Another effort started last summer by the Pancreatic Cancer Action Network, called the Early Detection Initiative for Pancreatic Cancer, will enroll more than 12,000 participants with elevated blood sugar levels and new-onset diabetes. Half will have periodic blood tests and abdominal imaging based on their age, body weight and blood glucose levels to look for evidence of early pancreatic cancer, while the others will serve as controls.

The aim of such studies is to identify biological markers, such as certain genes or proteins secreted by the tumor, that can be used in screening tests to indicate the presence of cancer when it may still benefit from surgery. Unfortunately, the results are probably not known before 2030, if that is the case then.

Meanwhile, Dr. Wolpin said doctors should consider a “checklist” of warning signs that could alert them to the presence of an early, curable cancer. Among other things, he said whether a patient’s glucose level rises quickly and is difficult to control with diabetes medication; whether patients with diabetes lose weight without explanation such as a change in diet or exercise; or if patients have been fine for years and then suddenly, in their early 70’s, they develop diabetes and it’s not clear why.

This post Looking for early warning signs of pancreatic cancer

was original published at “https://www.nytimes.com/2022/02/07/well/live/pancreatic-cancer-warning-signs.html”