Most early stage diagnoses of pancreatic cancer are inaccurate
CANCER DIGEST – Sept. 8, 2024 – A new analysis of early stage pancreatic cancer patients shows the stage of the disease is under diagnosed in 80 percent of cases. The study by researchers at the Cedars-Sinai Cancer Center in Los Angeles appears on the Sept. 5, 2024 journal JAMA Network.
The researchers examined data from more than 48,000 pancreatic cancer patients in the National Cancer Database who had been diagnosed with either stage 1 or stage 2 pancreatic cancer. After treatment with surgery to remove the cancer, 78 percent of stage 1 patients and 29 percent of stage 2 patients were upstaged due to lymph node involvement.
"Our research reveals that staging – essential for making treatment decisions and determining research eligibility is often inaccurate in early-stage pancreatic cancer," Srinivas Gaddam, MD, MPH, associate director of the Pancreatic Billiary Research program at Cedars-Sinai and senior author of the study said in a press release. "As the field is racing toward earlier diagnosis, early staging will become increasingly important."
The pancreas is soft tissue organ located deep in the body and is involved in digestion. It is difficult for current imaging technology to detect small tumors and even smaller cancer cells in the lymph nodes. These lymph nodes are located throughout the body and form an important part of the immune system. The lymphatic system serves as a kind of "highway" for transporting tumor cells from one organ to other parts of the body.
Consequently, finding cancer in the lymph nodes near the primary tumor is a key difference between early stage and later stage cancers. In pancreatic cancer, for example, the five-year survival rate for people with stage 1 pancreatic cancer is more than 83 percent. The five-year survival rate declines with each higher stage of diagnosis, with only about 3 percent of people with stage 4 pancreatic cancer surviving five years.
Even with MRI and ultrasound imaging, pancreatic cancer is difficult to diagnose and is most often diagnosed at later stages. With the discovery of gene variants associated with the disease, people with family history of pancreatic cancer are also being screened for those genes in the hope of catching the disease in its early stages.
Gaddam’s message for clinicians staging pancreatic cancer is to recognized the limitations of current imaging technology and to actively assess lymph node involvement.
“We know that our current screening and staging tools aren’t great,” Gaddam said in the press release. “My hope is that within the next 10 years, we will develop advanced tools for screening and staging pancreatic cancer, allowing us to diagnose most patients at stage 1 and stage 2 rather than stage 4. With these advancements, we can catch this disease much earlier, improving outcomes for many more patients.”
Source: Cedars-Sinai Cancer Center press release
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