Early Detection

Detecting pancreatic cancer in the early stages leads to better outcomes

What is early detection?

“Early diagnosis of cancer focuses on detecting symptomatic patients as early as possible, so they have the best chance for successful treatment. When cancer care is delayed or inaccessible there is a lower chance of survival, greater problems associated with treatment and higher costs of care.”(1)

Why is early detection important?

People who have pancreatic cancer diagnosed in the early stages of disease have better outcomes. If pancreatic cancer is detected before it has grown too large or spread to other areas in the body there are more treatment options available, including surgery.

Only around 10% of pancreatic cancers are diagnosed before they spread. However, if detected early, long-term (5 years +) survival rates are 10 times higher than if the cancer has already spread. It is important to remember that while survival statistics give an indication of prognosis on a population level scale, they cannot describe individual cases.(2,3)

Early detection also provides greater time and opportunity for patients to participate in research, accelerating discovery and treatment options.

Source: US National Cancer Institute

Why is pancreatic cancer hard to diagnose?

  • The symptoms of pancreatic cancer are not always obvious, come and go and can change over time.
  • The pancreas is located deep within the body, so it can be hard to see or feel a tumour from a physical exam.
  • Current diagnostic tests do not always detect small, pre-cancerous or early-stage tumours.
  • While there are several diagnostic tests available, there is not yet a single standard test.
  • There are no proven biological markers that can be used to determine if you have pancreatic cancer.
  • As pancreatic cancer is a less common cancer, population-wide screening programs are not recommended, and researchers are yet to determine conclusively which are the best sections of the population to screen.

Am I at higher risk of pancreatic cancer?

Known risk factors

Risk factors are anything that increases your chance of getting a disease. Having one or several risk factors does not necessarily mean that you will get pancreatic cancer, and people with pancreatic cancer may not have any of the below risk factors.

  • Family history of pancreatic cancer
  • Family history of other cancers
  • Inherited genetic conditions
  • Diabetes
  • Smoking
  • Pancreatitis
  • Age
  • Obesity

 Use this risk assessment tool to help you determine your risk.

Worried you’re at higher risk? Here’s what to do next.

Contact your GP to discuss the risk factors you are concerned about. You can take along a copy of these webpages to help you describe your risk factors. 

If you are concerned you are at a higher risk of pancreatic cancer due to genetic factors, including if a first-degree relative has recently been diagnosed with pancreatic cancer, please contact your GP.

It can also be a good idea to speak with a genetic counsellor. Find a genetic counsellor near you though the Human Genetics Society of Australasia website.

Watch our webinar with Genetic Counsellor Tanya Dwarte.

Should people who don’t have symptoms get tested?

Screening tests help detect cancer in people who do not have any symptoms. Screening cannot stop you getting cancer, but it can help to find it early when it is much easier to treat. There are useful screening tests for certain types of cancer, such as breast cancer and bowel cancer. 

Currently, it is not possible to test all the population for pancreatic cancer, however, there are some clinical trials in Australia screening people at high risk of pancreatic cancer. We need to wait for the results of these trials before we will know if this is effective and leads to a suitable screening test.

Concerned you have pancreatic cancer?

If something doesn’t feel right, or you are experiencing symptoms of pancreatic cancer, see your doctor.

Seeing your doctor

Be honest

Your doctor wants to help you so make sure you tell them about anything that doesn’t feel normal to you. Somethings can feel embarrassing to talk about, but your doctor has heard it all and needs to know as much information as possible to understand how you are feeling and determine the cause of your symptoms.

Be prepared

It can be helpful to keep a diary of any symptoms you are experiencing and when you have noticed them. You may also find it helpful to write a list of questions before your appointment to take with you to the doctor.

Here are some questions you might find useful to take with you or use the HealthDirect question builder tool.

During your appointment, take notes on your phone or with a pen and paper. It can also help to have someone with you at your appointment as a second pair of ears. If English is not your first language, you may find it helpful to bring a close friend or family member who speaks English fluently, even if an interpreter is available.

Be persistent

If your symptoms return or change, go back to the doctor, even if you went recently. It is important to get to the bottom of what is causing you to feel unwell. If pancreatic cancer is found early, it is more treatable.

Learn more about how pancreatic cancer is diagnosed here.

Our early detection initiatives

Since our inception, PanKind have been committed to funding impactful research that furthers the understanding of pancreatic cancer, including projects to detect the cancer earlier and provide better treatment options to improve survival outcomes.

Read more our early detection projects below and click on the links to find out more.

This project focuses on detecting pancreatic cancer earlier before symptoms develop so they have a greater chance of survival. General population screening is not feasible, partly due to the low incidence of pancreatic cancer in the general population, so we need to focus on people that are at a markedly higher risk of developing pancreatic cancer and create a surveillance program. The team is doing this by harnessing the power of national large-scale data linkage and modern machine learning methods to identify a cohort of patients who would benefit from surveillance. The second phase of this project will focus on reducing delays in diagnosis.

