Pancreatic cancer develops and spreads much more slowly than scientists have thought, according to new research from Johns Hopkins investigators. The finding indicates that there is a potentially broad window for diagnosis and prevention of the disease.
"For the first time, we have a quantifiable estimate of the development of pancreatic cancer, and when it would be best to intervene," according to Christine Iacobuzio-Donahue, M.D., Ph.D., associate professor of pathology and oncology at Hopkins' Sol Goldman Pancreatic Cancer Research Center, "so there is potentially a very broad window for screening." Right now, however, she adds, "pretty much everybody is diagnosed after that window has closed."
Pancreatic cancer is notoriously difficult to detect in its early stages because there are frequently few symptoms and current imaging techniques are not specific for cancer.
Bert Vogelstein, M.D., professor and director of the Ludwig Center for Cancer Genetics & Therapeutics at the Johns Hopkins Kimmel Cancer Center and an investigator at the Howard Hughes Medical Institute, says the results show that "many pancreatic cancer cases have a long lag time before they are detected through conventional tests. This leaves room to develop new early, diagnostic tools and intervene with potentially curative surgery."
The Hopkins work, published in the October 28 issue of the journal Nature, suggests that it takes at least a decade for the first cancer-causing mutation that occurs in a cell in a pancreatic lesion to turn into a full-fledged cancer cell. At this point, the lesion is called "high-grade" and should be removed, much like polyps are removed from the colon.
After the first cancer cell appears, it takes an average of nearly seven years for that cell to turn into the billions that make up a cancerous tumor the size of a plum, after which at least one of the cells within the tumor has the potential and ability to spre
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Johns Hopkins Medical Institutions