Category Archives: Pancreatic Cancer

Pancreatic cancer: are you at risk?

Heidi Mallis, Cancer Prevention & Treatment Fund

Pancreatic cancer is the 3rd leading cause of cancer death among women and men in the U.S.[1]

Surprising Facts

  • The five-year survival rate is less than 8%. This figure has improved only slightly since 1975, when it was 3%.[2]
  • There is no reliable screening test for early detection of pancreatic cancer.[3]
  • Only about 2.5% of the National Cancer Institute’s federal research funding is currently allocated to pancreatic cancer.[4]
  • Pancreatic cancer has claimed the lives of several public figures including: actors Patrick Swayze and Alan Rickman, opera tenor Lucianno Pavarotti, and professor and bestselling author Dr. Randy Pausch.[5]

Risk Factors

Every year, more than 50,000 people are diagnosed with pancreatic cancer in the U.S., and more than 40,000 people die from the disease.[6] It is known as a “silent killer” because its symptoms (pain, jaundice, and weight loss) can easily be mistaken for other diseases. Diagnosis is often at an advanced stage when the cancer has spread to other parts of the body, making treatment more difficult. That is why new research is needed to help identify earlier warning signs that could lower the fatality rate for this disease.

Several risk factors are known. Most are common and can’t be changed. The following traits increase your risk of developing pancreatic cancer:

  • 60 years of age or older
  • African American
  • Male
  • Smoking:  Smokers are 2-3 times more likely to develop pancreatic cancer than nonsmokers, and smoking is responsible for 20-30% of all pancreatic cancer cases.
  • Type 2 diabetes:  Several studies show that people with diabetes are more likely to also develop pancreatic cancer and vice versa, but it is unclear whether diabetes causes pancreatic cancer or is caused by pancreatic cancer.[7][8]
  • Family history of pancreatitis (inflammation of the pancreas), ovarian, or colon cancer. If a person has an immediate family member who has any of these types of cancer, his or her chance of developing pancreatic cancer is tripled.[9]

Research has shown that family history or shared genes were a risk factor for pancreatic cancer. In 2009, new light was shed on the role of genes when a new study showed that people with blood type O may have a lower risk of pancreatic cancer than those with blood types A, B, or AB. The study was conducted by a group of researchers from several academic institutions that are part of the Pancreatic Cancer Cohort Consortium, which is affiliated with the National Cancer Institute (NCI).[10] The group hopes to further examine genetic risks, and future findings could help increase early detection and prevention of pancreatic cancer.

Regardless of blood type and other risk factors, individuals can reduce their risk of developing pancreatic cancer by lowering controllable risk factors. A study revealed that a diet rich in fresh fruit and vegetables, Vitamin C, and fiber might actually reduce the risk of developing pancreatic cancer.[11] Other risk factors, such as smoking or diabetes related to weight gain, can be reduced by quitting smoking and maintaining a healthy weight, which decreases a person’s risk of many other diseases as well. In addition, one study of 60,000 adults indicates that drinking fewer (non-diet) soft drinks may decrease the risk of pancreatic cancer.[12] The authors suggest that sugary drinks, by increasing insulin levels, help fuel pancreatic cancer cell growth. They also speculate that people who consume more soft drinks tend to be more likely to smoke and to eat red meat, all of which are considered potential risk factors for pancreatic cancer.

All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.

