Why pancreatic cancer is so challenging to diagnose and treat

Dr. Daniel Breadner, Physician, Oncology at London Health Sciences Centre (LHSC)

November 3, 2022

Pancreatic cancer is one of the more challenging cancers to diagnose and treat. Even though medicine has come a long way regarding the treatment of pancreatic cancer, it is still difficult and progress in the diagnosis and treatment of pancreatic cancer has not kept pace with the progress of other cancers.

“The reasons why pancreatic cancer is difficult to treat is two-fold,” explains Dr. Daniel Breadner, Physician, Oncology at London Health Sciences Centre (LHSC) who is a medical oncologist that is a part of The Baker Centre for Pancreatic Cancer team. “First, the symptoms of pancreatic cancer can overlap with other more common ailments. Often, pancreatic cancer is found after treatments for those other ailments don’t work so it is found at a later stage. Second, the pancreas is fairly hard to image. Small lesions within the pancreas can be difficult to detect.”

The pancreas is deep in the middle of the body. It is not only more difficult to image, but to get to for surgery for treatment as well. If a person is more advanced in age or has other illnesses that may weaken the body, they may not be able to undergo a pancreatic surgery. 

Some of the signs and symptoms of pancreatic cancer include: 

  • Poor appetite/unintentional weight loss:  This is very common in people with pancreatic cancer. Often, these patients experience decreased or no appetite, bloating and indigestion. 
  • Abdominal pain:  People with pancreatic cancer often experience upper abdominal and/or mid back pain. 
  • Jaundice/Itchy skin:  People who are experiencing the yellowing of their skin and eyes are jaundiced. This is caused by high bilirubin counts in their blood.  When a person is jaundiced, they may experience itchiness all over their skin, abnormally dark urine and light clay-coloured stools.
  • Fatigue: People with any of the mentioned symptoms above, often find they become more tired more quickly with any activity/work. 
  • Late-Onset Diabetes:  Because the pancreas regulates our insulin levels, often people with a pancreatic tumor, develop the late onset of Diabetes Mellitus. 
  • Nausea and vomiting: Nausea and vomiting can occur when a pancreatic mass is pressing on the digestive tract. When a patient experiences nausea and vomiting, it can lead to poor appetite, dehydration and weight loss.

This is not a comprehensive list and other conditions can be risk factors including a history of pancreatitis (inflammation of the pancreas) and alcohol mis-use, as well as genetic factors.

Dr. Breadner says, “Individuals with the BRCA mutations that pose a higher risk of developing cancers such as breast and ovarian, are also at higher risk of developing pancreatic cancer as well.”

While pancreatic cancer is more challenging to diagnose and when diagnosed, is often found in those later stages where treatment is more difficult, there are researchers, like those at The Baker Centre for Pancreatic Cancer, who are working on ways to better identify and treat this cancer. 

“There are research focuses at The Baker Centre and beyond that are looking at new ways to test for cancer that don’t involve imaging, and new improvements to treat the cancer that may prolong quality of life with the hope we can find a way to cure it in the future,” Dr. Breadner says. “Until that point, the best way to lower your risk of developing pancreatic cancer is to live a healthy lifestyle inclusive of healthy eating and regular exercise and to speak with your primary care provider about concerns you may have about symptoms you may be experiencing.”