Oct. 27, 2010 -- Pancreatic cancer is among the most lethal malignancies, with fewer than 5% of patients still alive five years after diagnosis.

It has long been suspected the disease is so deadly because it grows so quickly, but surprising new research finds the opposite to be true.

The investigation found that pancreatic cancer develops and spreads much more slowly than has been thought, with the timeline from when it first forms to when it kills spanning two decades or more, says Christine Iacobuzio-Donahue, MD, PhD, of Baltimore’s Johns Hopkins Sol Goldman Pancreatic Cancer Research Center.

That means effective early detection strategies could have a major impact on outcomes, transforming a highly fatal disease into a largely treatable or sometimes preventable one like colon cancer, she adds.

The research appears in the Oct. 28 issue of the journal Nature.

“Based on this research there is reason to be very optimistic about how we will approach pancreatic cancer in the future,” Iacobuzio-Donahue tells WebMD. “I really do believe we will make great strides in curing people with this disease.”

Slideshow: Pancreatic Cancer Overview
Slow Growth of Pancreatic Cancer

It’s estimated that about 43,000 new cases of pancreatic cancer will be diagnosed in 2010 in the U.S. and about 37,000 people will die of the disease, according to the National Cancer Institute.

The vast majority of patients are diagnosed after their cancer has spread to distant organs. Very few patients show sustained responses to treatments such as surgery, chemotherapy, or radiation.

A major focus of the Hopkins research has been to determine whether this is a result of rapid spread of the disease or late detection.

By analyzing tissue samples taken from seven patients immediately after their deaths from pancreatic cancer, the researchers identified distinct subclones of cancer cells present in primary tumors years before the cancer spread to other parts of the body.

Using a mathematical model, they estimated that it takes on average about 20 years from the beginning of the tumor process to death from pancreatic cancer.

Iacobuzio-Donahue says the finding shows the importance of efforts to find effective screening strategies to detect pancreatic cancer in the years before symptoms occur.

“The thinking has been that pancreatic cancer is so aggressive there isn’t much that can be done about it, but there is a lot that we can do even now,” she says.
Importance of Early Detection

James Abbruzzese, MD, who chairs the GI Medical Oncology department at the University of Texas M.D. Anderson Cancer Center, is one of many researchers across the country searching for better ways to detect pancreatic cancer early.

He says the newly published research speaks to the urgency of these efforts.

“This makes it even more clear that the focus needs to continue to be on early detection strategies,” he says.

Between 5% and 10% of patients have a family history of the pancreatic cancer. Abbruzzese says researchers have learned a great deal in the last few years about the genetic influences on the disease and the impact of lifestyle factors such as smoking, obesity, and type 2 diabetes.

Imaging techniques such as MRI and ultrasound are already being used to screen patients with a family history of the disease.

“I think it is realistic to believe that we will have interventions to reduce the burden of pancreatic cancer within the next 10 years,” he says.