As much as 95 percent of people diagnosed with pancreatic cancer die. Often overshadowed by other, more well-known malignancies like breast and lung cancers, this unassuming organ can harbor tumors that spread silently through the body. Once a patient shows symptoms, it may be too late for effective treatment.
It’s time to shine a light on this deadly cancer and work towards finding innovative treatments.
Pancreatic Cancer, Survival, and Mortality
Pancreatic cancer is one of the leading causes of cancer-related deaths. In 2022, an estimated 62,210 Americans had the disease. 49,830 of them (over 80 percent) did not survive.
Pancreatic cancer survivorship varies depending on the stage of cancer at the time of diagnosis. According to the American Cancer Society (ACS), the five-year relative survival rate for pancreatic cancer is approximately 12 percent for all stages combined. If diagnosed early or detected before it metastasizes (spreads) to another area, the five-year survival rate can be as high as 44 percent. Unfortunately, most pancreatic cancers have already metastasized at the time of diagnosis. In such cases, the five-year survival rate drops to 3 percent.
What Makes Pancreatic Cancer Difficult to Detect?
Pancreatic cancer is difficult to detect for several reasons.
The pancreas is deep in the abdomen, making it impossible to feel for lumps or masses through a physical exam. Symptoms are also uncommon with early-stage pancreatic cancer, or the signs are vague and nonspecific such as abdominal pain and digestive issues. Because of how “ordinary” these symptoms seem, most patients mistake them for less serious illnesses like the flu, opting for over-the-counter medication instead of seeing a doctor.
For the few who seek medical care, unfortunately, early-stage pancreatic tumors may not appear on imaging tests. If CT and MRI scans do detect abnormalities, they may still fail to distinguish between benign and malignant growths. In most cases, a biopsy is necessary to confirm the diagnosis, which involves taking a tissue sample from the pancreas for examination under a microscope.
In consequence, up to 80 percent of cases are diagnosed at later, more complicated-to-treat stages, contributing to poor prognoses and high mortality rates.
Current Treatments for Metastatic Pancreatic Cancer
Doctors employ the following methods for pancreatic cancer care:
- Surgery: Involves removing some or all of the pancreas, tumors, surrounding tissues, and affected lymph nodes to address cancer.
- Chemotherapy: Involves using drugs to kill cancer cells throughout the body. Doctors often combine chemo with surgery and/or radiation therapy to treat cancer.
- Radiation therapy: Uses high-energy electromagnetic rays to prevent cancer proliferation.
- Chemoradiation therapy: A combination of chemotherapy and radiotherapy for improved outcomes.
- Targeted therapy: Uses drugs that target specific molecules or proteins involved in the growth and spread of pancreatic cancer cells.
In 2020, the American Society of Clinical Oncology released groundbreaking guidelines on new therapy options for metastatic pancreatic cancer. The recommendations – which include using FDA-approved drugs such as Pembrolizumab, Olaparib, Larotrectinib, and Entrectinib – could improve prognoses and provide new hope for eligible patients with high microsatellite instability or mismatch repair deficiency, BRCA mutations, and TRK alterations. The report also includes crucial information for second-line chemotherapy and palliative care.
According to a 2021 cancer treatment review, oncologists use cutting-edge techniques such as surgical resection and adjuvant chemotherapy to combat pancreatic ductal adenocarcinoma in local stages. They also employ different drug regimens, including FOL-FIRINOX and gemcitabine combined with nab-paclitaxel, which a 2013 study found to have increased survival in patients with advanced pancreatic cancer. Most oncologists customize treatment plans to meet the unique circumstances of individual patients. However, contrary to the conclusion of the aforementioned 2013 study, the overall prognosis has not dramatically improved.
Recent Advances on Pancreatic Cancer Treatment
In response, scientists have an ongoing mission to develop more precise treatments to address pancreatic cancer and prolong patient survival.
As we discussed immunotherapy for pancreatic cancer in a previous article, we will not include it in this list.
1. Polymerase Inhibition Therapy
Earlier in our discussion, we mentioned Olaparib as one of the recommended drugs for pancreatic cancer. It blocks poly (adenosine diphosphate–ribose) polymerase (PARP). Inhibiting PARP prevents cancer cells from repairing damage to their DNA, ultimately causing death in these malignant cells.
We have also mentioned BRCA mutations. BRCA1 and BRCA2 genes are commonly associated with breast cancer. However, these genes also increase risks for ovarian and pancreatic cancer.
BRCA genes and PARP inhibitors interact by exploiting the DNA repair defects occurring in cells with BRCA mutations. PARP inhibitors can block the cancer cell-repairing activity of PARP, leading to synthetic lethality in malignant cells with BRCA mutations.
PARP inhibitors are a promising alternative treatment option for pancreatic cancer patients with BRCA mutations. In a 2019 randomized trial involving 154 patients with pancreatic cancer, 92 received Olaparib, while 62 received a placebo. With a 7.4 months and 3.8 months respective difference, survival was longer in the Olaparib group than in the placebo group.
2. Local Intraperitoneal Nanotherapy
Local intraperitoneal nanotherapy involves using nanoparticles to deliver therapeutic agents to the serous membrane surrounding the abdominal cavity (peritoneum). The science behind this approach stems from pancreatic cancer’s tendency to spread to the peritoneum, leading to the development of peritoneal metastases that often resist conventional therapies.
Medical engineers can program nanoparticles to contain properties suitable for delivering therapeutic agents to cancer cells in the peritoneum.
In local intraperitoneal nanotherapy for pancreatic cancer, oncologists may inject nanoparticles directly into the peritoneal cavity, where they can interact with cancer cells. The nanoparticles can dispatch various therapeutic agents, including chemotherapy drugs, small interfering RNA (siRNA), or immunotherapy agents, to the malignant cells. Medical engineers can also program nanoparticles to release therapeutic agents in response to specific stimuli, such as changes in pH or temperature, which may help enhance the treatment’s precision and efficacy.
Preclinical trials highlight nanotherapy’s strong potential to treat pancreatic cancer. For example, a 2020 study published in ACS Publishing showed that nanoparticle-based therapy effectively delivered anti-miR-210 (for inactivating stroma-producing pancreatic stellate cells) and siKRASG12D (for eliminating pancreatic cancer cells). In conclusion, the trial reduced tumor growth and improved survival rates.
3. Targeting Cancer-Associated Fibroblasts
Targeting cancer-associated fibroblasts (CAFs) is an emerging treatment strategy for pancreatic cancer. CAFs are stromal cells present in the microenvironment of malignant pancreatic tumors. They play a key role in pancreatic cancer progression and aggressiveness, promoting tumor growth, invasion, and metastasis. CAFs also contribute to drug resistance development, making it difficult to kill pancreatic cancer cells using standard therapies.
Breaking down cancer treatment barriers requires specialized drugs that target CAFs. Medical researchers are working on a myriad of approaches, including small molecule inhibitors, monoclonal antibodies, and nanoparticle-based therapies, to inhibit or eliminate harmful cells from the tumor microenvironment. With effective CAF-targeted therapies, we may soon gain the upper hand in the war on pancreatic cancer.
New Hope for Metastatic Pancreatic Cancer Patients
Gain access to innovative cancer therapies unavailable in most high-income nations. New Hope Medical Center in Mexico offers alternative cancer treatment options that may stimulate tumor regression in patients with advanced-stage pancreatic cancer. Contact us at 480-757-6573 to schedule a consultation and learn how we can provide groundbreaking healthcare solutions.