“It’s important that every cancer is treated equally and that the problem goes back to the concept of ‘statistical life’ and ‘real life,’” said Dr. Gavini.
A silent disease that will soon be the second most common cause of cancer death by 2030. Pancreatic cancer doesn’t get the same funding popularity as other cancers do – even during its awareness month. There aren’t early warning signs and screening tests that catch the cancer and as a result, researchers are making strides to an earlier diagnosis.
Most signs and symptoms aren’t noticed until an advanced stage of diagnosis. About 90 percent of diagnosed patients are over the age of 55 but the silent disease is appearing in younger generations too – especially, if they have a family history of the cancer. It is currently the fourth-leading cause of death from cancer in the United States, according to the Lustgarten Foundation – which was created to honor the life of Marc Lustgarten, an executive with Cablevision Systems Corporation and The Madison Square Garden Company, who died from pancreatic cancer at the age of 52 in 1998.
Taken from the National Cancer Institute
“Because of emotional overturns, it’s generally easier to raise money for breast, ovarian, and prostate cancer than the less ‘sexy’ ones like pancreatic cancer,” said Dr. Peter Lance, a molecular and cellular biologist at the Arizona Cancer Center. “And because of funding, we make less progress with pancreatic cancer than other cancers.”
Taken from the National Cancer Institute
November is pancreatic cancer awareness month or as most refer to it as “purple month.” It has little to no funding or recognition because of its bad reputation of low survival rates.
The founder of the Pancreatic Cancer Network’s mother, Rose Schneider, died from the silent disease at 68 years old and her favorite color was purple – since then, it has become the universal color for the cancer.
The Pancreatic Cancer Action organization ran a campaign in 2014 called “I Wish I Had” that created controversy around the world. “I Wish I Had” featured three pancreatic cancer patients saying how they wish they had other cancers such as breast cancer so that they would get more funding for the potential to have a cancer with a higher survival rate.
Celia Barlow, an administrator at the organization, said even though breast cancer organizations were angry about the campaign, it still raised a lot of awareness for the forgotten disease.
Lisa Crowley, head of the Lustgarten Foundation’s fundraising walks in NYC, said their goal is to raise money for researchers to catch the cancer at an earlier stage and make people realize that it’s “purple November.” During their Long Island walk this year, they had 25 survivors and two young diagnosed patients at the age of 9 and 19 years old.
“It’s an awful cancer and we don’t get nearly as much funding as breast cancer does but we are trying. This year, we donated $40 million to research by having 40 walks around the country,” said Crowley. “My team is really small though, there’s only 13 of us so we are looking at other ways to fund.”
Catching the disease early isn’t the only step researchers and experts are moving towards. There are four potential ways that will help patients in the right direction of recovery. The others are clinical trials for chemotherapy which is a treatment using chemicals and other drugs, immunotherapy which is a treatment that uses certain parts of the immune system, and research into new treatments such as gene mutations where there is a permanent change in the patient’s DNA.
Dr. Hemanth Gavini, a gastroenterologist at Banner University Medical Center, said it’s important that every cancer is treated equally and that the problem goes back to the concept of “statistical life” and “real life.”
“If I said the hospital requests a million dollars to improve the outcomes of cancer patients versus a breast cancer patient requesting a million dollars, who would people donate the money to?” said Dr. Gavini. “Most people would donate to the patient with breast cancer because there is a direct effect to that opposed to giving an organization some money that will be distributed and they wouldn’t see the benefit right then and there.”
Dr. Gavini diagnoses patients, updates tissue, and treats certain aspects of pancreatic cancer. Other doctors refer patients to him saying their patient has jaundice – which is yellowness of the eyes and means the tube that carries the blood to the liver is blocked and some of these patients turn out to have masses in their pancreas.
He describes the process as first an endoscopy ultrasound is done, which has an ultrasound on the tip of the endoscopy. When the waves travel to the wall of the stomach, that’s where the pancreas lies and how experts are able to see if there is a mass close to the stomach. If he sees a mass in there, they put a needle across and get some tissue from it.
That information then goes to the pathologist who can see if the patient has pancreatic cancer. The doctors then make the decision for the patient to either go for surgery or for chemotherapy and radiation.