References

  1. Cancer Treatment Centers of America. (2016, October). What should you know about pancreatic cancer? http://www.cancercenter.com/~/media/Images/Others/Misc/10-2016-pancreatic-infographic.jpg
  2. National Cancer Institute. (2016, April). Cancer Stat Facts: Pancreas Cancer. https://seer.cancer.gov/statfacts/html/pancreas.html
  3. American Cancer Society (2017). Can cancer of the pancreas be found early? https://www.cancer.org/cancer/pancreatic-cancer/detection-diagnosis-staging/detection.html
  4. Office of Budget and Finance. Fiscal year 2015 fact book. National Cancer Institute. https://www.cancer.gov/about-nci/budget/fact-book/data/research-funding
  5. Pancreatic Cancer Action Network (2016). Public figures affected by pancreatic cancer. http://media.pancan.org/pdf/Public-Figures-affected-by-pancreatic-cancer.pdf
  6. American Cancer Society (2017). Key statistics for pancreatic cancer. https://www.cancer.org/cancer/pancreatic-cancer/about/key-statistics.html
  7. Coughlin SS, Calle EE, Teras LR, Petrelli J, Thun MJ (2004). Diabetes mellitus as a predictor of cancer mortality in a large cohort of US adults. American Journal of Epidemiology, 159: 1160-1167.
  8. European Cancer Organisation. (2017, January). Diabetes or its rapid deterioration can be an early warning sign for pancreatic cancer. http://www.eccocongress.org/Global/News/ECCO2017-News/2017/01/ECCO2017-NEWS-Diabetes-or-its-rapid-deterioration-can-be-an-early-warning-sign-for-pancreatic-cancer
  9. National Cancer Institute (2017). Pancreatic cancer. U.S. National Institutes of Health. https://www.cancer.gov/types/pancreatic
  10. Amundadottir L, Kraft P, Stolzenberg-Solomon RZ, et al (2009, August 2). Genome-wide association study identifies variants in the ABO locus associated with susceptibility to pancreatic cancer. Nature Genetics, September 2009; 41(9): 986-990.
  11. Ghadirian P, Lynch HT, and Krewski D (2003). Epidemiology of pancreatic cancer: an overview. Cancer Detection and Prevention, 27(2): 87-93.
  12. Muelle NT, Odegaard A, Anderson A, Yuan J-M, Koh W-P, Pereira MA. Soft Drink and Juice Consumption and Risk of Pancreatic Cancer: The Singapore Chinese Health Study. Cancer Epidemiology, Biomarkers & Prevention. 2010.19(2);447-455.

 

Can a handful of nuts a day keep cancer away?

By Krista Kleczewski and Claire Karlsson

Evidence is growing about the many ways in which eating nuts, seeds, and legumes can improve your health. These foods have been linked to healthier hearts and a lower risk of diabetes, but now studies show they may also cut your risk of getting cancer! Here’s what we know and don’t know.

Several studies show a great benefit from eating nuts, seeds, and legumes. In 2015, a Dutch study of 120,000 men and women between the ages of 55-69 found that those who ate about half a handful of nuts or peanuts each day were less likely to die from respiratory disease, neurodegenerative diseases, diabetes, cardiovascular diseases, or cancer than those who consumed no nuts or seeds.1 The same benefit was not seen for peanut butter, however, which suggests that the salt, vegetable oils, and trans fatty acids in peanut butter may counterbalance the benefits of the peanuts. A 5-year study conducted in Spain of 7,000 men and women aged 55 to 80 years old found that eating at least three servings of nuts per week reduced the risk of cardiovascular and cancer death.2 Another study similarly found eating nuts – especially walnuts — reduces the risk of developing cancers, diabetes and heart disease when eaten in conjunction with the Mediterranean Diet, which also emphasizes fruits, vegetables, whole grains, and legumes.3 Walnuts were highlighted by the study as reducing inflammation associated with certain cancers and other conditions like diabetes and heart disease. More evidence is needed, however, to determine the specific impact of walnuts on cancer risk.

Breast Cancer

Eating large amounts of peanuts, walnuts, or almonds can reduce the risk of developing breast cancer, according to a 2015 study of 97 breast cancer patients. 4 The researchers compared the lifetime consumption of nuts and seeds among the breast cancer patients with the consumption of those without breast cancer, finding that women who ate large quantities were half to one-third as likely to develop breast cancer. No difference was found between people who ate a small amount of nuts and seeds and those who ate none at all, suggesting that a person needs to consume a substantial amount of nuts and seeds over their lifetime to reduce their chances of developing breast cancer.

Girls who regularly eat peanuts and nuts may be less likely to develop breast cancer as adults. In a study published in 2013, girls between the ages of 9-15 who regularly ate peanut butter or any kind of nuts had almost a 40% lower chance of developing benign breast conditions as adults.5 Although not dangerous, benign breast conditions increase a woman’s chances of eventually getting breast cancer.

Many people think of peanuts as nuts, but they are actually a type of legume. Researchers found that eating legumes, which include beans, lentils, soybeans, and corn, may all reduce the risk of benign breast conditions (and therefore, breast cancer).

Can eating nuts, legumes and seeds reduce colorectal cancer risk?

To find out whether snacking on foods with peanuts lowers your chances of getting colorectal cancer (also called colon cancer), researchers studied more than 23,000 adults in Taiwan, ages 30 and older.6 The researchers found that women who ate meals with peanut products at least twice each week were less likely to develop colorectal cancer. More research is needed to see if this benefit is actually from the peanuts.

In one of the largest studies of diet and cancer, which was conducted in 10 European countries, researchers discovered that eating nuts and seeds reduced women’s chances of developing colon cancer, but did not lower the risk for men.7 Women who ate a modest daily amount of nuts and seeds (about 16 peanuts or a small handful of nuts or seeds) every day were less likely to develop colon cancer, and women who ate the largest quantities of these foods were the least likely to develop colon cancer. Again, more research is needed to understand these findings.

