I've been a huge fan of singer Aretha Franklin ever since the days of yore when I promoted folk music festivals, so I was distressed to hear reports that she is battling pancreatic cancer. My personal physician (and hero) is Dr. Stephen Pandol, who heads a research team devoted to curing pancreatic cancer at the West L.A. Veteran's Hospital -- where I go -- but also is at UCLA and a Scientific Advisory Board Member with the Hirshberg Foundation for Pancreatic Cancer Research. I asked him to tell me a bit more about this insidious illness, which seems to be raging in epidemic proportions these days.
"There are about 40,000 cases of pancreatic cancer diagnosed in the U.S. alone each year," he began. "The survival rate is very low, only about 5% over a two-to-five year period, one of the lowest survival rates of any of the cancers. It is actually number four in the death rate of all cancers, a very lethal one." I asked why that is, and he explained that a tumor in the pancreas usually doesn't display many symptoms until it is quite advanced. Incidentally, he startled me when he said that it is slightly more common in women than men, and the risk increases with age. I had always thought of it as a male-dominant disease.
With the cut in research funds evident everywhere, of late I have been striving to help him find private and foundation monies to advance these vital research studies. "Our goal is to find means of preventing it, as well as discovering early detection methods and advanced treatment options. There are some blood biomarkers which can help diagnose the disease, but they are still not very reliable -- and that is one of the areas we are intensely exploring. Generally, they don't turn positive until the disease is more advanced and then the therapies work less well."
I asked him about prevention, and he elaborated upon his comments. "I don't think many of the cases can be prevented late in life," he began, " but some risk factors are known. Smoking, for example, and obesity and diabetes are high risk factors for the disease. And our research is indicating, supported by epidemiology, that dietary factors can have a significant impact on decreasing the rate of the disease. Dr. Pandol and his research group have been doing much cutting-edge research in the dietary means of disease prevention.... adding more fruits, vegetables and grains to your daily intake, along with exercise. (This is an area which is of particular interest to both of us, and we will be writing about it further in future posts.)
He went on: "Unfortunately, once the disease develops, the changing of lifestyle won't generally have a significant effect... so we are left with surgery, chemotherapy and radiation therapy for treatment." He went to note, however, that if surgery is performed early on -- before the tumor has spread outside of the pancreas -- for select patients there is a 30% five-year survival rate. He did explain to me that chemotherapy does work for some patients, but said at best it is only transient and effective in about one in six patients. "We are working strenuously to try and correct this situation, where the cancer becomes resistant to chemo." I asked him about the pancreas, and he explained that it is a large organ which is found behind the stomach; it releases enzymes which help the body absorb foods, especially fats. I didn't realize that insulin is also made in the pancreas; it is the hormone which controls your blood sugar. I asked if it is hereditary and he thoughtfully replied that in a small number of cases, it may be passed down genetically.
Of course, like most older people inclined to be somewhat hypochondriatic, I wanted to know more about the symptoms. He reassured me (somewhat) by saying, "It may be evidenced by a pain in the abdomen, a loss of appetite and weight loss (not my problem), and a jaundiced appearance, as well as nausea, back pain, even depression. We do a CT scan, an MRI of the abdomen, and other tests, as well as a biopsy." At which point I didn't want to hear any more. I ate an apple and began to run on the treadmill.