More and more people are suffering from pancreatic cancer. The disease is insidious and often only becomes noticeable late. A doctor is now warning of the further spread. How you can protect yourself.

Over 20,000 Germans are diagnosed with pancreatic cancer every year. The trend is rising. The risk also increases with age.

Although this type of cancer is not one of the most common, experts say it could become one of the most fatal types in the coming years.

Jens Werner, director of the Clinic for General, Visceral and Transplantation Surgery at the LMU Munich Hospital, emphasized this in an interview with the “FAZ”. “We assume that pancreatic cancer will be the second most common cause of cancer-related death after lung cancer in 2030,” he says. This is because pancreatic cancer is considered to be extremely aggressive and insidious.

Pancreatic cancer is medically known as pancreatic carcinoma and is not one of the most common types of cancer. But no other is as insidious: those affected and their doctors often only become aware of pancreatic cancer when it is too late for a cure.

And while survival rates for most types of cancer have increased significantly in recent years, for pancreatic patients it is still only eight percent five years after diagnosis. The average life expectancy after diagnosis is only two to three years, and patients often only have months to live.

The reason: There have been hardly any medical advances for pancreatic cancer, such as those that have led to steadily increasing survival rates for other types of tumors in recent decades.

Lifestyle: Smoking, obesity, a diet rich in fat and meat, and excessive alcohol consumption are risk factors for pancreatic cancer. However, the connection is not as clear as with smoking and lung cancer. Conversely, you should avoid alcohol and nicotine and eat a balanced diet, for example following the example of the Mediterranean diet.

Inflammation: The influence of chronic pancreatitis on the risk of pancreatic cancer is clear.

Diabetes: Diabetes is not a direct precursor to pancreatic cancer, as polyps are to colon cancer, for example. But diabetes often precedes a cancer diagnosis shortly afterwards. In an interview with the Welt, Volker Ellenrieder, director of the Clinic for Gastroenterology and Endocrinology at the University Medical Center Göttingen, said that diabetes could perhaps even be an early detection feature. It has been found that when pancreatic cancer is diagnosed in a patient in their mid-50s, they have often already been diagnosed with diabetes a few years previously.

Predisposition: Genetic factors play a role, especially hereditary forms of chronic pancreatitis. If one or two close relatives have pancreatic cancer, it makes sense to seek medical advice.

Lack of early detection: Another risk factor is the fact that there are no early detection methods for pancreatic cancer, unlike for breast or colon cancer. In the future, research here will focus on blood tests (“liquid biopsy”). However, no approach is yet sufficiently advanced to allow reliable early cancer detection in the blood.

Doctors usually discover the malignant tumor late and often by chance during another examination of the abdominal cavity. If pancreatic cancer is suspected, the family doctor first carries out a physical examination with an ultrasound of the abdomen. For further examinations such as a CT scan and an endoscopic examination, the family doctor will refer the patient to a suitable specialist, or even to a cancer center if necessary.

A biopsy, which confirms the diagnosis in many other types of cancer, is not useful in the case of pancreatic cancer. This is because taking tissue from the pancreas is difficult and not without risk.

If the tests suggest pancreatic cancer and the tumor has not yet spread, doctors may recommend immediate surgery at a certified pancreatic cancer center.

1) Operation

If the tumor is detected early enough for surgery to be considered, there is a chance of a complete cure. The operation is almost always followed by supportive chemotherapy for six months. Sometimes chemotherapy prior to surgery is also intended to shrink a tumor. After the pancreas has been removed, the patient must replace the vital enzymes and hormones (such as insulin) produced there with medication.

2) Chemotherapy

In most patients, the disease is so advanced at the time of diagnosis that the tumor can no longer be operated on. It has then grown into the surrounding tissue or has already formed metastases. The standard treatment here is chemotherapy with the aim of prolonging survival time and improving quality of life.

3) Personalized cancer therapy

Pancreatic cancer often does not respond to standard chemotherapy. But until this is clear, valuable time is lost. A therapy that is precisely tailored to the tumor in question can help to resolve this dilemma. Based on the cancer’s genetic fingerprint, oncologists can select promising active substances and not even use those that the cancer will not respond to anyway.

4) Experimental therapies

At the centers specializing in pancreatic cancer, new therapeutic approaches are used in studies. Certain new drugs can complement chemotherapy or achieve success in patients for whom the usual cell poisons do not work. Patients can take part in such studies if their disease makes them suitable.

Immunotherapy, which is currently the main hope for cancer treatment, has so far failed to treat pancreatic cancer. Unlike most other types of cancer, the immune system does not recognize pancreatic cancer. Research must first find out how an immune reaction can be triggered.

Good palliative care is important for the quality of life of patients with a poor prognosis. This includes the clarification of symptoms associated with the tumor, but also support for the family, social and psychological situation of the patients and their relatives. In addition to the important and often necessary pain therapy, it also takes into account aspects such as nutrition and exercise.