Pancreatic cancer signs

Over the summer, the Supreme Court announced that Justice Ruth Bader Ginsburg completed three weeks of radiation therapy for pancreatic cancer and required no further treatment.

Justice Ginsburg’s cancer was discovered during a routine blood test. A biopsy confirmed a malignant tumor.

Are there risk factors for pancreatic cancer?

Ron G. Landmann, MD, FACS, FASCRS, chief of colon and rectal surgery for Baptist MD Anderson Cancer Center, said smoking is one risk factor for pancreatic cancer, but according to news reports, Justice Ginsburg isn’t a smoker.

Pancreatic cancer occurs most frequently in people over age 45, men, Ashkenazi Jews, and African Americans. Some patients may be predisposed to getting pancreatic cancer based on a history of other health issues, including obesity and diabetes. Some may also develop pancreatic cancer when existing cancer returns or spreads, otherwise known as metastatic disease. Other risk factors include:

• Inherited genetic syndromes such as hereditary breast and ovarian cancer
• Familial atypical multiple mole melanoma syndrome (FAMMM)
• Familial pancreatitis
• Lynch Syndrome, a hereditary cancer syndrome that leads to a higher cancer risk
• Peutz-Jeghers Syndrome, a genetic condition that leads to an increased risk of intestinal cancers

“In all cases, treatment is usually individualized based on the patient's overall status and function and past medical and surgical therapies,” Dr. Landmann said. “Most primary pancreatic cancers do not manifest until they are more advanced or found incidentally during workup for other symptoms.”

Jeopardy host Alex Trebek, for example, was diagnosed with stage 4 pancreatic cancer in March and underwent treatment that wrapped up in August.

Dr. Landmann said many cancers, including pancreatic, are only found when an individual goes in for a CT scan ordered by their doctor for other symptoms or severe pain. Other signs and symptoms that may appear in some people include:

• Floating stools or white/discolored stools
• Jaundice and yellowing or itchiness of the skin caused by elevated bilirubin levels. Bilirubin is formed during the breakdown of red blood cells and is normally processed through the liver.

There is no screening for pancreatic cancer, but the management of the disease has significantly and rapidly evolved with the increasing use of neoadjuvant chemotherapy (administered before surgery or other treatments) and radiation therapy, which is used to shrink the tumor before surgery and assess tumor biology. Preventive measures can also be taken to reduce the risk for pancreatic cancer, including eating a healthy diet and leading an active lifestyle.

“If a person is diagnosed with pancreatic cancer, it is imperative that they are evaluated and managed at a site that has a multidisciplinary team of physicians including surgeons, medical oncologists, radiation oncologists, diagnostic and interventional radiologists, pathologists, geneticists, gastroenterologists and social workers to maximize both patient care, survival and quality of life,” Dr. Landmann said. “Baptist MD Anderson has these specialized multidisciplinary teams in place to provide the most contemporary and personalized treatment for our patients.”

If you or a loved one needs a cancer specialist, please call 904.202.7300 or visit BaptistMDAnderson.com.