Medical expert discusses pancreatic cancer

Oct 06, 2011

Steve Jobs, a co-founder of Apple Inc., who suffered from a rare form of pancreatic cancer, died Wednesday at age 56.

Pancreatic cancer expert Anitra Talley will live chat with readers Thursday at 2:30 p.m. EST. Talley will discuss pancreatic cancer, the symptoms, how it's treated and more.

Ask questions now!

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Hello, this is Anitra Talley, Director of Patient Services & Medical Relations at the Pancreatic Cancer Action Network.  I welcome any questions you have about pancreatic cancer and the services we provide.

Is there any proven, specific, successful treatment plans for this type of cancer?

Treatment options for pancreatic neuroendocrine cancer are somewhat limited. Surgical removal of the tumor is a common treatment. Some patients may benefit from chemotherapy, targeted therapy, radiation and/or hormonal therapy. At this time, there isn’t a standard of care, or standard treatment, for pancreatic neuroendocrine cancer. Two targeted therapy drugs, Afinitor® (everolimus) and Sutent® (sunitinib), were recently approved by the U.S. FDA to treat advanced pancreatic neuroendocrine tumors and may be beneficial for some patients.

Clinical trials are an option for obtaining treatments that are on the leading edge of medicine. Several therapies are currently being tested for the treatment of pancreatic neuroendocrine tumors in clinical trials.  The Pancreatic Cancer Action Network recommends that all pancreatic cancer patients consider clinical trials when exploring treatment options.

Steve Jobs was adopted and may not have known his family medical history. How important is family history in determining one's risk for pancreatic cancer? Does it have a genetic component?

Few risk factors for developing pancreatic cancer are defined. Family history of the disease is one risk factor.  Approximately ten percent of pancreatic cancer cases are hereditary.  There are family registries and early detection studies for people who have a family history of the disease.  

When you say a "rare form"...I thought pancreatic cancer didn't have "forms."  I thought itt was just rare to have it.  My mother died of pancreatic cancer in '95.  Doctors wouldn't operate because she had been on blood thinners.

What are the symptoms and what "specialist" should you go to to detect it asap?  Also, what lab work can be done yearly to detect it (the tumor blood work?)?

There are several forms of pancreatic cancer.  Adenocarcinoma is the most common form of the disease.  Steve Jobs had a different type of pancreatic cancer, a pancreatic neuroendocrine cancer, which accounts for less than 5% of pancreatic cancer diagnoses.

Pancreatic cancer may cause only vague symptoms that could indicate many different conditions within the abdomen or gastrointestinal tract. Symptoms include pain (usually abdominal or back pain), weight loss, jaundice (yellowing of the skin and eyes), loss of appetite, nausea, changes in stool, and diabetes.

Symptoms of pancreatic neuroendocrine tumors vary depending on the specific type of pancreatic neuroendocrine tumor.  They may cause high hormone levels in the blood which may result in symptoms including weight loss, nausea, vomiting, muscle weakness and skin rash. Some pancreatic neuroendocrine tumors do not overproduce pancreatic hormones. They are generally detected because of pain or jaundice caused by the large size of the tumor.

Gastroenterologists who are experienced in pancreatic cancer may be able to help with diagnosis and detection.  

At this time, there is no standard early detection or screening tool, such as a blood test.

Is pancreatic cancer an equal opportunity cancer? I mean can anyone get it or is there things that lead to it like smoking and lung cancer? And why is it the most deadly of all the cancers?

Pancreatic cancer can affect anyone.  There are some risk factors including a family history of the disease, smoking, age, and diabetes.  

One of the reasons that pancreatic cancer is so  deadly is that it is difficult to diagnose.  Symptoms are vague and most patients are diagnosed at a late stage when the cancer has spread to other organs.  Additionally, few effective treatment options exist.

More research funding is needed so that scientists can better understand the biology of pancreatic cancer, find better treatment options and develop early detection methods.

