With the announcement by longtime Jeopardy! host Alex Trebek that he has advanced pancreatic cancer, a lot of people are wondering about the dreaded disease.
One thing that is not widely recognized: Pancreatic cancer is on the rise. It is now the third-leading cancer killer in the United States and is on track to become No. 2 as early as next year, surpassed only by lung cancer. This year, more than 56,000 Americans will be diagnosed, a 2 percent increase over last year, according to the American Cancer Society.
Trebek, 78, gave a shout-out to them in a video posted to YouTube.
“Just like 50,000 other people in the United States each year, this week, I was diagnosed with Stage 4 pancreatic cancer,” he said.
He acknowledged that “the prognosis for this is not very encouraging” but vowed to fight it and keep working: “I plan to beat the low survival rate statistics for this disease.”
Here are answers to some questions you may be asking about pancreatic cancer:
What is the pancreas?
It is a large, flat organ behind the stomach that secretes digestive enzymes. It also releases the hormones insulin and glucagon, which help the body control blood sugar and convert food into energy.
Why is pancreatic cancer increasing?
An aging population, changes in racial and ethnic demographics, and increases in obesity and diabetes all play a role, according to the Pancreatic Cancer Action Network.
But the alarming trend is also driven by unknown factors, and reflects the reality that pancreatic cancer remains difficult to detect and treat.
How is it detected?
There is no routine screening test, and symptoms of the disease are vague, which is why it is usually detected after it has spread beyond the pancreas -- as in Trebek’s case.
However, the use of high-tech screening tests including MRI and endoscopic ultrasound may be considered for people at high risk based on their family history or genetic predisposition. Mutations in BRCA 1 and BRCA 2 -- more commonly associated with breast and ovarian cancers -- also have been linked to higher risk of pancreatic cancer. The International Cancer of the Pancreas Screening Consortium published guidelines for screening high-risk individuals in 2013.
How is it treated?
If caught early enough, pancreatic cancer can be successfully treated with surgery; witness the remarkable example of Supreme Court Justice Ruth Bader Ginsburg. In 2009, she was having a checkup to make sure she had no colon cancer recurrence when a pancreatic tumor was incidentally discovered. Part of her pancreas and spleen were removed. Doctors did not disclose whether she had the most common, aggressive form of the disease, called exocrine, or the less aggressive neuroendocrine form.
Chemotherapy, sometimes combined with radiation, is the mainstay of treatment. But last year, two new drugs were approved that can benefit some pancreatic cancer patients. Researchers are steadily figuring out how to tailor treatment to the molecular profile of each patient’s cancer.
Immune-boosting therapies are also promising. In 2016, for the first time, the National Cancer Institute used an experimental therapy made with a patient’s own immune cells to wipe out metastatic lung tumors driven by mutations in KRAS genes. Such mutations cause almost all pancreatic cancers.
What are the survival rates?
When the tumor is only in the pancreas, the chance of surviving five years is 34 percent. That figure drops to 12 percent for patients with cancer in nearby lymph nodes.
For stage 4 -- disease that has spread to distant organs, usually the liver or lung -- the five-year survival rate is 3 percent. Only one in four patients survive a year. Trebek did not say where his stage 4 cancer has spread.