“Due to the location of the pancreas, early tumors can’t be seen or felt by health care providers during routine physical exams,” McAllister says. “Patients are usually diagnosed when the cancer cannot be surgically removed.”
Who’s at risk?
Pancreatic cancer risk is higher in those whose parents, siblings or children developed the disease, particularly at a young age, and in those who have any of 10 genetic mutations, including a mutation in the BRCA2 gene, better known for raising breast cancer risk.
Family history coupled with genetic mutations place a person in the high-risk category. Some genetic mutations alone place a person at an increased risk, even without a family history of pancreatic cancer. One example is a mutation in the STK11 gene, which can be found in people with Peutz-Jeghers Syndrome. The syndrome causes noncancerous growths in the gastrointestinal tract and puts people at a greatly increased risk of developing certain types of cancer, including cancer of the gastrointestinal tract, pancreas, cervix, ovaries and breast.
Other factors such as chronic inherited inflammation of the pancreas, called pancreatitis, are powerful and well-known risk indicators.
At MD Anderson’s high-risk clinic, patients are tested for a blood biomarker called CA-19-9, which can indicate cancer but also is prone to false positives. Magnetic resonance imaging and endoscopic ultrasound examinations follow, McAllister says.
Clinic participants are relatives of MD Anderson patients, referrals from other clinics, such as breast, or self-referrals — usually relatives of cancer patients.
Recent studies have found that about 1% of adult patients diagnosed with new-onset diabetes will also be diagnosed with pancreatic cancer within three years of the date of their diabetes diagnosis. The high-risk screening clinic will be expanding to screen new-onset diabetic patients during this three-year window.
Read more about the pancreatic cancer clinic on MD Anderson's website.