There are two types of chemotherapy that last about three to four months. Neo-adjuvant therapy is when a patient has surgery to shrink down the mass. The second is called adjuvant therapy where the patient already went through surgery but there was still some residue left in the mass so they go for additional chemotherapy because they want to treat the rest of the cancer that has spread throughout the body.
“Our preference nowadays is to do neo-adjuvant therapy which means we are trying to stage it really well so that patients don’t have to undergo unnecessary chemo,” said Dr. Gavini. “If you do surgery, what happens sometimes is patients don’t recover well enough or are not strong enough after that point to able to undergo adjuvant chemo as the situation arises.”
There are multiple approaches in the first two trials where they find a drug that is strong enough so they don’t have to add any toxicity. But in phase three of the trial, they try to see if there is a particular drug that is better than before and that is where the clinical trials come in.
Dr. Lance said the problem with pancreatic cancer is that by the time it is diagnosed in a patient, it has already spread throughout the rest of the body so sometimes surgery isn’t even an option and patients go right to chemotherapy.
There have been improvements with tweaking combinations of drugs in clinical trials rather than big breakthroughs. Dr. Lance said the use of immunotherapy has been considered more recently as it has worked for other cancers but it’s just an alternative they are trying to make so the therapy kills the cancer cells.
Dr. Lance said oncologists stay away from blood tests because one positive test doesn’t necessarily mean the patient has cancer – they are required to do further testing which usually doesn’t help. But, Dr. Gavini said “never say never” because time is a factor and technology is advancing everyday. The reason being is because pancreatic cancer doesn’t have distinct symptoms that indicate the patient is ill so it would be hard to find one specific molecule that can be picked up by a screening test and with time, that may be possible.
Dr. Lance believes the five- year survival rate after chemotherapy has been slowly increasing by a few months in the past few years. The survival rate has increased from 3.5 percent to about eight percent.
“We’re looking to double the five-year survival rate by 2020 since pancreatic cancer will soon be the second leading cause of cancer death in the country by 2030,” said Mara Bautista, patient central associate at PanCAN.
To double the five-year survival rate, PanCAN raised about $7.14 million last year for research. Bautista said their goal is to accelerate the process of finding new treatments and earlier detection methods. They also created a clinical trial database called “Know Your Tumor,” and raised $12.4 million through PurpleStride events across the country.
PanCAN helped pass a Congressional bill that funded $2 million to the National Institute of Health.
Dr. Lance said the bedrock of medical research in this country is through the NIH, which has a club of the top cancer centers in the country and the Arizona Cancer Center happens to be one of them.
Both doctors believe that medical centers provide better treatment for patients and that if the “I Wish I Had” campaign helped raise money for pancreatic cancer research then that’s a good thing.
“You don’t really want to set up competition between cancers but the fact is that the patient that has been treated successfully or patients with a particular cancer in question are the best source of funds.”
My Personal Take:
As my last story ever written for the University of Arizona’s School of Journalism, I decided to end on the note that I started with. My grandmother died of pancreatic cancer when I was 7 years old and this upcoming February will mark 14 years since her beautiful soul was taken from our family. She was my biggest inspiration behind becoming a writer.
She was the type of woman that lit up the room when she entered and would always care for everyone else before herself. She had a true passion for fashion and designed clothing for Saks Fifth Avenue. She also designed all of the famous Latin singer, Charo’s dresses because she had a small waist and my grandmother knew how to get the size just right.
We were really close and did almost everything together while my parents worked during the day. She taught me how to speak Italian and my favorite memory was picking her up from the train station after work with my grandfather. We would then go their house and make some type of Italian dish for dinner – since my grandparents immigrated to America in the 80s when my mother was about 10 years old.
When she passed, I was too young to understand that she would be gone forever and soon realized that I never got to formally say goodbye. So, I wrote her a letter about how much she meant to me and stuck it next to her body at the funeral. My parents knew at that moment that I would be a writer one day – and they weren’t wrong. Since then, I held a notebook in hand until this very day that documents my life as I get older.
Her passion for fashion rubbed off on me and I held a fashion column in my high school paper where I decided that journalism was my true calling and now my career. So in memory of my lovely grandmother, Lucia Muto, this one is for you.
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