Category Archives: Pancreatic Cancer

Emerging New Evidence on Pancreatic Cancer Risks

By Hui Xie-Zukauskas

Risk_assessThis is a key topic on my editorial calendar this year due to the striking statistics of the increasing incidence and lethality of pancreatic cancer. For 2017, an estimated 53,670 people will be diagnosed with pancreatic cancer, and over 43,000 deaths resulting from it are expected in the U.S. alone (source: American Cancer Society).

Pancreatic cancer still has a very poor prognosis, with an overall survival of 5% over five years. The disease is remarkably aggressive, rarely diagnosed at an early stage, and difficult to treat due to its resistance to radiotherapy and chemotherapy. Therefore, the cancer’s cruelty creates a tremendous emotional burden for both patients and their loved ones. Even for survivors, the battles and treatments are brutal.

This does not mean we can do nothing.

To treat this horrible disease early and save more lives, identifying risk factors of pancreatic cancer and targeting high-risk people for effective screening are crucial. Therefore, steps to help prevent pancreatic cancer need everybody’s attention. A better understanding of the factors associated with pancreatic cancer can pinpoint preventive strategies to reduce its incidence.

Through literature review, I’ve compiled a list of risk factors for pancreatic cancer from research findings and emerging new evidence over the last 10 years. Here I share them with you in three categories.

First – Established risk factors

  1. Cigarette smoking: It is consistently associated with a two-fold increase in pancreatic cancer risk. Cancer-causing agents (i.e., carcinogens) existing in tobacco products cause DNA damage, which lead to abnormal cell growth.
  2. Obesity: Obesity produces an inflammatory state. Specifically, visceral obesity (i.e. belly fat) is linked to an increased risk for pancreatic and other cancers, independent of general obesity measured by body mass index (BMI).
  3. Chronic inflammatory conditions: such as chronic pancreatitis, liver cirrhosis.
  4. Diabetes: Particularly, type 2 diabetes is among a cluster of metabolic syndromes including hypertension, dyslipidemia, insulin resistance, and obesity.
  5. Age (55+): The risk of developing pancreatic cancer increases with age.
  6. Gender: Men are more likely to develop pancreatic cancer.
  7. Inherited genetic mutation: Genetic factors accounts for ~10% pancreatic cancer. 

Second – Emerging risk factors

  1. Environmental risk: Exposure to mutagenic nitrosamines, organ-chlorinated compounds, or heavy metals is involved in the initiating phase of pancreatic cancer.
  2. Gut microbiota: The role of the microbiota in the development of pancreatic diseases is increasingly accepted. Gut bacteria translocation and small intestine bacterial overgrowth have been found in acute pancreatitis and chronic pancreatitis, respectively.
  3. Infection: Helicobacter pylori (H. pylori) infection.
  4. Ionizing radiation: Most relevant evidence comes from studies done on workers due to occupational exposure. 

Let me add a bit more on invisible microbiota. Imbalance in gut microbiota is also related to other risk factors for pancreatic cancer (such as smoking, diabetes, and obesity). Furthermore, oral microbiota change in periodontitis is associated with an increased risk of developing pancreatic cancer.

Third – Preventable or modifiable risk factors

  1. Sedentary behavior: Physical inactivity is directly and independently linked to multiple types of cancer.
  2. Smoking: Smoking is the biggest preventable cause of cancer.
  3. Excess alcohol intake
  4. Dietary factors: A diet high in red and processed meats, fat, calories, and fructose may increase cancer risk.  In contrast, a diet rich in whole wheat or whole grains, fiber, vegetables, and fruits is associated with reduced cancer risk.
  5. Obesity: Obesity is a significant risk factor for more than 10 types of cancer, severe morbidities, and premature death; it is also considered the major modifiable risk factor for multiple cancers and chronic diseases.

Each cancer is different. Sadly, pancreatic cancer has struck individuals who were healthy, non-smokers, athletes, or as young as age 30-40.

In summary

Fighting against pancreatic cancer starts with learning about its risk factors so as to save preventable deaths in the larger population.

Meanwhile, there is hope – thanks to advanced research and technology that deliver better treatments or promising therapeutic options. So, let’s also remember HOPE.


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Why It Is Critical to Prevent Diabetes: Association with Pancreatic Cancer

By Hui Xie-Zukauskas

Stop diabetes logoHere are a couple of sobering statistics: A total of 25.8 million children and adults in the United States and 347 million worldwide have diabetes. These figures demonstrate clearly that diabetes has become a pandemic in today’s world.

Preventing diabetes in our own and our families’ lives should be of great concern to us for several reasons. One reason is that a diagnosis of diabetes can result in life-altering changes needed to manage the disease. But there is another big reason such a diagnosis is troubling, and today I’m going to focus on that reason. I’m going to talk about the urgent need for diabetes prevention because diabetes is a known risk factor of pancreatic cancer.

