Gas, fatigue and abdominal discomfort can be signs of pancreatic cancer

Gas, fatigue and abdominal discomfort can be signs of pancreatic cancer

Pancreatic cancer is a severe and stubborn killer that has so far defied the best medical efforts for early diagnosis and effective treatment. In November, my friend Peter Zimmeroth, a 78-year-old New York public service attorney who recently oversaw the partial disruption of the police department’s stop-and-search strategy, was murdered.

Zimmeroth was on my “Most Admirable” list even before he married esteemed actress Estelle Parsons, who was 16 years his senior. Even during his year-long treatment during the pandemic, Zimmeroth remained dedicated to the public good: He created a brightly colored T-shirt and hat with an urgent plea: “Crush the virus! Get the vaccine” and raised more than $73,000 to support research at Memorial Sloan Kettering Cancer Center, where Doctors hurried to buy him more time.

He was in good shape and in good health before the symptoms appeared – in his case, stomach pains and constipation. By that time the disease had spread and it was too late for surgery. His death came after the deaths of several well-known people who succumbed to the same disease: Supreme Court Justice Ruth Bader Ginsburg, actor John Lewis, TV presenter Alex Trebek, and Apple co-founder Steve Jobs.

Although pancreatic cancer is relatively rare, it is so fatal that it is expected to become the second leading cause of cancer-related deaths in the United States by 2040. It currently accounts for about 3% of all cancers and 7% of all cancers. mortality from this disease.

Overall, only one in 10 people with pancreatic cancer lives for five years. Recovery is almost always a stroke of luck, when the disease is caught at an early stage, and is asymptomatic, during abdominal examination or unrelated surgery, and the tumor can be surgically removed.

This is a disease that is difficult to detect early because it is “relatively uncommon in the population, and the symptoms it causes, such as weight loss, fatigue and abdominal discomfort, are nonspecific and likely to They are due to other cases.

As a result, he said, “When 80 percent of patients come into my office for the first time, I know it’s highly unlikely we’ll cure their cancer.”

risk factors for pancreatic cancer

There are still many important risk factors for developing pancreatic cancer. Smoking doubles the risk and accounts for about a quarter of all cases. Being overweight, being overweight as an adult, and being overweight around your waist, even if not above average, also increase your risk.

Perhaps this is why type 2 diabetes, which is often associated with being overweight, is also a major risk factor. Other risks include chronic pancreatitis, persistent pancreatitis, often associated with excessive alcohol consumption and smoking, and workplace exposure to certain chemicals, such as those used in the dry cleaning and metalworking industries.

Advanced age is also a risk factor – about two-thirds of cases occur in people over 65 years of age. Family history can also play a role, including inherited genetic conditions such as mutations in the BRCA1 or BRCA2 genes, which are often linked to breast and ovarian cancer.

Diabetes as a warning sign

It has long been known that the best chance of surviving most cancers comes from early detection, when the malignancy is completely limited to the organ or tissues in which it originated. (Blood cancers cause various problems.)

The pancreas is a very small carrot-shaped organ – about 15 cm long and less than 5 cm wide – which is well hidden between the ribs and the stomach.

Early pancreatic cancer does not result in a palpable lesion and rarely causes symptoms that require definitive medical evaluation until it has escaped the boundaries of the organ and spread elsewhere.

But scientists are studying a possible early warning sign: the link between pancreatic cancer and the recent onset of type 2 diabetes. Diabetes also originates in the pancreas. The organ contains cells specialized in producing the hormone insulin, which regulates blood sugar levels.

Although we don’t know which comes first, diabetes or cancer, some research suggests that the recent emergence of type 2 diabetes may portend an underlying cancer in the pancreas.

A preliminary 2005 study of 2,122 residents of Rochester, Minnesota by Suresh Shari, now a gastroenterologist at the University of Texas MD Anderson Cancer Center, found that three years after being diagnosed with diabetes, people had a six-fold greater tendency to Eight times more than the general population to be infected. the disease.

Together with colleagues at the Mayo Clinic, he also identified a gene called UCP-1 that could signal the development of this cancer in people with diabetes.

More recently, Maxim Petrov, professor of pancreatology at the University of Auckland School of Medicine in New Zealand, led a September 2020 study of nearly 140,000 people with type 2 diabetes or pancreatitis, or both, who were followed for up to 18 years. . year.

The results revealed that those who developed diabetes after an episode of pancreatitis were seven times more likely to develop pancreatic cancer than those with type 2 diabetes.

Translated by Luis Roberto M. Gonsalves

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