PANCREATIC CANCER CAUSES AND RISK FACTORS
The true specific cause of pancreatic cancer (ductal adenocarcinoma of the pancreas) in an individual is generally never fully known. But there are population level studies which demonstrate associations between specific behaviors or characteristics and pancreatic cancer. And pancreatic cancer is more common in some families, for example those who appear to carry one of the BRCA genetic mutations which are found more commonly in Ashkenazi Jewish backgrounds and certainly others.
A risk factor is a variable that may tend to increase an individual’s risk of acquiring pancreatic cancer. Who we are and what we do has some effect on the diseases that we may contract. In this process, pancreatic cancer is no different from other diseases; although there is still a great deal that we do not understand about the cause and effect of risk factors to pancreatic cancer.
Having many risk factors does not necessarily mean that one will contract pancreatic cancer. And again in many individuals, there is no fully understood reason why they may have acquired the disease. It is important to understand the limitation of this central idea of risk factors – they are perhaps useful but not definitive.
The incidence of pancreatic cancer increases with age; most people are between the ages of 60 to 80 when they receive the diagnosis. The median age at the diagnosis of pancreatic cancer is between 70 and 71 years old. Men had tended to be over-represented, though in recent years the gap between men and women has shrunk, possibly due to increased cigarette smoking among women. It was observed in the past that men had about an up to 30% increased risk of acquiring pancreatic cancer (over women), but for unexplained reasons, possibly smoking, this gender gap seems in more recent times to have significantly decreased.
OUR PHILOSOPHY ABOUT PANCREATIC CANCER
Pancreatic cancer is a serious disease. Taking an aggressive rational stance at the earliest possible time, supported by the best medical team, and treated in the most appropriate manner gives the best chance for survival.
We believe in strong patient-physician bonds, scientifically-based treatment, and that comfort can come from knowing that everything that reasonably can be done – is being done.
That the best approach is meeting cancer of the pancreas head-on and armed with the best available information.
African Americans tend to be more likely to acquire cancer of the pancreas as compared to their Caucasian counterparts. The causes of this are not entirely clear, but may have to do with diet, smoking, diabetes rates, and obesity.
Cigarette smoking is a prominent risk factor. Between 20-30% of cases of pancreatic cancer are thought to be attributable to smoking. Other forms of tobacco use (including smokeless forms) can increase risk too. But it is also true that at about ten years after quitting smoking, the rate of pancreatic cancer moves about back to that of those who have never smoked.
Pancreatic cancer is more likely in those with diabetes, but the study results are a bit mixed. It is not entirely clear if diabetes is a cause or a result. This includes and may be especially true in those with type 2 diabetes. Similarly, those who are obese have an increased risk of acquiring pancreatic cancer, though some of this may be explained on the basis of the relationship between diabetes and obesity.
Certain published medical articles have associated diets rich in fat, with a high level of meat, and/or with processed meat to be linked to a higher rate of pancreatic cancer. Coffee is currently thought not to be a risk factor for pancreatic cancer. Moderate intake of alcohol appears relatively safe, but in recent studies the excessive and prolonged drinking of alcohol has been linked to an increased likelihood of pancreatic cancer.
Certain illnesses which may or may not appear to directly affect the pancreas appear to confer an increased possibility of contracting pancreatic cancer – and thus are risk factors. These include, for example, chronic pancreatitis, cirrhosis of the liver, peptic ulcer disease associated with the Helicobacter pylori (H. pylori) bacteria, and certain kinds of hepatitis.
Prolonged exposures to given metals, chemical and dyes may be risk factors for pancreatic cancer.
Pancreatic cancer can run in some families due to increased risk factors related to genetics. It is thought that having a genetic predisposition may be responsible for as much as 10% of pancreatic cancer. Some of the genetic type syndromes or disease complexes that can dispose to a higher incidence of pancreatic cancer (adenocarcinoma) include familial mutations in the BRCA1 and BRCA2 genes, genetic melanoma, genetic chronic pancreatitis, genetic non-polyp colorectal tumor (Lynch syndrome), Peutz-Jeghers syndrome, and Von Hippel-Lindau syndrome.
Neuroendocrine tumors, islet cell tumors and carcinoid tumors can also, for example, be associated with hereditary predisposition tendency diseases such as neurofibromatosis, and with various “multiple endocrine neoplasia” (MEN) type syndromes.