pancreatic cancer | Pancreatic cancer: One of the most dreaded cancers

Pancreatic cancer: One of the most dreaded cancers

Pancreatic cancer is a cancer that is particularly scary, although it represents only 3% of cancers or 10,000 cases per year in France according to the High Health Authority (HAS) and the National Cancer Institute (CNIB). Pancreatic cancer affects men twice as much as women, usually after 50 years. Not all tumors are operable, and post-operative complications remain important. However, pancreatic cancer can increase the chances of survival at five years.

Summary
Pancreatic cancer: Causes and symptoms diagnosing pancreatic cancer surgery pancreatic cancer after pancreatic cancer: regular and obligatory medical follow-up recent advances in chemotherapy research to improve the Depista GE the benefits of physical activity in the study pancreatic Cancer: Causes and symptoms
Marina Carrère of Encausese and Philippe Chan explain the causes and symptoms of pancreatic cancer
The number of new cases of pancreatic cancer in France is estimated at about 10,000. Pancreatic cancer is constantly increasing, difficult to diagnose and particularly complicated to treat. It does indeed withstand several antitumor treatments.

The pancreas is a small organ with an elongated shape. It is close to the gallbladder, just below the stomach. It's primarily a gland that has two functions. A first part is a group of cells specialized in the synthesis of enzymes necessary for the digestion of fats. A second part consists of cells that produce insulin, the role of which is essential for regulating the blood sugar level.

The impairment of enzyme-producing cells disrupts digestive functions and the attainment of insulin cells can induce diabetes. When a cancer develops, it can appear from several different cell types. That's what makes this cancer difficult to treat. The tumor that appears can be demarcated and remain in the pancreas. But it can also overflow on nearby tissues: for example, block the nearby bile ducts.

A jaundice sometimes appears, accompanied by itching, which signs that the bile made by the liver no longer flows normally. Strong and persistent pains behind the stomach or at the back level are also signs. When the tumor compresses the stomach or the upper part of the intestine that surrounds the pancreas, the duodenum, the patient has nausea, it lacks appetite and thinner quickly. Signs that are often late and do not immediately think of pancreatic cancer.

Diagnosing pancreatic cancer
When you suspect pancreatic cancer, a test is necessary to make a sample
In the course of a CT scan or an ultrasound, suspicious lesions may be detected in the pancreas. To confirm or reverse the diagnosis of cancer, a more precise examination must be carried out. This is an echo-endoscopy.

echo-Endoscopy is performed under general anesthesia. The purpose of this review is to examine the pancreas as closely as you like. When the detected mass is suspicious, the procedure continues with a biopsy. A needle is brought under ultrasound control in the lesion of the pancreas to identify the exact nature of the tumor. This technique is a major step forward.

Once punctureded, the fragments are pushed using a syringe filled with air in a tube. They are then sent to the laboratory for histological analysis under a microscope. These analyses allow to define the type of cell and the type of tumor taken. If the detected mass proves to be cancerous, the results of the analyses allow to quickly put in place a suitable treatment.

Pancreatic Cancer surgery
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Attention, images of surgical intervention: thanks to the operation, the chances of survival can go from six months to five years.
In more than 50% of cases, pancreatic cancer is diagnosed too late to be operated. But thanks to the progress of scanners and treatments, this trend is starting to reverse. A hope, because the operation greatly improves the vital prognosis. It increases the life expectancy to 5 years by 20%. But it can also be practiced in prevention when a benign tumor, but likely to degenerate, is discovered by MRI.

No generalized screening

We do not now have the tools to track the beginner forms of this cancer. A screening of subjects at risk is possible, but this is quite invasive, since it requires repeated general anesthesia. However, we cannot do repeated general anesthesia to a population in which we have a chance on 10,000 to find pancreatic cancer.

If there are blood markers of this cancer (CA19-9, among others), these are not specific to this disease.

The operation is very delicate, the risks of complications are important. And unfortunately, not all tumors are operable. Only a few patients benefit (about 15%). If the tumor touches important blood vessels or is too large, it is necessary to reduce its size by chemotherapy (combination of radio and chemo) to make it operable, and this is not always possible.

