Navigation Links
Surprise finding: Pancreatic cancers progress to lethal stage slowly

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 spread to other organs. Patients die an average of two and a half years after this metastasis.

The results contradict the idea that pancreatic cancers metastasize very early in their development, says Iacobuzio-Donahue.

For the study, scientists collected tissue samples during autopsies of seven patients who died from pancreatic cancer that had metastasized to other organs. Because the tissue samples were taken within six hours of each patient's death, the scientists were able to keep some of the cells alive long enough to extract the DNA and sequence the series of chemical "letters" that form genes.

In all patients, metastatic deposits were found in two or more sites in the body, most often the liver, lung and peritoneum (lining of the abdomen). The researchers found similar mutations present in both the areas of metastasis and in the primary pancreatic tumors from which the metastases arose.

They also identified and classified the types of mutations ones that occur before metastasis and others that happen after the cancer has spread. Both types of mutations were present within the primary tumor years before the metastases became clinically evident, according to Iacobuzio-Donahue.

Using mathematical models to study the timing of pancreatic cancer progression, the scientists conservatively estimated an average of 11.7 years before the first cancer cell develops within a high-grade pancreatic lesion, then an average of 6.8 years as the cancer grows and at least one cell has the potential to spread, and finally, an average of 2.7 years from then until a patient's death.

The Hopkins scientists say the goal is develop a pancreatic cancer screening method similar to the protocol used for breast and colon cancer. Though early stages of pancreatic cancer cause no symptoms, Iacobuzio-Donahue says, perhaps at a certain age people should undergo an endoscopy to screen for pancreatic cancer. Endoscopy is a procedure allowing doctors to look inside the body through the use of an instrument that has a tiny camera attached to a long, thin tube.

Another study published in the same issue of Nature, directed by British researchers at the Wellcome Trust Sanger Institute in collaboration with Iacobuzio-Donahue, used cell lines and tissue samples from the same pancreatic cancer patients as the Johns Hopkins study to look for rearrangements of genetic material. They found more than half of specific rearrangements occurred in all metastases and primary tumors.


Contact: Vanessa Wasta
Johns Hopkins Medical Institutions

Related medicine news :

1. SIDS surprise: Study finds that infant boys are more easily aroused from sleep than girls
2. Health: Surprise Best Seller is Stem Cell Book – Author in Spokane - 10 City Tour
3. Revising the timeline for deadly pancreatic cancer
4. Rice, TMC team take aim at pancreatic cancer
5. UNC scientists receive grant to develop nanotechnology for pancreatic cancer diagnosis and treatment
6. Protein key to growth of pancreatic cancer
7. New investigational compound targets pancreatic cancer cells
8. Endoscopic ultrasound evaluation is associated with improved outcomes in pancreatic cancer patients
9. New combination effective against pancreatic cancer
10. Cysts hold clues to pancreatic cancer
11. Targeted immunotherapy shows promise for metastatic breast, pancreatic cancers
Post Your Comments:
(Date:11/27/2015)... Los Angeles, CA (PRWEB) , ... November 27, 2015 , ... ... new study carried out by the University of Toronto and the University of British ... number of hospitalizations for head injuries. The article explains that part of the reason ...
(Date:11/27/2015)... ... 2015 , ... "When I was traveling, I was very ... "Many people catch diseases simply from sitting on such dirty toilet seats. I ... germs." , He developed the patent-pending QUDRATECS to eliminate the need to sit ...
(Date:11/27/2015)... ... 27, 2015 , ... Consistent with the Radiology Business ... Better Radiology Marketing Programs meeting will showcase some of the best 2015 ... Caesars Palace in Las Vegas with a pre-conference session on a collaborative approach ...
(Date:11/27/2015)... , ... November 27, 2015 , ... CBD College ... of Allied Health Education Programs (CAAHEP) awarded accreditation to its Diagnostic Medical Sonography program. ... accredited colleges, as only one of twelve colleges and universities in the state of ...
(Date:11/26/2015)... ... November 26, 2015 , ... Patients at Serenity Point ... come together on Thanksgiving Day to share the things that they are most ... Serenity Point YouTube channel, patients displayed what they wrote on index cards, describing ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... 25, 2015 AAIPharma Services Corp./Cambridge Major ... at least $15.8  Million to expand its laboratories ... . The expansion will provide additional office ... growing demands of the pharmaceutical and biotechnology markets. ... will provide up to 40,000 square feet of ...
(Date:11/25/2015)... 25, 2015  Henry Schein, Inc., the world,s largest ... dental, medical and animal health practitioners, will unveil at ... Henry Schein ConnectDental® Pavilion , which brings together for ... solutions designed to help any practice or laboratory enter ... for a schedule of experts appearing at the Pavilion. ...
(Date:11/25/2015)... , Nov. 25, 2015  Trovagene, Inc. (NASDAQ: ... announced that Chief Executive Officer Antonius Schuh, Ph.D., is ... th Annual Piper Jaffray Healthcare Conference. ... New York Palace Hotel in New York ... p.m. EST. Mr. Schuh will be available for one-on-one ...
Breaking Medicine Technology: