PHILADELPHIA — Just seven years from now, pancreatic cancer is projected to become this country’s second-leading cancer killer, surpassed only by lung cancer and claiming 48,000 lives a year.
Now No. 4, pancreas cancer will climb in the ranking partly by becoming more common, but mostly because it is ferociously difficult to detect and treat, according to an analysis by the Pancreatic Cancer Action Network.
“The dramatic increase in the anticipated number of deaths … is a wake-up call to the research and health-care systems in the United States,” senior author Lynn Matrisian, a molecular biologist, wrote last month in the journal Cancer Research.
The hopeful counterpoint to this dire prediction is that the call has already been heard. A war on pancreas cancer is underway, and it is improving the outlook, at least a little, for patients with the grimmest common malignancy.
The war is being driven by unconventional players who want to get new treatments into the clinic now. That includes the entertainment industry’s Stand Up to Cancer initiative, family philanthropies such as the Lustgarten Foundation, the advocacy group Pancreatic Cancer Action Network (PanCan), and the PanCan-inspired federal “recalcitrant cancer” law.
The result is that medical centers across the country are testing chemotherapies, targeted therapies, immunotherapies, and much more, as they reshape the understanding and treatment of pancreatic cancer.
“We’re not declaring victory. We’re declaring progress,” said Jeffrey Drebin, chair of surgery at the University of Pennsylvania’s Abramson Cancer Center and a member of the SU2C “dream team.”
The survival rate for cancer overall has steadily improved since war was declared in 1972. Today, 67 percent of all patients live five years, and the rate is over 90 percent for the most common cancers, breast and prostate.
In contrast, five-year survival for pancreatic cancer is 6 percent. Only one in four patients live a year. (Apple founder Steve Jobs had a neuroendocrine tumor of the pancreas, a rare and less aggressive form with a five-year survival rate of about 60 percent.)
In 2012, pancreatic cancer was diagnosed in 44,000 Americans and killed 37,000. Lung cancer, which was responsible for more than 150,000 deaths that year, will remain the No. 1 killer by far, but last month’s paper projects that pancreatic cancer will edge past colorectal, breast, and prostate cancers for the No. 2 spot by 2021.
Obesity and diabetes are factors behind the rising incidence of pancreatic cancer, although the connections are unclear.
The National Cancer Institute in March outlined plans to investigate the link between diabetes and pancreatic cancer, and to develop drugs that target mutated RAS genes. Both initiatives are the result of the Recalcitrant Cancer Research Act, signed into law by President Barack Obama last year, which requires the institute to step up research on cancers with low survival rates.
“We absolutely need to figure it out,” said Penn oncologist Robert Vonderheide. “It’s a medical emergency.”
