Pancreatic Cancer

Dear World

TODAY is World Pancreatic Cancer Day and November is also World Pancreatic Cancer Month.

Most of us are very unaware of this type of Cancer and although it has been around for 200 years we have not really made any Real and true progress.

Simple Living Global responds if there is call to bring more awareness to humanity where it is possible.

Digestive Diseases

Digestive Diseases are very common worldwide and account for considerable health care use and expenditures.

1990 – 2019
Annual case numbers, age-standardised rates of prevalence, incidence, death and disability-adjusted life years (DALYs) and their annual percentage changes for Digestive Diseases were derived from the Global Burden of Disease, Injuries and Risk Factors Study (GBD).

2019
88.99 million disability-adjusted life years due to Digestive Diseases

Digestive Diseases – 13^th leading cause of DALYs globally

Global Digestive Disease DALYs were highest in the middle sociodemographic index quintile (SDI) and in South Asia and were higher in males than females. (1)

The SDI is intended to avoid the outdated labelling of nations as “developed” (comparatively rich) or “developing” (not so rich) and instead use a fine-grained yardstick of development.

That yardstick can be used to evaluate progress (or not) of countries as a country’s wealth status as a whole does not accurately reflect what is happening in its more disenfranchised communities. (2)

Pancreas

The pancreas is part of the digestive system. It is in the upper part of the abdomen, behind the stomach and in front of the spine. It is level with where the ribs meet at the front of the body and is 15cm/6 inches long.

The pancreas has 3 main parts:

Head of the Pancreas
The large, rounded section next to the first part of the small bowel (duodenum)

Body of the Pancreas
The middle part

Tail of the Pancreas
The narrow part on the left side of the body

The Pancreas makes digestive juices, called enzymes and hormones including insulin. Hormones act as chemical messengers in the body. They control how different organs work.

Digestive enzymes help the body digest food, especially fats. The enzymes are made by the pancreas in cells called exocrine cells. Most cells in the pancreas are exocrine cells. The others are called endocrine cells. (3)

95% of pancreatic cancers develop from the exocrine pancreas.

5% develop from endocrine cells, often called neuroendocrine tumours or islet-cell cancers. (4)

The enzymes travel through the pancreas in small tubes called ducts. They move into a larger duct called the Pancreatic duct. It joins with the common bile duct, which carries bile from the liver and gall bladder. Together they empty into the small bowel through an opening called the ampulla of Vater. The enzymes and bile flow into the duodenum, where they help digest food.

Insulin is a hormone that controls the amount of sugar in the blood. It helps move sugar into the body’s cells, so it can convert into energy.

The pancreas makes insulin in the endocrine cells. The endocrine cells group together in small clusters called islets of Langerhans. These cells release insulin directly into the blood. (3)

Symptoms of Pancreatic Problem

• Abdominal Pain
• Back Pain
• Reduced Appetite
• Bloating
• Greasy stools
• Weight loss (5)

Pancreatic Cancer is a common pancreatic disease (6)

Pancreatic Cancer

Pancreatic Cancer is one of the most lethal malignancies.

Despite substantial improvements in the survival rates for other major cancer forms, Pancreatic Cancer survival rates have remained relatively unchanged since the 1960s. Pancreatic Cancer is usually detected at an advanced stage and most treatment regiments are ineffective, contributing to the poor overall prognosis. (7)

Symptoms of Pancreatic Cancer

This information is for the most common type of Pancreatic Cancer, known as Pancreatic Ductal Adenocarcinoma.

Rarer types of Pancreatic Cancer may behave and be treated differently.

In the early stages, a tumour in the pancreas does not usually cause any symptoms, which can make it difficult to diagnose.

First notable symptoms of Pancreatic Cancer are often:

• Pain in the back or stomach area which may come and go at first and is often worse when lying down or after eating.
• Unexpected weight loss
• Jaundice – yellowing of skin and whites of the eyes, causes urine to be dark yellow or orange and pale coloured faeces.