The prognosis has long been very dark for people whose diagnosis of pancreatic cancer is confirmed, not exceeding 5 years. According to the Foundation Help and research in Digestive CAncerologie (ARCAD), all stages, this survival at 5 years is today 5%.

In the case of surgery followed by chemotherapy, it is in the order of 20-25%.

This operation is heavy and the patient must be regularly followed by a multidisciplinary medical team, oncologists, of course, but also nutritionists and psychologists. The patient must agree to change his way of life to help his body weakened by cancer and by the removal of the pancreas.

After pancreatic cancer: regular and obligatory medical follow-up

A therapeutic trial demonstrated the efficacy of targeted biotherapy for the treatment of pancreatic cancer.

Although one of the most dreaded cancers remains, significant progress has been made in improving the quality of life of patients and hindering tumor evolution.

But after the operation of the pancreas, patients have to return on average three times a year to the hospital to control the evolution of their disease. This is the case of Jean-Louis, who operated the pancreas in 2001.

Recent advances in chemotherapy

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Denise benefits from chemotherapy by Folfirinox.

For a long time, chemotherapy have been ineffective in the case of pancreatic cancer. French doctors had the idea of proposing a "cocktail" of Medicines (Folfirinox protocol). And the results, published in 2011, are more conclusive with a threefold chance of survival at 18 months. For the sick and their families, it is little. But for doctors, this is the first positive step in the last twenty years against this dreaded cancer.

Folfirinox

The chemotherapy protocol  "Folfirinox " is considered to be one of the greatest advances in pancreatic cancer research for more than fifteen years.

It is a combination of three very aggressive molecules against cancer (+ a vitamin). Treatment greatly improves the condition of patients with non-operable pancreatic cancer.

The major benefit of this treatment is a clear improvement in the duration and quality of life of the patients. However, doctors remain very attentive to the side effects: possible neuropathic disorders and digestive problems. This toxicity also forces some patients to stop the treatment or makes it inaccessible to many others.

Nab-paclitaxel

The NAB-paclitaxel (Abraxane ®) was cleared at the beginning of 2014 for the treatment of metastatic cancers. The active molecule, long known to pharmacists, is now administered as nanoparticles, which are able to penetrate into highly inflammatory tumors (in which most chemotherapy products do not reach penetrate), and to slow the progression of the disease.

Research to improve screening

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The diagnosis of pancreatic cancer is often late. A number of research trails are currently under consideration to improve screening. In Toulouse, a team of researchers is developing an electronic microchip system that could become an interesting detection tool within a few years.

Facilitating the diagnosis of pancreatic cancer through new technologies is the goal of a team of researchers. To do this, just a little blood or saliva. "We know that these samples contain biological markers that will indicate the presence of cancer or its evolution," explains Pierre Chowdary, an oncology researcher.

The samples are then deposited on a microchip, a concentrate of technology that eventually would be able to detect pancreatic cancer:  "On these microchips are micro-membranes that will vibrate at a frequency of resonance. And when we bring on these chips a drop of saliva for example and if this drop of saliva contains target molecules involved in pancreatic cancer, the frequency of vibration of the micro-membrane will change  ", explains Jean capillary, student in Biotechnology.

This micro-chip is still in the prototype state. The results are not yet optimal and the technology needs to be improved but it is a way of the future as confirmed by Thierry Leichle, researcher in physics:  "In the specific case of pancreatic cancer, our devices and our technologies could To enable the diagnosis to be democratized by offering low-cost sensors that allow for much faster analysis and more performance compared to current tools in the biomedical field.

Ultimate goal of researchers: to make this device accessible in medical practices. A project that will require a few more years of work.

The benefits of physical activity under study

One of the objectives of the study is to encourage patients to gradually resume physical activity

If for breast, prostate or colon cancer, physical activity helps support the treatments, a study tries to assess its interest in pancreatic cancer.

 "One of the hypotheses to explain the effect of physical activity in cancers and especially for pancreatic cancer is that physical activity can play on the secretion of a number of substances that come from the fat of the patient . And these substances, of course, promote the growth of the tumor. By doing physical activity, we are somehow reducing the nutrition of the tumor, explains Dr. Pascal Hammel, a digestive oncologist.