Over the past two decades, a growing number of men and women have been diagnosed with pancreatic cancer, which is sometimes referred to as a silent killer because it's more difficult to detect in its early stages. Blacks are not only more likely to be diagnosed with pancreatic cancer, they are also more likely to be diagnosed at an advanced stage.
"We knew that there was a trend [of younger patients] in colon cancer, but we didn't know about pancreas cancer. So, I decided to see if there was a real trend. Was it just that I happened to see those few young patients disproportionate to everybody else in the field," Dr. Srinivas Gaddam, who is an assistant professor of medicine in the Karsh Division of Gastroenterology and Hepatology at Cedars-Sinai Medical Center in Los Angeles says. "It turns out to be true."
Even more surprisingly, they found the disease was disproportionately growing in younger women, those under age 55, and especially among those aged 15 to 34, though the sample size was small. Pancreatic cancer has typically been more common in men.
If the current trend continues, researchers said pancreatic cancer among women aged 15 to 34 would grow to be 400% of that experienced by men of the same ages by 2040.
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Without knowing why, the answer for now is left open to speculation. It could be that women have a disproportionately high exposure to some environmental risk factor in recent decades that researchers don't understand yet, Gaddam says.
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Risk factors
Although you can't change risk factors such as age, gender, race, family history and inherited genetic syndromes, there are some risk factors that you can change to decrease your risk of developing pancreatic cancer.
Risk factors that you can change:
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- Tobacco use
- Being overweight
- Workplace exposure
- Diet
- Pyshical inactivity
- Coffee
- Alcohol
A deadly disease if not caught early
The difficulty in diagnosing pancreatic cancer is that there is no solid screening test to identify it early and patients don't have symptoms until quite late in the disease, Gaddam says.
Despite tremendous advances in cancer detection and treatment for other types of cancer, the five-year survival rate of pancreatic cancer has improved from 3% to just 10% over the past several decades, Gaddam adds.
As mentioned above risk factors include family history, obesity or smoking, but they are not
fairly strong predictors for pancreatic cancer, Gaddam notes. Doctors also look for jaundice with no abdominal pain, profound, unexplained weight loss or a new diagnosis of diabetes.
Questions remain
"Obviously not all causes of a new diagnosis of diabetes are cancer, or not everyone that has weight loss has pancreas cancer. So, we have to be really careful about that, but we look for these subtle tell-tale signs when we talk to our patients," Gaddam shares.
Many people with pancreatic cancer have very vague symptoms in the beginning, such as minor abdominal discomfort or indigestion, according to Dr. Sajan Nagpal, an assistant professor in the department of medicine at the University of Chicago.
Longstanding diabetes and chronic pancreatitis are other risk factors.
By the time the cancer is detected, 80% of patients are no longer eligible for surgery, the only way to cure the cancer, Nagpal notes. Other treatments include chemotherapy and radiation.
"The actual number of people that are successfully able to get surgery is even smaller, which is why the outcomes from pancreatic cancer remain poor," Nagpal adds. "It would be great if we could identify patients at an earlier stage, because that would mean patients would qualify for surgery and we could improve outcomes in these patients."
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What can you do?
Doctors are calling for more research to better understand why more Blacks and women are being affected by pancreatic cancer. In the meantime, aside from lowering your risk factors, Gaddam suggests having conversations to learn about your family history. If you are worried about pancreas cancer in your family, or see a trend, you should talk to their doctor about it.
