Pancreatic Cancer: Can It Be Prevented?

Pancreatic cancer isn’t common, making up just 3 percent of all cancer cases in the U.S. At first glance, the numbers seem reassuring, but in reality, pancreatic cancer is rarely caught early, and its 5-year survival rate is just 10 percent. It is the third leading cause of cancer deaths in the U.S., behind the much more commonly diagnosed lung and colon cancer.

While the numbers are grim, the experts at Miami Cancer Institute, a part of Baptist Health, say if you better understand your risk for pancreatic cancer, you can modify the risk factors that can be changed. On World Pancreatic Cancer Day, Thursday, Nov. 18, the Institute held a free informational program to build awareness.

Is It In Our DNA?

Domenech Asbun, M.D., a hepatobiliary and pancreatic surgeon at Miami Cancer Institute

“Every cell in our body has a rule book of sorts and that is our DNA,” explained Domenech Asbun, M.D., a hepatobiliary and pancreatic surgeon at the Institute. “When there are changes in that rule book, cells can mutate and grow in an uncontrollable fashion. Most people want to know if these changes are a matter of nature or nurture.”

Physician scientists have determined that in most cases, it’s a combination of the two. “We can be born with changes in our DNA that will predispose us to develop cancer at some point in our lives but there are also environmental factors,” Dr. Asbun said.

The first step in understanding your risk is knowing your family history ― and not just for pancreatic cancer, but for other cancers as well. About 10 percent of pancreatic cancers are associated with some familial or inherited factor. For example, those with the BRCA1 and BRCA2 gene mutation (most often linked to breast and ovarian cancer), have a 3 to 10-fold increase of getting pancreatic cancer, he said.

In addition, those with a PALB2 mutation, or conditions such as FAMMM (familial atypical multiple mole melanoma), Lynch Syndrome, Peutz-Jeghers Syndrome or hereditary pancreatitis are at increased risk. Having a first-degree relative with pancreatic cancer also raises your odds slightly. Even if your DNA predisposes you to cancer, you may never get the disease, but if you suspect your genetics is putting you at risk, Dr. Asbun suggests talking to your doctor.

Decreasing Your Risk

“I wish there was a silver bullet for prevention,” Dr. Asbun said. “But the best thing you can do is modify those risk factors that can be changed.”

You can lower your risk for many types of cancer, including pancreatic cancer, by making some lifestyle changes. Among them:

· If you smoke or use tobacco products, stop. Smokers also have a poorer response to cancer treatment.

· Lose weight if you are overweight. A BMI above 30 increases your risk for pancreatic cancer by 20 percent.

· Keep type 2 diabetes at bay. “Some of these risk factors go hand in hand, and being overweight is closely associated with diabetes,” Dr. Asbun said.

Other possible contributing factors are a diet high in red meat, saturated fats and sugary drinks; low vitamin D; not enough exercise; alcohol consumption (which is associated with chronic pancreatitis, which can lead to cancer); and infections such as H. Pylori and hepatitis B.

Risk Factors Beyond Your Control

Unfortunately, there are some things you can’t change. Your age is one (the average age at diagnosis is 70, although once above age 45 the risks do go up). More men tend to get pancreatic cancer. There is also a higher incidence among African-Americans and those of Ashkenazi Jewish descent. However, there may be other factors contributing to these associations, and the reasons for increased risk are not always clear.

Screening for pancreatic cancer is not typically recommended, Dr. Asbun said, and symptoms such as weight loss and jaundice often don’t appear until the disease is advanced. If suspected, endoscopic ultrasound or an MRI may be performed. Sometimes, pancreatic cancer is detected when a patient has an MRI or CT scan for another problem. Results of a CA 19-9 blood test may suggest cancer, but not everyone who has pancreatic cancer has a high CA 19-9 level.

Better Treatments

There are new options for treating pancreatic cancer and Miami Cancer Institute is leading clinical trials in different types of chemotherapy and high-dose radiation, and offers minimally invasive procedures. They are extending life and improving quality of life among those with pancreas cancer. “We have many more tools at our disposal now and we know how to use them better,” Dr. Asbun said. “We are very much at the forefront of cancer care.”