Pancreatic cancer prevention
Q. Every time I open a newspaper, I seem to read about another VIP with cancer of the pancreas. It sounds like a dreadful disease. Is there some way I can be tested to see if I'm at risk?
A. Cancer of the pancreas is relatively uncommon; only about 43,000 cases are diagnosed in the United States each year, putting it far behind prostate cancer (218,000 a year), breast cancer (209,000 a year), and colorectal cancer (143,000 a year) — yet because pancreatic cancer is so hard to treat, it has a much higher mortality rate than any of these more common malignancies. It is indeed a dreadful disease, and its poor prognosis explains why it gets so much publicity.
Early on, cancer of the pancreas is clinically silent. Later, patients may develop back pain, abdominal pain, weakness, weight loss, depression, or jaundice. Imaging studies such as ultrasounds, CTs, and magnetic resonance imaging scans may detect abnormal tissue in the pancreas, but a definite diagnosis depends on a biopsy. Unfortunately, imaging studies are not sensitive enough or specific enough to be useful for screening, and the CA19-9 blood test that is sometimes used to check for the disease is even less reliable.
If early detection is still in the future, how about prevention? Conventional wisdom holds that cancer of the pancreas is not preventable, but a 2009 study may change that view. In 1995 and 1996, 450,416 individuals between the ages of 50 and 71 volunteered for the National Institutes of Health (NIH)–AARP Diet and Health Study. At the start of the study, each participant submitted detailed diet and lifestyle information. Researchers tracked the volunteers through 2003 to see if lifestyle factors influenced the risk of pancreatic cancer.
A total of 1,057 patients were newly diagnosed with the disease during the study. Scientists compared these patients with their healthier peers with regard to five factors: not smoking, limited alcohol use, regular exercise, normal body mass index, and adherence to a Mediterranean-style dietary pattern. People who scored well in all five areas were 58% less likely to develop pancreatic cancer than people who scored poorly in all categories.
It's only one study, but it reinforces earlier research that identified smoking and obesity as pancreatic cancer risk factors. And a series of reports published in 2010 linked a high carb intake (sugary sodas, fructose, and overall carbohydrate load) to an increased risk of pancreatic cancer.
More research is needed, but you shouldn't wait for results to adopt a healthy lifestyle. Preventing pancreatic cancer is still only a hope, but it's a well-established fact that wise lifestyle choices can dramatically reduce your risk of heart attack, stroke, diabetes, hypertension, and even malignancies ranging from lung cancer to colon cancer.
For better or worse, bad news about a dreaded disease gets more press than good news about simple ways to preserve health.
— Harvey B. Simon, M.D.
Editor, Harvard Men's Health Watch