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Is there a connection between uncontrolled diabetes and pancreatic cancer?

Thursday, May 18, 2017

This is an excerpt of an article that appeared in US News and world Reports. Read the full story here. 

Gastrointestinal oncologist Allyson Ocean of the Meyer Cancer CenterAllyson Ocean, M.D. The facts about pancreatic cancer can be bleak. Pancreatic cancer accounts for 3 percent of all cancer cases but 7 percent of all cancer-related deaths. Of the predicted 53,670 people in the U.S. who will be diagnosed with pancreatic cancer this year, more than 43,000 will die from it, according to the American Cancer Society. And pancreatic cancer recently became the third-leading cause of cancer deaths. By the year 2020, it’s expected to become the second-leading cause of cancer deaths.

The reason it’s so fatal is that it can be hard to detect until there are obvious symptoms. “It’s almost always diagnosed in stage 4. There are no symptoms until then,” says Dr. Allyson Ocean, a medical oncologist at Weill Cornell Medicine in New York. Stage 4 indicates a cancer's most advanced form, and at that point it has spread to other parts of the body.

When you have diabetes, you’re at a higher risk for a number of health conditions than someone who doesn’t have the disease. These include high blood pressure, vision loss and certain types of cancer. But if you have a sudden onset of uncontrolled diabetes, does that mean you’re at a higher risk for pancreatic cancer?

The bottom line: The risk may be a little higher, but it’s not a simple answer.

First, consider the math. There are 1.4 million new diagnoses of diabetes each year, according to the American Diabetes Association. However, there are only about 53,000 new pancreatic cancer patients. If you recently developed diabetes, and it’s hard to control – which could indicate pancreatic cancer – doctors will look at other risk factors you may have, such as a family history of pancreatic cancer, pancreatitis, an older age, a history of smoking and presence of the BRCA gene.

Diabetes is also a risk factor for pancreatic cancer, especially in those who have had it for more than five years, according to the Pancreatic Cancer Action Network. However, it’s not clear why the risk is higher... Many patients with pancreatic cancer and diabetes may have a poor diet and a sedentary lifestyle, both of which can raise your cancer – and diabetes – risk.

Doctors also check for pancreatic cancer-associated symptoms, like recent weight loss, abdominal or back pain and jaundice (a yellowing of the skin), Ocean says. Other symptoms include decreased appetite, itching and darker urine. If you have symptoms of Type 2 diabetes and possible pancreatic cancer, doctors may consider how you don’t match the typical Type 2 diabetes profile – for example, you’re thin versus overweight or you’re younger than the typical person with Type 2 diabetes.

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Although screening for pancreatic cancer is not recommended for all new patients diagnosed with diabetes, Ocean believes it will become more common in the future for higher-risk patients, such as those with a family history of pancreatic cancer or a long history of smoking.

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Ocean encourages those with pancreatic cancer to participate in clinical trials, which can help shed light on the best screenings and future treatments. Ask your doctor about available clinical trials or check out the clinical trials information on the Pancreatic Cancer Action network website.

To help lower your risk for cancer overall, try to eat healthy, lose weight if necessary and keep up with any regular cancer screenings recommended by your doctor. “We have to try to empower people before they get cancer. So much has to go into prevention,” Ocean says.