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Pancreatic cancer from a different perspective

directorsblog.nih.gov

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Re: Pancreatic cancer from a different perspective

#31

Post by scurvy »

mikeyouse wrote: post #29
melling wrote: post #15

Earlier quoted context omitted.

What about the other 70% chance? We really need early detection. The list of famous people that I've heard of who died from pancrer cancer keeps growing: Randy Pausch - Last Lecture Steve Jobs Patrick Swayze Sally Ride - astronaut Piers Sellers - astronaut Hans Rosling Richard Hatch

Steve Jobs very notably had the 'good' kind of pancreatic cancer which has a very high success rate from treatment. There are two types of cells in the pancreas, exocrine cells and endocrine cells. 1. Exocrine cells - 95% of pancreatic cancer are in the exocrine cells which produce the enzymes that are responsible for food digestion, and 95% of exocrine cancers are adenocarcinomas which impact the cell lining of the…

And while squamous cells don't normally exist in the pancreas, you can get squamous cell carcinomas in the pancreas (which is particularly vicious and faster spreading than even adenocarinomas -- but is exceedingly rare).

Re: Pancreatic cancer from a different perspective

#32

Post by arwhatever »

rscho wrote: post #11
gthtjtkt wrote: post #3

Earlier quoted context omitted.

Every time I read about something like this, I wonder how people can make it through medical school without dying of anxiety. So many terminal illnesses that could already be killing you with no early warning signs... how can they sleep!?

Medical school makes you dead inside, which is very practical to work long hours and not worrying about dying on the outside :) As a European working in the US medical system, my general impression is that US people fear death much more than in Europe, where people bother much more about suffering than dying in itself. I don't really understand why, but americans seem in my experience far more willing to undergo inva…

All the better to politically motivated is with :-)

Re: Pancreatic cancer from a different perspective

#33

Post by SwellJoe »

mikeyouse wrote: post #29
melling wrote: post #15

Earlier quoted context omitted.

What about the other 70% chance? We really need early detection. The list of famous people that I've heard of who died from pancrer cancer keeps growing: Randy Pausch - Last Lecture Steve Jobs Patrick Swayze Sally Ride - astronaut Piers Sellers - astronaut Hans Rosling Richard Hatch

Steve Jobs very notably had the 'good' kind of pancreatic cancer which has a very high success rate from treatment. There are two types of cells in the pancreas, exocrine cells and endocrine cells. 1. Exocrine cells - 95% of pancreatic cancer are in the exocrine cells which produce the enzymes that are responsible for food digestion, and 95% of exocrine cancers are adenocarcinomas which impact the cell lining of the…

"His tumor was first diagnosed in 2003 and he basically ignored it for a year in favor of alternative treatments and healthy eating. By the time he actually had surgery, the cancer had progressed to mets in his lymphs and his liver."

And, to make it clear just how ridiculous his decision was, among the alternative treatments he used included coffee enemas. There's literally no reason at all to believe coffee enemas can cure cancer, but that's what he was doing while his cancer was spreading.

Everyone should be able to make their own treatment decisions, of course. But, my dad was killed by the distinctly not good kind of pancreatic cancer, and I feel a little entitled to be pissed off at folks who squander the incredible fortune of having a treatable case and ignoring every bit of relevant science in favor of the advice of quacks.

Re: Pancreatic cancer from a different perspective

#34

Post by obstinate »

gms7777 wrote: post #22
lazerpants wrote: post #14

Earlier quoted context omitted.

The most promising early warning tests I've seen in the past few years look at degraded DNA fragments floating in the blood that have been shed by cancers. This will probably be the winning technology for all cancer early diagnoses, though genetic biomarkers will probably fail to catch all cancers.

Circulating tumor DNA has several challenges towards being an effective test. The first is just the relatively low proportion of it in the blood (especially before growth is significant) makes reliable detection fairly difficult. The bigger issue though will likely be managing the false discovery rate. Nearly everyone will have precancerous growths and benign lesions which may share many genetic biomarkers with poten…

One wonders if one could train a neural network to look at the mix of junk in the blood and predict what a person will have died of in five years. At this point I'm sure the idea is science fiction. But seeing how DeepMind's AlphaGo played that game, teasing out moves that are beyond human conception routinely, one begins to suspect that there must be some signal that a sufficiently intelligent device could suss out.

I suspect that one decade we will consider this idea almost impossible, and by the end of the next, it will seem old hat. I just wonder which decade that will end up being.

Re: Pancreatic cancer from a different perspective

#35

Post by killjoywashere »

Meh, finding a transcription factor for a tissue type is helpful, but the diagnosis of pancreatic cancer isn't in doubt all that often. The hard part is target a tumor that has already mutated its way out of its organ of origin. And transcription factors are very hard to target therapeutically.

Re: Pancreatic cancer from a different perspective

#36

Post by honestoHeminway »

mikeyouse wrote: post #26
rosser wrote: post #4

Earlier quoted context omitted.