Australian Pancreatic Cancer Genome Initiative

The APGI's ongoing mission is to further develop the existing world-class resource comprising biological samples and comprehensive information on pancreatic cancer patients from diagnosis onwards, including clinical, genomic and outcome data and to use this resource to improve pancreatic cancer care in the era of personalised medicine. Biospecimens are materials taken from the human body, such as tissue or blood, that can be used for cancer diagnosis and analysis. When patients have a biopsy or surgery often a small amount of the specimen removed can be stored and used for research. Biospecimens contain an extraordinary amount of biological information, written in the language of cells, genes and proteins. Researchers can then frame questions that will be answered by looking at these biospecimens, for example, they often use the biospecimen to identify the biological characteristics of cancer cells over time, and then correlate those patterns with the clinical picture ­ - and investigate how different patients experience progression of the disease.

Ying Zhu, 2019 Innovation Grant

Development of a non-invasive method of early detection for pancreatic cancer patients using nanotechnology

Dr Zhu and her team will use their grant to develop an integrated and small device based on nanotechnology for rapid and sensitive exosome analysis.

The team will define a set of biomarkers that can differentiate between cancer and non-cancer subjects from cells and plasma carrying early signs of human pancreatic cancer. This novel technology will also be applicable for doctors monitoring the development and customising the treatment of a patient’s tumour. 

The team will aim to develop a blood test to detect pancreatic cancer in the early stages. The blood test will detect exosomes, which are nanosized fragments released by cancer cells. Exosomes are important for communicating messages and transporting materials between cells. Exosomes have been identified as more accurate and promising biomarkers or biological clues for pancreatic cancer diagnosis.

John Hooper, 2019 Innovation Grant

A novel agent for imaging and treatment of pancreatic cancer

Professor Hooper and his team will use this grant to develop new precision-medicine agents, called theranostics, for detection and treatment of the most common form of pancreatic cancer, pancreatic ductal adenocarcinoma (PDAC).  These agents can accurately detect tumours using PET-CT imaging. They provide a powerful and selective way to deliver anti-cancer drugs to PDAC tumours, and would, therefore, improve the effectiveness of anti-cancer drugs whilst reducing their side-effects.  Professor Hooper’s team has already successfully developed a lead theranostic agent that is very effective at detecting and treating pancreatic cancer in relevant pre-clinical models in the laboratory. The team will now bioengineer the lead theranostic so that it can be administered to patients for clinical testing, and then manufactured in quantities that are clinically useful and economically viable for production and marketing. Bioengineering will also allow the lead agent to be readily linked with a range of molecular imaging and anti-cancer drugs that are designed to best suit each PDAC patient.

Marco Falasca, 2016 Accelerator Grant

A novel therapeutic target in pancreatic cancer: Implications for therapy and diagnosis

Project

The project team have discovered that a protein named GPR55 promotes pancreatic cancer growth. Their preliminary data demonstrates that a GPR55 inhibitor, in combination with a drug used in therapy, is able to increase survival in mice that develop pancreatic cancer. The project team’s plan is to identify more potent drug combinations to treat pancreatic cancer and also identify new marker that will enable to diagnose pancreatic cancer earlier.

Impact

In this research, the team identified a synergistic combination of gemcitabine and cannabidiol on pancreatic cancer models in vitro and in vivo. In addition, they have a stronger effect on tumorspheres compared to the corresponding parental tumour cells. The implications of these key discoveries are that a combination of cannabidiol and gemcitabine can be used in clinical trials and the major effect of extracts on pancreatic cancer tumorspheres suggests that they could be more efficacious in resistant tumours. The major objective of Professor Falasca’s work is to bring these discoveries to the clinical trial stages. The team is very close to reaching this outcome and are discussing with clinicians and a pharmaceutical company the details of the trials. In addition, this research stimulated many other research avenues such as the investigation of exosomes role in pancreatic cancer and the identification of novel targets such as ABCC3.

Minote Apte, 2015 Innovation Grant

Circulating stromal cells (pancreatic stellate cells) and tumour cells in pancreatic cancer

Project

The spread of cancer from the primary organ to distant sites involves the movement of clusters of cancer cells and stromal cells from the original tumour through the circulation. Prof Apte aims to characterise these cells so as to identify novel markers that would aid early diagnosis as well as facilitate assessment of treatment response and prognosis.

Impact

Prof Apte reported that the most important research finding produced by this Project funded by the Avner Pancreatic Cancer Foundation thus far is that circulating pancreatic stellate cells can indeed be isolated in the blood of patients with pancreatic cancer. Furthermore, as these pancreatic stellate cells are likely important in the formation of metastases, Prof Apte’s findings open the door to a new avenue of research in the prevention of pancreatic cancer metastases. Prof Apte effectively isolated circulating tumour cells in the portal vein blood of pancreatic cancer carrying mice. She positively demonstrated that the number of circulating tumour cells in the portal vein is higher than that found in cardiac puncture samples and that the number of such cells in the portal vein correlates with the size of the tumour. Prof Apte has reported that this is also an important finding as it lends further strength to the concept of portal vein sampling in the clinical setting to maximise the probability of successfully obtaining circulating tumour cells for analysis.

We thank the Foundation for supporting pancreatic cancer research. This Project has led to the first ever successful isolation of circulating pancreatic stellate cells in a pancreatic cancer patient as well as in a mouse model of pancreatic cancer. These findings open a new area of investigation for the prognostication and the treatment of pancreatic cancer. ~ Prof Apte.

Sources:

(1) World Health Organisation.

(2) American Cancer Society, Survival Rates for Pancreatic Cancer.

(3) P Rawla, T Sunkara, V Gaduputi; Epidemiology of pancreatic cancer: global trends, etiology and risk factors; 2019 World J Oncol.

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