The word cancer often strikes fear into a person’s heart. When they hear the diagnosis either for themselves or a loved one, they are often overwhelmed with questions. Will I recover? How will the doctors treat this cancer? Will I be able to work while I am undergoing treatment? How will I be able to afford this treatment? And a host of other questions, some of which are easy to answer and some of which are not.
These questions likely crop up no matter what type of cancer a patient is diagnosed with, but the questions may seem even more urgent when one is diagnosed with a cancer that does not always have great patient outcomes. One type of cancer with generally low survival rates is pancreatic cancer. And, despite advances in overall cancer therapy in the past several decades, the survival rate for pancreatic cancer has shown only a modest uptick.
Pancreatic Cancer: The Figures
Just over 50,000 people in the United States are diagnosed with pancreatic cancer each year. The most up-to-date statistics show that depending on the stage at which pancreatic cancer is diagnosed, the five-year survival rate ranges from roughly 1 percent to 14 percent, with the lowest rates happening in cancers that have metastasized to the bone and other internal organs And, the survival rates are not significantly higher even at the one-year mark.
These numbers are definitely scary for patients and their loved ones!
Pancreatic cancer has not traditionally been very responsive to standard cancer treatments, such as surgery and chemotherapy and radiation treatments. The reasons for this lack of responsiveness are not yet fully understood, but the difficulty in diagnosing pancreatic cancer until it is very advanced is one contributing factor. Generally, most tumors are not discovered until they are too large to be surgically removed. This is due to the fact that pancreatic cancer can be largely asymptomatic, or if symptoms exist they can easily mimic the symptoms of other cancers and illnesses. On the other hand, if a tumor is found when it is still small and there is no lymph node involvement, survival rates are significantly better.
Pancreatic Cancer: Searching for Hope
Given the ongoing failures of traditional treatments to effectively treat pancreatic cancer, the medical community, as well as impacted patients, are looking at alternative treatments that may offer long-term hope to those affected by pancreatic cancer. One of these potentially promising alternatives is stem cell therapy. Doctors hope that stem cells could potentially offer insights into a wide range of new treatment options.
Unlike some types of cancers where there is only one type of cancerous cell involved in the tumors, pancreatic cancer often involves multiple types of cancerous cells. And, some of these cells are persistently resistant to drug and radiation therapy. If scientists are better able to understand the underlying mechanisms behind this resistance, then potentially they could be able to design drugs and other treatment protocols that could get around this resistance, providing patients with newfound hope!
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Understanding tumor resistance is only one direction of pancreatic cancer research. Scientists around the world are also looking at how the power of immunotherapy can be effectively harnessed. Immunotherapy uses the body’s own immune system to target and eradicate cancerous cells in the body; although to date immunotherapy has been less successful in treating solid organ tumors. However, a team of researchers in the United Kingdom believes that stem cells can be artificially engineered to boost the immune system response to these solid organ tumors. More specifically, the researchers will be looking to find a way to break down cancer-associated fibroblasts. Theoretically, once these fibroblasts are broken down, the body’s T-cells will be able to do a more effective job of targeting these cancerous cells.
And, this is not the only avenue that scientists are considering.
Scientists also continue to devote significant attention to exploring pancreatic cancer stem cells. This is fueled by a belief that understanding these stem cells in greater detail will provide insight into what originally starts a tumor and what determines tumor progression. There appears to be multiple types of pancreatic cancer stem cells. Two of the cancer stem cells that have prompted the greatest interest on the part of researchers are DclK1 and Lgr5, for a variety of reasons. Researchers note that these stem cells represent less than 1 percent of all cancerous cells, but they seem to hold the key to drug resistance. And, if they hold the key to drug resistance, then unlocking this key may change the course of therapeutic outcomes.
Disrupting Signal Pathways
Researchers, for example, have determined that if they know more about these cancerous stem cells than they may be able to design therapies that target and interrupt the signal pathways. However, this pathway inhibition is still in its earliest possible stages. In most cases, it has not yet been tested on actual patients who have pancreatic cancer. Therefore, the conclusions, at least at the moment, are largely hypothetical. This does not mean that this therapeutic approach should not be explored in detail. It definitely should be. It simply means that patients’ expectations should be gently tempered.
Despite the generally early stage nature of this pathway inhibition research, one clinical study has been started. This study focuses on a particular inhibitor, napabucasin (BBI-608). This inhibitor is being studied both for its efficacy in stopping the spread of pancreatic cancer stem cells and also colorectal cancer stem cells. These studies are still in their early stages, but preliminary results have been promising. Researchers emphasize that these treatments may not be standalone treatments for pancreatic cancer, but that instead they will go hand-in-hand with other treatment options. To carve out success in treating pancreatic cancer, various treatment options will likely need to be combined.
Despite dramatic advances in the treatment of other cancers, the survival rates for pancreatic cancer remain almost stagnant. The one- and five-year rate are abysmally low, particularly for people with advanced forms of the disease that have metastasized and can no longer be treated surgically. More research still needs to be carried out to better understand the unique functioning of pancreatic cells and why pancreatic cancer stem cells may be particularly resistant to standard treatment protocols. This research also will continue to explore the pathways through which these stem cells may replicate, leading to an explosion in the number of cancer cells. New research will continue on a variety of other routes as well. For example, researchers in the United Kingdom will continue to look into ways that immunotherapy, coupled with genetically modified stem cells, can be used to more effectively address and attack stem cells.
New research on stem cells, no matter what form this research ultimately takes, will offer a potentially promising breakthrough for thousands of people who battle pancreatic cancer each year. Ideally, these treatments will extend both the length of the patient’s life and also upgrade their quality of life, providing hope to so many people who were previously without it. However, given the early stage of this research, a significant number of questions remain and the timeframe for resolving these questions largely remains uncertain or at least open for active debate.
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