What is pancreatic cancer?
Pancreatic cancer is one of the lesser common cancers, affecting an estimated 49,620 people in the United States in 2013. Risk factors for developing cancer of the pancreas include: cigarette smoking, obesity, cirrhosis of the liver, diabetes, chronic pancreatitis, and a family history of pancreatic cancer. While most people who develop pancreatic cancer have no family history (called “sporadic” cancers), about 10% of those diagnosed do.
Genetic associations
Hereditary pancreatic cancer, otherwise known as familial pancreatic cancer, is associated with five genetic syndromes. Note, the following five are extremely rare:
- BRCA2 Mutation
- Familial Atypical Multiple Mole Melanoma (FAMMM)
- Peutz-Jeghers Syndrome
- Hereditary Pancreatitis
- Hereditary Non-Polyposis Colorectal Cancer syndrome (HNPCC)
While there is no agreed definition of hereditary pancreatic cancer, it is generally diagnosed when at least two first-degree relatives (brother, sister, parent, or child) have been diagnosed with pancreatic cancer.
Those at high-risk
Genetic counselors are specifically trained to evaluate one’s risk of hereditary pancreatic cancer. Typically, a family tree is devised and if an increased risk is identified further testing is recommended. Genetic testing is a typically a sampling of ones blood or saliva. The test can take several weeks for results to be available. In some unique cases, a patient’s risk of pancreatic cancer is increased but the specific gene involved has not yet been identified.
Genetic testing
Gene testing offers multiple benefits, including identifying personal cancer etiology, defining potential risk to siblings/offspring, and shedding light on surveillance and treatment. That said, gene testing is only valuable when treatment is based on genetic information. Additionally, the potential clinical, social and psychological consequences sometimes associated with gene testing should be considered beforehand. Testing is possible, but not considered a certainty in terms of its analytical validity, clinical validity, and utility (likelihood that a positive result lead to improved outcome).
Testing process
The genetic test is conducted via a blood or saliva sample. Once the patient’s sample is collected with a special kit, it’s shipped overnight to a laboratory (coordinated by a healthcare provider). While in the lab, 13 known pancreatic cancer genes are analyzed. Granted, everyone has these genes, but the genetic test is looking for any mutations that make the gene(s) non – functional.
Get registered
Families with a history of pancreatic cancer offer medical professionals an opportunity to study the cause of the disease. This growing collective of research is offering better ways to diagnoses pancreatic cancers (often during earlier stages), as well as continues to develop better treatments. Due to this, it’s highly recommended that those living with, or related to patients of pancreatic cancer get registered. The registries are research-based, and a patient’s participation with one may help investigators learn more about familial pancreatic cancer. Note: participation in a registry does not replace actual clinical care by doctors.
Surveillance programs
In addition to family research registries, patients can participate in an available surveillance program. These programs differ throughout the United States, with each designing its own protocols. Both surveillance programs and registries aim to learn more about the biological cause of familial pancreatic cancer, and to better develop detection and treatment strategies.
Risk reduction
When it comes to lowering the chance of getting pancreatic cancer, there are numerous factors to consider. Tobacco use is a major contender, with the risk of getting pancreatic cancer being about twice as high among smokers compared to those who have never smoked. It’s estimated that 20-30% of pancreatic cancers are caused by cigarette smoking. Additionally, heavy alcohol consumption has been linked to patients of pancreatic cancer. While a definite connection has yet to be determined, heavy alcohol use often leads to conditions such as chronic pancreatitis and cirrhosis, which are known to increase pancreatic cancer risk.
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