What do Alex Trebek and I have in common?
Like the beloved host of Jeopardy!, I’m a trivia buff and I’m proud of my Ukrainian heritage. But the resemblance I’m concerned about right now is a little different from those.
It’s that I’ve been having stomach problems recently.
It’s nothing major—just some indigestion and loss of appetite, and it doesn’t bother me all that much. I’m pretty good at ignoring minor discomfort, and if anything, I’d consider suddenly losing a little weight a positive. But it started to concern me when I took a look at an information sheet put out for National Pancreatic Cancer Awareness Month.
Digestive problems like these are some of the most common early signs of pancreatic cancer. They’re caused by its disruption of the pancreas’ role in producing digestive enzymes. Similar symptoms were Alex Trebek’s first sign of the pancreatic cancer that ultimately took his life, and he made it a point to tell his audience to watch out for them when raising awareness of the disease (Alex Trebek appears, 2019).
What is the cancer with the highest mortality rate?
Alex Trebek’s death in 2020 was one of many prominent pancreatic cancer deaths in recent years. Ruth Bader Ginsburg, Patrick Swayze, and Steve Jobs fell to it as well. That’s not surprising, since more Americans die of pancreatic cancer than any cancer but lung or colorectal cancer. That doesn’t mean
that it’s a common cancer. In fact, it barely even makes the top 10 (American Cancer Society, 2024). That’s because people diagnosed with it are far more likely to die of it than any other cancer. Only 13% survive for 5 years after diagnosis. Even though its survival rate has drastically increased since the 1990s,
it’s still many times smaller than that of breast, prostate, and other common cancers (Siegel, 2024).
How do you treat something you don’t know is there?
Pancreatic cancer takes such a high toll because it’s a very difficult disease to identify. There may be no
symptoms at all until the tumor has spread too far to treat. The symptoms that do occur can seem
minor, like back pain and the digestive issues I just discussed. Once symptoms do develop, the pancreas’ location deep in the abdomen makes it difficult and dangerous to investigate with invasive methods like biopsies (Mazer, 2023). Diagnostic imaging and blood tests can identify it as well, but it’s hard to distinguish clearly from other pancreatic disorders and cancers (Zhang, 2018). Early detection of pancreatic cancer has improved over the past generation. Awareness of risk factors like smoking, obesity, advanced age, pancreatic problems like diabetes, and family history of pancreatic cancer makes it possible to identify people who are at higher risk (Blackford, 2020). That doesn’t change the big picture, though: pancreatic cancer is seldom diagnosed until it’s far too late.
How can we find the right clues?
Early detection is a matter of life and death, and that’s why awareness of its early symptoms is such a
focus of Pancreatic Cancer Month. Catching it before it spreads improves the 5-year survival rate to 44% (American Cancer Society, 2024) and makes surgery more of a possibility. That’s a crucial factor, as
removal of the pancreas is considered the only curative treatment (Zhang, 2018).
Right now, there isn’t any way to carry out widespread screening for it in its early stages. One stumbling
block is the fact that any successful test for it will have to have been extremely accurate. That’s because
tests for rare conditions need high accuracy to provide benefits that outweigh the stress and
unnecessary treatments resulting from false positives (Mazer, 2023).
One way of striking a balance between over-treatment and under-treatment is testing the body for tumor
markers (substances that indicate the presence of cancer). Researchers have made great strides in
tumor marker testing in recent years, making screening for conditions like colon cancer less invasive and
more accurate.
So far there haven’t been any similar breakthroughs for pancreatic cancer, but the search is ongoing. As
with other attempts to screen for this elusive target, they have been prevented by the challenge of
distinguishing it from other disorders and catching it soon enough to make a difference (Mazer, 2023).
One potential route to success is the antigen CA19-9. CA19-9 is easy to detect in routine blood tests and
is known to be associated with pancreatic cancer. It’s not sufficient to identify cancer when used alone,
but recent research suggests that it can be combined with bilirubin, another target of routine blood
tests, to improve early-stage diagnosis (Boyd, 2023).
Why do so many people wear purple in November?
Purple is the official color of Pancreatic Cancer Awareness Month. It’s held in November of every year, and no matter who you are, there is a way for you to support it. You can donate to an organization like Project Purple, raise awareness by wearing purple, or raise money and build community by walking in a PurpleStride.
I’m choosing to raise my own awareness and ask my doctor about something I’d usually just brush off.
I don’t expect a clear yes or no answer from her. But who knows—the apparently minor symptoms I report now might turn out to be important later on. That little bit of knowledge might give her some insight into new symptoms or test results in the future, and that bit of insight might be life-saving.
After all, any Jeopardy! fan can tell you that sometimes the most important thing is coming up with the right question.
References
"Alex Trebek appears in new PSA about pancreatic cancer symptoms." YouTube, uploaded by CityNews, 30 Oct. 2019. https://www.youtube.com/watch?v=DqVcN8F9wNE
American Cancer Society. Cancer Facts and Figures, 2024. American Cancer Society, 2024, Atlanta.
Blackford, Amanda et al. Recent Trends in the Incidence and Survival of Stage 1A Pancreatic Cancer: A Surveillance, Epidemiology, and End Results Analysis. Journal of the National Cancer Institute. Vol. 112, No. 11, 2020, pp. 1162-69. doi: 10.1093/jnci/djaa004
Boyd, Lenka et al. Prediction Model for Early-Stage Pancreatic Cancer Using Routinely Measured Blood Biomarkers. JAMA Network Open. Vol. 6, No. 8, 2023. doi:10.1001/jamanetworkopen.2023.31197
Mazer, Benjamin et al. Screening for pancreatic cancer has the potential to save lives, but is it practical? Expert Review of Gastroenterology and Hepatology. Vol. 17, No. 6, 2023, pp. 555-574. doi:10.1080/17474124.2023.2217354.
“Pancreatic Cancer.” National Pancreas Foundation. https://pancreasfoundation.org/pancreas-disease/pancreatic-cancer/?gad_source=1
Siegel, Rebecca et al. Cancer Statistics, 2024. CA: A Cancer Journal for Clinicians, Vol. 74, No. 1, 2024, pp. 12-49. doi:10.3322/caac.21820
Zhang, Lulu et al. Challenges in Diagnosis of Pancreatic Cancer. World Journal of Gastroenterology. Vol. 24, No. 19, 2018, pp. 2047-2060. doi:10.3748/wjg.v24.i19.2047
Hi, I'm David Newby. In my career as a translator, editor, and writer in the life sciences, I’ve focused on communicating complex scientific and regulatory material, with a particular emphasis on the Japanese market. To succeed in that, I’ve cultivated precision and rigor, but also the empathy and curiosity you need to communicate with different audiences, cultures, and disciplines.
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