Pancreatic cancer can be tough to spot and even harder to beat

On Wednesday, Jeopardy! host Alex Trebek announced that he has been diagnosed with Stage 4 pancreatic cancer.

“Now normally, the prognosis for this is not very encouraging, but I’m going to fight this, and I’m going to keep working,” the 78-year-old Sudbury native said in a video shared to YouTube.

Unfortunately, Trebek was right.

According to Michelle Capobianco, the executive director at Pancreatic Cancer Canada, pancreatic cancer is predicted to become the deadliest cancer worldwide by 2030.

“The five year survival for Stage 4 is unfortunately less than one per cent,” said Capobianco. “For all stages of pancreatic cancer combined, the one year relative survival rate is 20 per cent, and the five year rate is about seven to eight per cent.”

Pancreatic cancer may cause only vague symptoms, if any, and those symptoms can indicate a number of different conditions. This makes it very difficult to diagnose.

“Because most patients are diagnosed after the cancer has already spread, it is a difficult cancer to treat,” Capobianco told Global News. “While chemotherapy can help to keep the cancer at bay, it is ultimately not a curative treatment.”

Another reason pancreatic cancer can be tough to spot is because it hasn’t been researched enough.

“While there is real momentum now in researching pancreatic cancer across the world, it has been woefully underfunded in comparison to other cancers,” said Capobianco, and its rising mortality rate reflects this.

In the video, Trebek said he is determined to beat the “low survival rate statistics for this disease,” joking that his Jeopardy! contract requires he work three more years.

Risk factors of pancreatic cancer

Smoking, a poor diet, alcohol consumption and obesity are all modifiable lifestyle choices that can increase your risk of developing pancreatic cancer, according to Pancreatic Cancer Canada.

Smokers are, “two to three times more likely to develop pancreatic cancer than non-smokers,” said the organization. “Use of smokeless tobacco may also be associated with pancreatic cancer development.”

Drinking two or more alcohol beverages per day can increase your risk of both pancreatic cancer and pancreatitis, according to researchers.

“A diet high in cholesterol, fried foods, red and processed meats may increase the risk of pancreatic cancer,” said the organization. “A diet high in fruits, vegetables and fibre may reduce risk.”

There are other non-modifiable risk factors as well, including a family history of the disease, diabetes, age, race, chronic pancreatitis and environmental factors, such as exposure to some chemicals.

Signs and symptoms

As Capobianco said, it can be especially difficult to recognize pancreatic cancer because its symptoms are the same as several other illnesses.

Pancreatic Cancer Canada lists pain in the upper abdomen or back, jaundice, changes in stool colour, itchy skin, loss of appetite, unintended weight loss, newly diagnosed diabetes in adults, nausea, vomiting, diarrhea and constipation as symptoms of pancreatic cancer.

However, many of these symptoms can also occur due to other issues.

Pancreatic cancer is divided into 4 stages with some subsets within each.

The stages for pancreatic cancer are not the same for other cancers.

“It is recommended that all patients receive chemotherapy,” said Capobianco. However, “only a small percentage of patients can have the cancer removed by surgery.”

Stage 1

Stage 1 pancreatic cancer is also known as “resectable,’ and it usually entails “a relatively small tumour (about three centimetres or less) localized to the pancreas that does not involve important arteries and veins so it can be removed by surgery,” Capobianco said.

This is also known as “localized,” which means “there is no sign that the cancer has spread outside of the pancreas.”

Stage 2

Stage 2 is also called “borderline resectable.” This usually refers to a “slightly larger tumour which involves some vessels that may be possible to be removed by surgery,” said Capobianco.

Stage 2 is split into two sub-groups known as IIA and IIB.

Stage IIA usually means the cancer is confined to the pancreas, it’s bigger than four centimetres across and it hasn’t spread to nearby lymph nodes or to other distant sites.

Stage IIB has many sub-groups within it, but it’s usually similar to IIA, except that the cancer has spread to nearby lymph nodes.

Stage 3

Stage 3 is “locally advanced,” which means “the tumour is still localized to the pancreas but encases or surrounds arteries and veins that are needed to feed other organs,” said Capobianco.

These tumours are not amenable to surgery.

Another word used to refer to a cancer which has spread from the pancreas to nearby structures or lymph nodes is “regional.”

Stage 4

Stage 4 is also known as “metastatic pancreatic cancer,” defined by cancer cells which have “spread beyond the pancreas to lymph nodes or other organs,” Capobianco said.

Another word used for Stage 4 is “distant.”

“Generally, Stage 4 is nearly incurable in most cancers. The later the diagnosis and stage, the more advanced and likely spread the cancer has become.”

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