Early detection tools the key in battle with killer cancer

Only 50 per cent of Australians are aware of the signs of pancreatic cancer and only one in 10 is aware that it’s the nation’s third deadliest cancer.

The pancreas goes quietly about its business, but when things go wrong, the problem can be stubbornly difficult to diagnose.

A new survey shows that it takes on average three to six medical appointments before pancreatic cancer is even considered. It took British actress Olivia Williams four years to get a diagnosis. (For lovers of the Netflix hit The Crown, Ms Williams has signed on to play the next iteration of Camilla Parker Bowles.) 

More than 3300 Australians die every year from pancreatic cancer. PanKind, the only foundation in Australia exclusively dedicated to the disease, wants to change that by educating the public and clinicians on the warning signs, investing in medical research and developing early detection screening.

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A recent survey by the foundation found that more than 50 per cent of Australians are not aware of any signs or symptoms of pancreatic cancer, which can include yellowing of the skin and the whites of the eyes, loss of appetite or unintended weight loss, abdominal pain that radiates to the back, dark-coloured urine and light-coloured oily stools.

“One of the greatest challenges we face with pancreatic cancer is time,” says Michelle Stewart, CEO of PanKind. “Sadly, it has one of the worst survival rates of any cancer. Often when a patient is diagnosed, they are close to death. This is largely because most patients are diagnosed when the cancer has already progressed too far for existing treatments to work.

 “To give some perspective, while many more people are diagnosed with breast cancer each year, more people die of pancreatic cancer due to a huge difference in survival rates – breast cancer has a 91 per cent five-year survival rate, while for pancreatic cancer it is only 10.7 per cent, dropping to just 6 per cent for people who live in regional Australia,” says Ms Stewart. “Yet our survey indicated that 88 per cent of people thought breast cancer was the biggest killer. There is a huge gap in awareness, attention and understanding that needs to be addressed.”

Lucky break
Professor Chris Baggoley AO, a former Australian chief medical officer, was diagnosed with pancreatic cancer in early 2019, and considers himself one of the lucky ones due to an “accidental” early detection.

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“The difficulty is that early stage pancreatic cancer rarely causes signs or symptoms, or they can be vague and come and go with varying severity for each person,” says Prof. Baggoley.

“My tumour was detected during a check-up for something completely unrelated and because it was detected early, I was lucky enough to actually have a treatment option. This is not the case for the majority of patients.

“I always encourage people to listen to their body and go to their GP if anything feels off because the earlier pancreatic cancer is detected, the greater chance you have treat it, which has a huge impact on survival rates.”

PanKind plan
Exact causes of the disease are not well understood but risk factors may include smoking, obesity, heavy alcohol consumption, family history, pancreatitis, ethnicity and inherited genetic conditions.

PanKind aims to better understand those links and improve the early detection of pancreatic cancer.

“We believe that early diagnosis offers the greatest hope to triple survival rates by 2030,” explains Ms Stewart. “That is why we are extremely proud to launch the PanKind Early Detection Initiative and announce $465,000 in funding for two new research projects.”

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One will create a national database to build a detailed picture of risks, led by Professor Rachel Neale, head of the Cancer Aetiology and Prevention Laboratory at QIMR Berghofer Medical Research Institute in Brisbane.

“Unfortunately screening all Australians for pancreatic cancer is not a viable option,” Prof. Neale says. “Instead, we are looking to identify who is most at risk of pancreatic cancer and to determine whether monitoring this group would lead to better outcomes.

“To do this, we will be linking the national data of thousands of patients who had pancreatic cancer over the past 15 years. We will use sophisticated machine-learning methods to predict people’s risk of pancreatic cancer.”

The other research funded by PanKind is at the Epworth’s Jreissati Family Pancreatic Centre in Melbourne, and will explore the link between pancreatic cancer and late onset diabetes.

US research
Scientists in the US have identified a novel drug that effectively thwarts pancreatic tumours addicted to the cancer-causing mutant KRAS gene.

KRAS is mutated in 90 per cent of pancreatic cancers and research has demonstrated that some tumours that harbour mutant KRAS are actually addicted to the mutant gene, meaning they cannot survive or grow without it. Scientists are now testing a drug, named AT7519, that can specifically kill tumours addicted to mutant KRAS.

Meanwhile, the US Pancreatic Cancer Action Network this week announced clinical trials of pamrevlumab, an antibody that inhibits the activity of connective tissue growth factor. The experimental drug is used to combat pulmonary fibrosis and muscular dystrophy, and it’s hoped will help those patients with metastatic pancreatic cancer.

Were you aware that pancreatic cancer is so hard to detect? And so dangerous? Share your thoughts in the comments section below.

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Written by Rebecca Tolan

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