Research

Pancreatic Cancer: Alex Trebek's 'Fight' Highlights Difficult Diagnosis

Alex Trebek, who has hosted the Jeopardy! TV game show since 1984, has announced that he has been diagnosed with stage 4 pancreatic cancer. In a video announcing his illness, Mr. Trebek conceded that he was facing a formidable challenge.

“Normally, the prognosis for this is not very encouraging, but I’m going to fight this, and I’m going to keep working,” Mr. Trebek said

Indeed, those who are diagnosed with pancreatic cancer usually face many questions, fears and emotions. Pancreatic cancer makes up just 3 percent of cancers in the U.S., but it is particularly deadly. It accounts for 7 percent of deaths from cancer, the American Cancer Society says. Just 8.5 percent of people survived five years after diagnosis between 2008 and 2014, according to the National Cancer Institute.

About 1.6 percent of U.S. adults will be diagnosed with pancreatic cancer in their lifetimes, according to the National Cancer Institute. More than 55,000 new cases were diagnosed last year, the institute estimates. In stage 4 pancreatic cancer, the disease has usually spread to other parts of the body, such as the liver, lung, or peritoneal cavity (the body cavity that contains most of the organs in the abdomen).

Mr. Trebek is 78. The risk of pancreatic cancer increases with age, says the U.S. Centers for Disease Control and Prevention. Nearly, 70 percent of pancreatic cancer patients are aged 65 or older.

“Pancreatic cancers can best be treated with an integrated, multi-specialty approach where the patient’s case is reviewed by more than one specialist,” says Govindarajan Narayanan, M.D. , chief of interventional oncology at Miami Cancer Institute. “But Mr. Trebek is correct. A diagnosis of stage 4 pancreatic cancer is very challenging. Most advances in pancreatic cancer treatments are most effective when the cancer is confined to the pancreas. Stage 4 pancreatic cancer means the cancer has spread to other organs.”

Nonetheless, Dr. Narayanan adds that Mr. Trebek’s positive attitude can be beneficial as treatment progresses.

“It’s important that a patient be psychologically ready to proceed with any appropriate treatment that’s available,” he says. “You may not be able to cure this advanced cancer, but you still have treatment options.”

Dr. Narayanan is well known as a pioneer in this field, developing new techniques and researching innovative applications of technologies, including irreversible electroporation (IRE) or NanoKnife. Interventional oncology is a subspecialty of interventional radiology, using minimally invasive techniques, in combination with image guidance, to precisely target cancerous tumors.

NanoKnife therapy is primarily used for liver, kidney and pancreas tumors. In early 2018, the U.S. Food and Drug Administration (FDA) granted an Expedited access pathway designation for this technology to be studied in pancreatic cancer, an area of special interest to Dr. Narayanan, who has been researching it for 9 years.

“Based on all the data that has been published by me and other clinicians involved in this field, we believe that there is a clear signal that it’s something that needs to be studied further,” says Dr. Narayanan.”We think there’s a lot of promise for NanoKnife’s role in pancreatic cancer.”

There are several factors that can increase someone’s risk of developing pancreatic cancer, including diabetes, smoking, obesity, age, family history and chronic inflammation of the pancreas. The pancreas is an organ that sits behind the stomach. It’s shaped a bit like a fish with a wide head, a tapering body, and a narrow, pointed tail. In adults, it’s about 6 inches (15 centimeters) long but less than 2 inches (5 centimeters) wide.

Here are key facts about pancreatic cancer from the National Cancer Institute:

  • Smoking and health history can affect the risk of pancreatic cancer.
  • Signs and symptoms of pancreatic cancer include jaundice, pain, and weight loss.
  • Pancreatic cancer is difficult to detect and diagnose early.
  • Tests that examine the pancreas are used to detect, diagnose, and stage pancreatic cancer.
  • Certain factors affect prognosis (chance of recovery) and treatment options.

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