Pancreatic Cancer

Eating nuts also seems to lower the risk of developing diabetes,8 which may then lower the risk of developing pancreatic cancer. In addition, a large study of women found that frequently eating nuts was associated with less chance of developing pancreatic cancer,9 one of the most deadly cancers.

What about ovarian cancer?

A 2010 study examined the possible link between ovarian cancer and foods high in phytoestrogens and/or fiber, including nuts, beans, and soy. They found that these foods seemed to help prevent “borderline ovarian cancer”—slow-growing tumors that are less dangerous and more likely to affect younger women. However, these foods did not seem to protect against the more aggressive types of ovarian cancer.10

The Bottom Line

There is growing evidence that nuts, legumes, and seeds reduce the risk for several types of cancer, as well as having other health benefits. Nuts are high in calories, so don’t overdo it. It seems safe to assume that adding these foods to your diet, in small quantities several times a week, is a good idea, especially if you use them to replace less healthy snacks.

This gives new meaning to the name “health nut”!

 

Pancreatic Cancer: Could Bacteria in our Mouth Help us Detect this Deadly Cancer Sooner?

Jessica Cote, Cancer Prevention and Treatment Fund

Pancreatic cancer has one of the worst survival rates of all cancers: 94% of patients die within five years of diagnosis. Pancreatic cancer is the fourth-leading cause of cancer-related deaths in the U.S. and is expected to claim over 37,000 American lives in 2012.[1]

Early Detection Would Improve Survival Rates

Like most cancers with low survival rates, pancreatic cancer is usually not diagnosed until after it has grown and spread to other parts of the body. Because the pancreas plays such a large role in the absorption of foods and the regulation of blood sugar levels, an advanced tumor in the pancreas severely impairs the digestive system and hormone regulation. When the cancer is finally found at this advanced stage, it can be very difficult to remove because the tumor has expanded into nearby blood vessels or organs such as the liver. For those lucky enough to discover the cancer early (only 10% to 15% of cases), tumors can be surgically removed, along with part or all of the pancreas (pancreatectomy). For the more than 80% of cases of pancreatic cancer that can’t be removed by surgery because it is too advanced, treatment includes radiation therapy, chemotherapy, or surgery to remove part of the pancreas, or a combination of the three.[2] These treatments don’t cure the cancer but they can help shrink tumors and slow the cancer’s spread.

Survival rates for pancreatic cancer patients could be greatly improved with a better method for finding and diagnosing the cancer at earlier stages. There is no simple screening test for pancreatic cancer, but new research suggests that testing for oral bacteria using a sample of saliva, gum or plaque might help doctors figure out who has the greatest risk of developing pancreatic cancer.

Could Oral Bacteria Serve as a Warning Sign for Pancreatic Cancer?

A study by Dr. Dominique Michaud and colleagues at Brown University, published in 2012 in the journal Gut, focused on whether high levels of certain types of bacteria in the mouth could serve as a warning sign that a person might later develop pancreatic cancer.[3]

The researchers looked at health data from 519,978 people from 10 European countries, most of whom had provided blood samples as part of a study. Among the half million who participated in the study, 578 had developed pancreatic cancer, and these cancer patients had no additional malignant tumors except some had non-melanoma skin cancer. Only 405 of these patients had previously provided blood samples (five years prior to diagnosis, on average), so they were the focus of this study. The pancreatic cancer patients’ blood samples were compared with blood samples from 416 people of the same sex and close in age who didn’t have any cancer. The blood samples were then tested for antibodies, or proteins produced by the immune system that would show whether or not certain types of bacteria had been present in the person’s mouth.

The people who were diagnosed with pancreatic cancer had higher amounts of three kinds of oral bacteria compared to people without pancreatic cancer. Perhaps most surprisingly, people who had one particular strain of bacteria in their mouth, called Porphyromonas gingivalis, were twice as likely to have developed pancreatic cancer compared to those without the bacteria. Because the blood samples of patients with pancreatic cancer were taken an average of five years before diagnosis of the cancer, it seems like the presence of these specific oral bacteria could serve as a warning sign for pancreatic cancer.

Some bacteria are harmless, and some bacteria are considered “good” rather than dangerous (such as those included in yogurt with active cultures or dietary supplements). People who had lots of harmless or good oral bacteria had almost half the risk of pancreatic cancer compared to those without such high levels of good bacteria.

