My dad passed in 2020 from pancreatic cancer. He'd been to the doctor several times complaining about issues and all they would do is send him home with laxatives. Eventually it got bad enough my mom ran him to the ER when they found the cancer which had progressed into its final stages already. He was dead less than a month later.
Similar story with a guy I worked with. He went home sick one day. A few days later our boss told us he was sick and had pancreatic cancer. He came into the office to say goodbye to us a few weeks later and then died about 10 days after that.
FWIW it's commonly the case with cancers of abdominal organs: stomach, pancreas, liver, kidney, etc. These cancers are frequently not diagnosed until at an advanced stage. Symptoms tend to be nonspecific, overlap with ubiquitous conditions like constipation, gastritis.
A goal of research is improving early detection of these cancers but it's an uphill battle. It's difficult to increase providers' "index of suspicion" of seemingly "minor" complaints.
That’s a generalization, pancreatic cancer is often extremely lethal, depending on the type and case the survival rate can be as or more grim than glioma. Bowel and urinary cancers including kidney cancer are often very treatable and survivable when discovered due to symptoms. I don’t think it’s helpful to group all abdominal cancers as being uniquely or especially bad or late discovered. Likewise for the particularly aggressive or advanced cancers these types of announcements and trials rarely translate to major changes in prognosis. More typical if there is any positive result it looks like additional weeks or at best months of aggressive treatments rather than significant ”cure” rates.
It can be disappointing to see that even a successful drug, like this one, is "only" extending life expectancy from 6.7 months to 13.2. But this is what the first steps towards a cure look like.
Childhood leukemia used to be overwhelmingly fatal, and early chemotherapy trials also only managed a couple months of remission. Researchers were even criticized for subjecting patients to harsh side effects to no apparent benefit. But thanks to that research, most patients are now cured; per capita death rates from childhood leukemia are down 14x from the 1950s, mostly driven by improved treatment.
Daraxonrasib is an incredible invention on a technical level, and a meaningful step forwards in the treatment of many cancers. We'll need a couple more equally incredible inventions to be able to cure pancreatic cancer.
Moderna is testing an mRNA vaccine that might be useful against bladder and kidney cancers. Hopefully the same technology can be applied to pancreatic and liver cancers. Fingers crossed.
mRNA vaccines are being studied for pancreatic cancer. To quote a post I wrote in April:
> First, the personalized mRNA vaccine autogene cevumeran, developed by BioNTech and Genentech, just reported 6-year follow-up results from their Phase 1 clinical trial. 16 patients were treated, 8 were responders (showed signs of immune reaction to vaccine), 8 were non-responders.
> 7/8 responders (87.5%) survived 6 years after surgery, 2/8 nonresponders survived (25%).
> The most important result in this small trial is that vaccine response is strongly correlated with better outcomes. But for context, the trial was restricted to patients with operable pancreatic cancer. Patients diagnosed with stage 1 or 2 pancreatic cancer have a 5-year survival rate of 12%. Patients who get their pancreatic cancer surgically removed have a 5-year post-surgery survival rate of 20%. This makes the overall 6-year post-surgery survival rate of 56% among the 16 trial patients pretty impressive. Keep in mind that the trial patients may have been healthier than average for other reasons, and small n is small n, so we shouldn't be too hasty until we see Phase 2 and 3 data.
We are able to early detect these cancers right now with routine targeted imaging. Perhaps we should be working to solve or improve on the drawbacks associated with doing this, some of which are:
CT scans emit ionizing radiation.
MRI contrast can buildup and be retained in the body over repeated administrations.
The scans can produce false positives, surface benign abnormalities which result in a wild goose chase, cause severe patient anxiety and healthcare burden, and result in over-treatment.
And of course doing this on a whole population level is not cost or time effective.
If you look at what practitioners and informed epidemiologists are saying the incidentaloma problem for any type of screening is huge and underestimated with no clear solution. It’s not only about finding and invasively testing benign masses, which can cause actual serious health problems (the associated anxiety and stress alone can actually kill, not to mention the cost and painful or damaging biopsies). But many true positive cancerous or malignant conditions can progress so slowly relative to the patient’s overall health that they do not shorten the patient’s life and/or the treatment may be worse than the “disease” that was detected. Hence why so many types of screenings that actually work can do positive harm for certain populations.
And once you find something with a screening you can’t unfind it. The patient or at least their doctor now has that knowledge and has to live with it and actively decide what to do about it.
Absolutely terrible. As human beings, we should be prioritizing solving these kinds of problems. I don't think we need to live forever, but a graceful ending later in life remains an objective we haven't fully realized for everyone.
We do. There’s something like half a billion dollars spent on pancreatic cancer research annually in the United States alone. It’s a giant money pit and that’s created an enormous body of research, increased understanding of the biology of the cancer and just how insidious it is, and funded the careers of thousands of scientists, technicians, academics and administrators, but very little of all this translates into better treatment outcomes. There’s no evidence than just pouring more money into cancer research is going to give us a miracle cure. There are competing priorities starved for funding to that we know can use meaningful help. Not incidentally some of those include financial aid, medical care and quality of life assistance for the actual patients and their families, as well as prevention.
> There’s no evidence than just pouring more money into cancer research is going to give us a miracle cure.
The HPV vaccine will almost entirely wipe out cervical cancer: not by curing it, but preventing it entirely. Not sure if that meets your “miracle” standard, but it’s a totally unreasonable standard to apply to scientific research. By definition, a miracle is something that is not physically possible.
Research seems expensive, yes. You have to work in every possible direction, fumbling in the dark metaphorically, because you don’t know the answers yet. It’s a lot messier than giving a hungry person a meal. But hundreds of years of research have made that meal way more abundant and less expensive…
In the grand scope of the country, we spend quite small amounts on research. The U.S. GDP generates half a billion dollars in less than 10 minutes, for example. It’s less than what we spend on takeout coffee.
> The HPV vaccine will almost entirely wipe out cervical cancer: not by curing it, but preventing it entirely.
That only underlines my point. The HPV vaccine was in not really a product of cancer research, in terms of the cancer itself. It’s purely a multivalent viral vaccine with the munificent effect of preventing several cancers and nasty genital warts as an additional motivator. It has saved many thousands of lives that would have been lost with the best available cancer treatments and avoided their costly and excruciating effects.
It’s too early to write off cervical cancer, besides HPV-negative ones, there are evolving strains not covered and a huge pool of viral reserves worldwide and among the unvaccinated in the USA. A universal mandate won’t happen and coverage isn’t high enough to eradicate it.
Prevention is important for almost all cancers. There will likely be other vaccines in the future targeting carcinogenic infections but most cancers don’t have a simple infectious cause. Cancer is a family of nasty diseases that has time and again defied all pronouncements of impending universal cures.
Similar story with a guy I worked with. He went home sick one day. A few days later our boss told us he was sick and had pancreatic cancer. He came into the office to say goodbye to us a few weeks later and then died about 10 days after that.
Fuck cancer