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Why Is Pancreatic Cancer So Hard to Diagnose and Treat?


More than 60,000 people will be diagnosed with pancreatic cancer in the United States this year. Because it often doesn’t cause symptoms until it has progressed into later stages, the deadly condition can be very difficult to treat.

“Pancreatic cancer is hard to diagnose early because there’s no standard screening test for it,” says medical oncologist and associate director of clinical research Maged Khalil, MDwith LVH Hematology Oncology (part of Lehigh Valley Topper Cancer Institute). “People experience symptoms before ever being checked for it.”

By the time Khalil sees most of his patients, they are already experiencing symptoms, including:

  • Abdominal or back pain
  • Blood clots
  • Dark urine
  • Fatigue
  • Jaundice
  • Light-colored stools
  • Loss of appetite
  • Unexplained weight loss

However, even if Khalil and his team identify it early, pancreatic cancer is still problematic. “Stage for stage, pancreatic cancer is associated with lower survival rates than many other cancers,” he says.

This is because pancreatic cancer is resistant to many standard therapies due to signaling redundancy – “single targeted agents are less likely to be effective,” Khalil says. The tumor is often surrounded by connective tissue, which makes it difficult for treatment to reach its target.

Who is at risk for pancreatic cancer?

Khalil sees pancreatic cancer in more men than women and usually in older patients, between the ages of 65 and 80. About 30 percent of patients are smokers, and 5 percent have a history of pancreatitis, an inflammation of the pancreas, which can be caused by stones or heavy alcohol intake.

Approximately 10 percent of pancreatic cancers are due to inherited gene alteration, like BRCA1 and BRCA2 gene mutations. Diets high in fat and processed meat, obesity, a history of diabetes, and exposure to industrial carcinogens also may increase your risk.

More options than ever

While advanced pancreatic cancer is considered incurable, there are more treatment options available today than ever before:

Pancreatic Cancer Care

Lehigh Valley Topper Cancer Institute

To learn more about our Cancer Institute, options for care, and the dedicated people who provide that care, call 888-402-LVHN (5846).

Read more about the Cancer Institute

Expanded chemotherapy treatments

Within the last two decades, chemotherapy treatment options have expanded from one single drug to a menu of options that offer patients longer life expectancy, a better quality of life and more hope.

A multidisciplinary clinic (MDC) at Lehigh Valley Topper Cancer Institute

Lehigh Valley Topper Cancer Institute offers cancer patients consultations with multiple cancer specialists through multidisciplinary clinics (MDC). For pancreatic cancer patients, the gastrointestinal cancer MDC brings together specialists from surgical oncology, radiation oncology, medical oncology, nursing, radiology, pathology clinical trials, nutrition and social services. This collaborative, interdisciplinary group explains the patient’s diagnosis and offers recommendations for treatment. As part of the MDC meeting, the patient and his or her loved ones are encouraged to ask questions. A nurse navigator also attends the MDC and coordinates care for the patient afterward.

Access to clinical trials

There is so much new pancreatic cancer research taking place every day, including trials for new chemotherapy drugs, targeted therapies, immunotherapies  and other drug combinations. Patients at the Cancer Institute can participate in clinical trials through NCI Community Oncology Research Program (NCORP), as well as clinical trials available at Memorial Sloan Kettering through the Memorial Sloan Kettering Cancer Alliance. We also offer many other pharmaceutical and investigator-initiated trials.

“At Lehigh Valley Topper Cancer Institute, we check tumor molecular profiling to look for actionable mutations. This helps us recommend the most appropriate clinical trials for each of our eligible patients,” Khalil explains. “There’s more happening now than ever before.”

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