Together with findings from other research studies, these results suggest that doctors may someday in the future prescribe good bacteria as a treatment, rather than antibiotics which kill bad bacteria. Good bacteria would likely be taken in the form of probiotics, which are supplements designed to reduce damage from antibiotics and other medicines and restore a healthy internal world of bacteria. Researchers are only beginning to learn about the ways bacteria can improve our health, and in what form to deliver good bacteria to people who need them.

What is Porphyromonas gingivalis?

In addition to its link to pancreatic cancer, P. gingivalis is a type of bacteria that is the major cause of periodontal disease, more commonly known as gingivitis or gum disease. Gingivitis is generally caused by long-term deposits of plaque on your teeth. The disease causes inflammation and infection that destroys the tissues around the gums and teeth. Common symptoms of gingivitis include bleeding gums, mouth sores, and sensitive or swollen gums.[4]

To make matters a bit more complicated, the 2012 study also found that some people with healthy gums had quite a bit of P. gingivalis in their mouths.3 This means that the bacteria don’t always cause gingivitis and some people may have loads of P. gingivalis living in their mouth without knowing it. A doctor or dentist might need to perform a test using a sample of saliva, plaque or gum to locate the bacteria.

The researchers at Brown don’t fully understand the relationship between harmful oral bacteria and pancreatic cancer. For instance, they don’t know if oral bacteria like P. gingivalis lead to pancreatic cancer or if cancer in the pancreas somehow promotes the growth of P. gingivalis in the person’s mouth. Or perhaps both the cancer and the bacteria are the result of something else–an infection or some other assault on the body causing inflammation?

Perhaps most importantly, it is still unclear whether treating gingivitis more effectively can reduce the risk of pancreatic cancer, or whether you should get tested for pancreatic cancer if you find out that you have P. gingivalis bacteria. There are several ways to test for pancreatic cancer, but they can be expensive and invasive: you can get an MRI (magnetic resonance imaging) of your pancreas, a CT scan (computerized tomography) of your pancreas, or your doctor can use a scope to take a picture inside your body or take a biopsy (tissue sample) from your pancreas.

Since smoking, being overweight or obese, or having diabetes or long-term inflammation of the pancreas increase a person’s chances of developing pancreatic cancer, you can reduce your risk if you quit smoking, lose weight, and keep your diabetes under control-especially if you have P. gingivalis bacteria.[5] If you have any of those risk factors and haven’t been to the dentist or periodontist lately, get a check-up and ask to be tested for P. gingivalis. Although medical experts aren’t completely certain how to remove these bad oral bacteria, they usually recommend flossing and brushing teeth regularly as well as rinsing with mouthwash as the best ways to get rid of them.

More research is needed to understand the link between oral bacteria and pancreatic cancer, and it will take medical experts some time still before they figure out how best to reduce the number of harmful bacteria in our bodies and increase the good kind.

The Bottom Line:

  • Pancreatic cancer is typically fatal because it is difficult to detect at an early stage. A method for earlier diagnosis would greatly improve chances for survival.
  • New research suggests that people who have a specific type of oral bacteria (P. gingivalis) are twice as likely to get pancreatic cancer as those without the oral bacteria. Also, people with lots of healthy oral bacteria have a much lower risk of pancreatic cancer than those without healthy bacteria.
  • Researchers still aren’t sure if harmful bacteria in the mouth cause pancreatic cancer or if the cancer wipes out healthy bacteria and leads to a person having harmful oral bacteria. More research will help clarify the connection between oral bacteria and pancreatic cancer.
  • Until then, take good care of your teeth and gums (brushing and flossing your teeth, and gently massaging your gums with a toothbrush) and see your dentist regularly. You’ll have a healthier mouth, and you might just have a healthier pancreas, too.

References:

  1. Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Altekruse SF, Kosary CL, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations). National Cancer Institute. Bethesda, MD. http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER web site, April 2012.
  2. Sener SF, Fremgen A, Menck HR, Winchester DP. Pancreatic Cancer: A Report of Treatment and Survival Trends for 100,313 Patients Diagnosed from 1985-1995, Using the National Cancer Database. Journal of the American College of Surgeons 1999; 189(1):1-7.
  3. Michaud DS, Izard J, Wilhelm-Benartzi CS et al. Plasma antibodies to oral bacteria and risk of pancreatic cancer in a large European prospective cohort study. Gut 2012; 00:1-7.
  4. Gingivitis (Gum disease; Periodontal disease). In A.D.A.M. Medical Encyclopedia. PubMed Health: U.S. National Library of Medicine. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002051/.
  5. Pancreatic carcinoma (Pancreatic cancer). In A.D.A.M. Medical Encyclopedia. PubMed Health: U.S. National Library of Medicine. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001283/.