What ever happened to the point-of-care test developed by a teenager (Jack Andraka) using CNTs to isolate and test for mesothelin, a potential biomarker for pancreatic cancer? EDIT: Looks like it's tied up in various patent and testing limbos, the former of which seem somewhat self-imposed. There's also some doubt about the specificity of mesothelin to pancreatic cancer.

It's almost always safe to ignore any 'Wonder Teenager makes Breakthrough' articles if the field of the breakthrough is hard science. The likelihood of a novice inventing something novel in a field with tens of thousands of PhDs is so incredibly low that the breakthrough is almost guaranteed to be overstated. George Church (and others) looked at Andraka's preprinted paper and wasn't exactly blown away. The cost and s…

It often turns what could be a very fruitfull career- with contributions to a breakthrough- into a one-trick-pony.

My grandfather, a professor for chemistry, did as a student research on ion exchange resin - which later became valuable applied to water softeners. He did a lot of interesting research later when it came to analytical sciences (radio-chemistry) but that early success sort of over-shadowed everything.

Its a haunting experience, unless you dono longer externalize your value as a researcher.

Re: Pancreatic cancer from a different perspective

#37

Post by johapers »

jessriedel wrote: post #2

A reliable early warning system for pancreatic cancer is highly sought after because the disease progresses so quickly once detected. If caught while still confined to the pancreas it can often be cured by surgery, but the large majority of patients are already metastatic before symptoms appear. The one-year relative survival rate after diagnosis is 20%, and the five-year rate is 7%. In the US it is the 4th most comm…

A quite interesting Swedish company that uses immune system biomarkers for early detection

http://immunovia.com/

They use these biomarker together with a statistical algorithm to find very high specificity and sensitivity at the same time.

Re: Pancreatic cancer from a different perspective

#38

Post by odiroot »

jessriedel wrote: post #2

A reliable early warning system for pancreatic cancer is highly sought after because the disease progresses so quickly once detected. If caught while still confined to the pancreas it can often be cured by surgery, but the large majority of patients are already metastatic before symptoms appear. The one-year relative survival rate after diagnosis is 20%, and the five-year rate is 7%. In the US it is the 4th most comm…

Yes, this kind of cancer is brutally fast.

My father died less than a year from the diagnosis. The only real symptoms appeared 2-3 months before doctors even considered cancer.

The tumor was sneakily sandwiched between different organs, on the tail of pancreas.

As far as I know (from Polish oncologists) it was basically undetectable early enough to fight successfully. And it was probably developing for 15-20 years before.

I would really love to be able to easily check my pancreas for any unhealthy changes as the inherited risk is pretty high.

Re: Pancreatic cancer from a different perspective

#39

Post by petercooper »

odiroot wrote: post #38
jessriedel wrote: post #2

A reliable early warning system for pancreatic cancer is highly sought after because the disease progresses so quickly once detected. If caught while still confined to the pancreas it can often be cured by surgery, but the large majority of patients are already metastatic before symptoms appear. The one-year relative survival rate after diagnosis is 20%, and the five-year rate is 7%. In the US it is the 4th most comm…

Yes, this kind of cancer is brutally fast. My father died less than a year from the diagnosis. The only real symptoms appeared 2-3 months before doctors even considered cancer. The tumor was sneakily sandwiched between different organs, on the tail of pancreas. As far as I know (from Polish oncologists) it was basically undetectable early enough to fight successfully. And it was probably developing for 15-20 years be…

I would really love to be able to easily check my pancreas for any unhealthy changes as the inherited risk is pretty high.

That sounds good, but it would be necessary to do this in a way where problems with only a low risk would not be highlighted.

For example, to avoid a brain aneurysm, you might opt to be scanned on a frequent basis. Except what happens if they find a blood vessel with a 1% annual chance of rupture but the fatality rate of an operation to reduce the risk is, say, 10%? This places most people into a very difficult situation where the difficulty of having a 1% annual risk of rupture is hard to balance against the 10% chance. This is just one reason why proactive screening is not done in otherwise healthy subjects.

Re: Pancreatic cancer from a different perspective

#40

Post by nerdponx »

petercooper wrote: post #39
odiroot wrote: post #38

Earlier quoted context omitted.

Yes, this kind of cancer is brutally fast. My father died less than a year from the diagnosis. The only real symptoms appeared 2-3 months before doctors even considered cancer. The tumor was sneakily sandwiched between different organs, on the tail of pancreas. As far as I know (from Polish oncologists) it was basically undetectable early enough to fight successfully. And it was probably developing for 15-20 years be…

I would really love to be able to easily check my pancreas for any unhealthy changes as the inherited risk is pretty high. That sounds good, but it would be necessary to do this in a way where problems with only a low risk would not be highlighted. For example, to avoid a brain aneurysm, you might opt to be scanned on a frequent basis. Except what happens if they find a blood vessel with a 1% annual chance of rupture…

That doesn't make sense to me. What if that 1% chance suddenly turns into a 50% chance? If I suddenly present with symptoms of a risky aneurism, wouldn't having that "1% chance, last we checked" on my medical history help accelerate the correct diagnosis and treatment?
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