What is diabetes?

Diabetes is a chronic disease in which the body either cannot make enough insulin (Type 1) or cannot effectively uses its own insulin (Type 2). Insulin is a pancreatic hormone that regulates blood sugar by facilitating glucose (sugar) storage in the cells for energy. When insulin fails to do its job, blood sugar levels rise.

Type 2 diabetes affects 90% of people with diabetes around the world and results largely from being overweight and physical inactivity. High blood sugar levels can lead to long-term damage to cells and organs, as seen in complications like high blood pressure, blindness, kidney disease, and nerve disorders.

What is pancreatic cancer?

Pancreatic cancer is a deadly disease in which cancerous cells develop inside the pancreas, an organ that produces hormones such as insulin and digestive juices. (See more on “The Rule of Three for Pancreatic Cancer Prevention”).

What is the relationship between the two?

Accumulated studies have revealed a positive association between diabetes and pancreatic malignancy, although the details of what is the exact causal relationship are complex and controversial. Diabetes may be either a symptom or a risk factor of pancreatic cancer. Here are some facts showing why it has been concluded that the two maladies are connected:

-          Pancreatic cancer occurs two times more in people who have diabetes than in those without diabetes.

-          Approximately 80% of patients diagnosed with pancreatic cancer, when diabetes co-exists, often have a progressive malignancy.

-          Patients with new-onset Type 2 diabetes are at a higher risk of developing pancreatic cancer. When suffering from cancer, they have a worse rate of long-term survival and a higher rate of post-surgical complications.

-          45% of pancreatic cancer patients have diabetes and more than half of diabetes cases are newly developed. Thus diabetes has been proposed to be a clue for early cancer diagnosis.

In summary, diabetes is considered to be a risk factor of pancreatic cancer and has a negative impact on the prognosis and outcome of this deadly form of cancer. That is one excellent reason why it is so important to prevent diabetes.

To help in that prevention, here are a couple of small, easy, and effective dietary practices that can be achieved on a daily basis:

  • To help keep your blood glucose under control, avoid foods high in sugar. High sugar-containing foods include rich desserts, candies, ice cream, sweetened drinks and fruits packed in syrup. Furthermore, many processed foods hold excessive sugar.
  • Drink plenty of water, which benefits your body in many ways, especially helping remove metabolic by-products when hyperglycemia occurs.

Following these two suggestions daily can go a long way toward helping keep you free of the plague of diabetes… And oh yes, don’t forget to include an appropriate measure of exercise in your lifestyle!

Until my next cancer prevention blog, I wish you Good Health, Good Living and Happy Thanksgiving!


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The Rule of Three for Pancreatic Cancer Prevention

By Hui Xie-Zukauskas

Imagine this – it starts from deeper in the abdomen, inside the pancreas, an organ between the stomach and backbone, gradually hits a person at 60s with no sign or some digestive discomfort, pain in the abdomen, yellowish skin, and then unexplained weight loss. After that, it aggressively takes the person’s life. That is pancreatic cancer.

pancreas-cancer_Med.WorldPancreatic cancer is one of the deadliest forms of all cancer. With current medical technology, the five-year survival rate is only six percent. The cases are apparently increasing, as about 45,000 people are expected to be diagnosed with pancreatic cancer in 2013; among them 38,000 people will die of the disease this year.

To help raise awareness of this devastating disease among those who are unfamiliar with pancreatic cancer, let me use “The Rule of Three” to highlight pancreatic cancer prevention.

Rule #1: Never smoke, and live a healthy lifestyle.

Cigarette smoking is a well-established risk factor for pancreatic cancer. It’s also important to maintain a healthy lifestyle, eat more plant-based foods and less meat, stay physically active, and keep a healthy weight. Obesity has also been linked to pancreatic cancer.

Rule #2: Prevent and treat chronic pancreatitis.

Inflammation plays a role in developing pancreatic cancer, and chronic pancreatitis is a known risk factor. In addition, pancreatic cancer is more common among individuals with histories of cirrhosis (a chronic liver disease), diabetes, and previous surgery to the upper digestive tract. Pancreatic cancer may also be attributed to a pathogen for periodontal disease (named porphyromonas gingivalis).

Rule #3: Keep diabetes at the bay.

Type 2 diabetes is closely associated with pancreatic cancer, as a body of research reveals. As the population ages and the obesity epidemic continues, the incidence of diabetes is predicted to rise. People with diabetes are more likely to develop pancreatic cancer than those free of diabetes.

A final point

Still, as is true for other cancers, early detection is always important for combating the pancreatic cancer. This is particularly critical for those with a family history of this disease, because the risk can be doubled or tripled by familial pancreatic cancer.

In brief, pancreatic cancer is deadly, but you can lower your risk by not smoking, preventing pancreatitis and diabetes, and raising your awareness about the importance of living a healthy lifestyle.


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