A moment for measured optimism in the ongoing battle to tackle pancreatic cancer

·4 min read

Over the past few years, we have lost several iconic figures to the same deadly disease, Supreme Court Justice Ruth Bader Ginsburg, Congressman John Lewis and “Jeopardy!” host Alex Trebek. Each of these leaders – and thousands of other fathers and mothers, sisters and brothers, lovers and friends passed away after losing a hard-fought battle with pancreatic cancer, one of the deadliest of all cancers.

In the oncology world, pancreatic cancer has frustrated doctors, scientists and other experts for decades, while causing untold suffering for patients. Often called “the silent killer,” pancreatic cancer usually does not carry symptoms until the tumors have advanced to the point where they invade nearby organs.

Alex Trebek
Alex Trebek

Though pancreatic cancer is relatively uncommon, it exacts a significant toll, accounting for about 3% of all cancers in the United States and about 7% of all cancer deaths.

However, we have cause for measured optimism as we mark Pancreatic Cancer Awareness Month. The reason is that over the past decade, there have been more advancements in our understanding of the biology of pancreatic cancer than we have seen in a generation. In addition, there have been small but real improvements in the available treatments. Thanks to these small-but-steady improvements, pancreatic cancer patients are living longer, fuller lives.

The battle will continue, but we are in our strongest position yet.

Facing a challenging foe

To appreciate the progress made, it is important to understand why pancreatic cancer is such a formidable opponent. For one, there is no reliable screening test, making it among the most difficult cancers to detect in time to effectively treat. We estimate that more than half of pancreatic cancer patients are diagnosed when the condition is already metastatic – meaning it has spread to other parts of the body and thus more difficult to treat.

In addition, unlike with some other cancers, pancreatic cancer is not as receptive to immunotherapy treatments now available. Surgery for pancreatic cancer is also more complex than many other cancer surgeries.

A steady stream of progress

The severity of these challenges makes the accomplishments in treatment and research of the past decade more impressive. These include advancements in surgery that allow patients to better tolerate the procedures. Doctors now use techniques such as blood vessel removal and minimally invasive, robotic surgery to target the cancer in a way that’s more precise and easier on the patient.

Other advances include a post-surgery drug regimen that has the potential to extend survival rates for some patients by nearly five years. We also know that a class of drugs known as PARP inhibitors, successfully used to treat hereditary breast and ovarian cancer, has shown promise in treating pancreatic tumors in people with specific inherited gene mutations.

And while pancreatic cancer does not yet respond well to immunotherapies, doctors are making gradual improvements in understanding its tricky molecular makeup.

Rep. John Lewis , D-Ga., leads a rally in Selma, Ala., in 2013.
Rep. John Lewis , D-Ga., leads a rally in Selma, Ala., in 2013.

At Memorial Sloan Kettering Cancer Center, where we treat patients with pancreatic cancer, we are running clinical trials. Our colleague Vinod Balachandran, in partnership with BioNTech, is exploring how mRNA technology can yield a potential treatment for patients suffering from the disease. BioNTech is the developer of the mRNA Pfizer-BioNTech COVID-19 vaccine.

Researchers say the use of mRNA technology, in conjunction with checkpoint inhibitor drugs like pembrolizumab, have the potential to boost immune responses and train a person’s immune system to recognize and attack pancreatic tumor cells.

The case for optimism

These small advances are providing researchers and doctors with renewed optimism when it comes to treating pancreatic cancer. Indeed, the five-year survival rate for people diagnosed with the disease has increased significantly over the past several years. People diagnosed with the disease have more options than ever, and we can think differently about a diagnosis that once left very little room for hope.

Supreme Court Justice Ruth Bader Ginsburg poses for a portrait on Apr 27, 2009.
Supreme Court Justice Ruth Bader Ginsburg poses for a portrait on Apr 27, 2009.

To maintain this level of progress, we must increase our funding support for pancreatic cancer research. While the public’s awareness of this disease has grown in recent years due to the deaths of high-profile individuals such as Ruth Bader Ginsburg, John Lewi and Alex Trebek, there is still insufficient funding for the doctors, scientists and other experts trying to beat this disease.

We urge the scientific community to increase its support for the doctors and scientists who treat and research pancreatic cancer. And in the meantime, we urge people with pancreatic cancer – or anyone with a loved one with the disease – to stay positive and draw inspiration from the momentum we are building each day.

Dr. William R. Jarnagin is chief of Hepatopancreatobiliary Service and the Leslie Blumgart Chair in Surgery at Memorial Sloan Kettering Cancer Center. Dr. Alice Wei is surgeon and co-director of Surgical Initiatives at the David M. Rubenstein Center for Pancreatic Cancer Research at Memorial Sloan Kettering Cancer Center.

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This article originally appeared on USA TODAY: Pancreatic cancer treatments are improving, and there's cause for hope

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