November: A Time for Awareness

November not only marks the beginning of shorter days and longer nights, it is Pancreatic Cancer Awareness month! Pancreatic cancer is the fourth leading cause of cancer-related deaths in the U.S. among both men and women. Here at Digestive Health Specialists, our providers see patients for pancreatic problems in addition to a multitude of digestive issues. It is important to be aware of the risk factors for pancreatic cancer, especially ones that can be modified by lifestyle. I asked our own Dr. Gonzalez and Dr. Jue, who specialize in Pancreatic diseases, some specific questions about this form of cancer. Their answers have been combined to give insight on how you can decrease your risk and why this cancer type is climbing in prevalence.

How can one lessen his or her risk for Pancreatic Cancer through lifestyle?
Patients with familial pancreatic cancer in first and second degree relatives are at a higher risk of developing pancreatic cancer. Breast cancer is also a risk factor associated with certain germline mutation, among which increase one’s risk of pancreatic cancer. Of the risk factors we may be able to control, diabetes has an affiliation to pancreatic cancer but it is unclear whether it is a result of the cancer or if it is a risk factor in itself. There is conflicting data to support both theories. Obesity, physical inactivity, and cigarette smoking all are associated with a much higher risk of developing this form of cancer. With smoking cessation, we could see an approximate 25 percent decrease in pancreatic cancer deaths in our country per year. As for body weight, a BMI of 30 or greater is associated with a significant increased risk of pancreatic cancer in comparison to those with a BMI of less than 23.

Why do you feel this type of cancer is on the rise?
While this disease is rare before the age of 45, incidence rises sharply after that point. There are currently no screening guidelines for this cancer type and most diagnoses of it are made at a late stage with no curative options. With surgery being the only curative treatment, only 15 – 20% of pancreatic cancers are operable at the time of diagnosis. In addition, more than two-thirds of American adults are considered overweight or obese.

What types of procedures are done to address problems of the pancreas?
Patients with symptoms like upper abdominal pain, unexplained weight loss, and jaundice over age 45 should seek medical attention regarding their pancreatic health. Pancreatic problems can be addressed through ERCP, EUS and surgery. Radiology tests of the pancreas include MRCP, CT scans, ultrasound and CT or ultrasound guided biopsies. Lab work related to the pancreas includes amylase, lipase, and CA19-9.