The Pancreatic Cancer Action Network (PanCan) now hopes to "double the pancreatic cancer survival rate" by 2020. Based on your work at Hopkins and the field more generally, do you view this goal (i.e., 12 percent survival at 5 years) as realistic -- or merely an optimistic rallying cry for increased funding for research and advocacy? Thanks for your time, -Patrick Grzanka (my father passed away in February 2011 after 27 months of pancreatic cancer treatment at Hopkins)

The Pancreatic Cancer Action Network is leading the way to increase the survival rate for people diagnosed with this devastating disease through a bold initiative—The Vision of Progress: Double the Pancreatic Cancer Survival Rate by 2020. Together, we can know, fight and end pancreatic cancer by intensifying our efforts to heighten awareness, raise funds for comprehensive private research, and advocate for dedicated federal research to advance early diagnostics, better treatments and increase chances of survival.

 

We, along with our Medical & Scientific Advisory Boards and others in the medical community, absolutely believe that this is a realistic goal.  There is exciting, cutting-edge research taking place, there are many clinical trials available that will advance the treatment of this disease, and more people are getting involved in the cause to raise awareness about the urgent need to make progress in this disease.  

How reliable are tests for early screening for Pancreatic Cancer?

There is no standard test to screen for pancreatic cancer.  Studies are underway to find a screening tool.

Can you explain the difference between islet cell pancreatic cancer like Jobs had and the more common adenocarcinoma variant? Does this explain his relatively long survival with the disease (years vs. months)?

The five-year survival rate for pancreatic adenocarcinoma, the most common form of pancreatic cancer, is only 6%.

The average five-year survival rate for pancreatic neuroendocrine tumors is 42%.

Theses two types of pancreatic cancer arise from different types of cells in the pancreas.

How does the stage of this cancer when first diagnosed affect the treatment options available?

Early stage pancreatic cancers may be able to be treated surgically.  Once the cancer has spread, and is no longer operable, pancreatic cancer is usually treated with chemotherapy and/or targeted therapies.

Clinical trials are available for patients with all stages of pancreatic cancer.

Treatment options may vary for patients with pancreatic neuroendocrine cancers.

Also is alcohol consumption a risk factor?

Studies have shown conflicing results on this matter.  More research is needed to determine if alcohol consumption is a true risk factor for the disease.

Was this the same sort of pancreatic cancer that afflicted Randy Pausch (The Last Lecture)??

No.  Randy Pausch suffered from the most common form of pancreatic cancer, pancreatic adenocarcinoma. 

There seems to be an increase in reports of pancreatic cancer. Is it more prevalent today than it has been in the past?

Pancreatic cancer is on the rise, likely due to an aging population.  If nothing is done to impact the upward trend, 5 years from now nearly 200,000 Americans will have been diagnosed with the disease. We must change the course of this disease. 

It is time for me to sign-off.  Thank you all for your questions.  If you have further questions, please feel free to contact the Pancreatic Cancer Action Network's Patient and Liaison Services (PALS) program at 877-272-6226 or visit our website at www.pancan.org.  Thank you!

In This Chat
Anitra Talley
Anitra Talley is the Director of Patient Services & Medical Relations at the Pancreatic Cancer Action Network. Talley worked in a number of capacities within the PAL program. Most recently she worked as the PALS Manager of Operations. In this role she was responsible for managing and overseeing the PALS call-in program, training new team members, and ensuring the high quality of the information provided by PALS Associates. In her current and previous roles, Anitra has been committed to providing pancreatic cancer survivors and their loved ones with the best service possible.

Anitra graduated from the University of Minnesota - Twin Cities with a B.S. in Biology and a minor in Spanish Studies. Before joining the Pancreatic Cancer Action Network, she gained a tremendous amount of experience working and volunteering in a number of health related capacities. Also, as part of her studies for the College of Biological Sciences Honors Program, Anitra worked in a thoracic oncology laboratory where she conducted research for a thesis project.
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