Other possible symptoms of Pancreatic Cancer include:

• Nausea
• Vomiting
• Diarrhoea
• Constipation
• Fever
• Shivering
• Indigestion
• Blood clots

Symptoms of Diabetes can develop with Pancreatic Cancer. This is because it can interfere with both the production of insulin and its effectiveness in lowering blood sugar. (8)

How does Pancreatic Cancer develop

The ductal cells in the head of the pancreas are exposed to pancreatic secretions, as well as bile and environmental carcinogens can reach these cells through these fluids or the blood, through which endogenous factors may also act.

The pancreas is relatively inaccessible to routine medical examination, so the progression of this Cancer through precursor lesions is not well understood.

However, inflammation is implicated in this process through Chronic Pancreatitis, which is a factor for Pancreatic Cancer. The role of infection with Helicobacter pylori is the subject of ongoing research.

Conditions characterised by high insulin secretion, such as insulin resistance and Type 2 Diabetes are associated with the risk of Pancreatic Cancer. (9)

History of Pancreatic Cancer

1761
The first known description of Pancreatic Cancer is attributed to Giovanni Battista Morgagni in his publication ‘de Sedibus Et Causis Morborum Per Anatomen Indagatis Libri Quinque’.

The lack of a microscopic evaluation makes the true diagnosis of Ductal Adenocarcinoma uncertain.

1858
The next important advancement in our understanding of Pancreatic Cancer was when Jacob Mendez Da Costa revisited Morgagni’s original work and also described the first microscopic diagnosis of Adenocarcinoma, manifesting Pancreatic Cancer as a true disease entity. (7)  

Pancreatic Cancer Surgery

1898
The first reported attempt at a Pancreaticoduodenectomy (surgery to remove cancerous tumours from the pancreas) was performed by Italian surgeon Alessandro Codivilla for a tumour involving the head of the pancreas; however the patient did not survive the postoperative period.

In the same year, William Steward Halsted from Johns Hopkins Hospital performed the first successful resection for ampullary cancer by excising portions of the duodenum and the pancreas. (7)

1912 (10)
The first successful Pancreaticoduodenectomy is credited to the German surgeon Walther Carl Eduard Kausch, as part of a two-stage procedure. (7)

1914
Georg Hirschel performed the first successful Pancreaticoduodenectomy in one stage.

1935
Allen Oldfather Whipple presented the results of a two-stage procedure involving the resection of the head of the pancreas and duodenum for ampullary carcinoma at the American Surgical Association annual meeting. This renewed interest in pancreatic surgery.

NB: Whipple performed 37 Pancreaticoduodenectomies, with the procedure evolving into a one-stage technique. (7)  

Whipple, Parsons and Mullins published the first seminal report of 3 patients in a New York hospital.

The two-stage procedure included a radical re-section of the duodenum and head of the pancreas for ampullary cancer.

The 3^rd patient underwent a total duodenectomy and excision of a large portion of the head of the pancreas. This was the first reported case of complete excision of the duodenum and a large portion of the head of pancreas.

The 1^st patient died within 30 hours after the operation because of consequences of anastomotic breakdown.

The 2^nd and 3^rd patients lived for 9 and 24 months and succumbed to cholangitis and liver metastasis respectively. (11)

1937
Alexander Brunschwig was the first to perform a radical Pancreaticoduodenectomy for Pancreatic Adenocarcinoma in two stages, with complete excision of the head of the pancreas to the right of the superior mesenteric vein. (11)  

2016
With the concentration of experience in high-volume hospitals, pancreatic surgery has become a safe procedure associated with an operative mortality below 3%.

While major advances have been made in the surgical management of Pancreatic Cancer since the era of Whipple, the long-term survival for Pancreatic Cancer patients is still extremely poor.

In the Nordic countries and in the rest of the World – 5 year survival rates for Pancreatic Cancer have remained stagnant since the 1960s. (7)

Pancreatic Cancer is caused by the ab-normal and un-controlled growth of cells in the pancreas, which is the large gland that is a part of our digestive system.

What we know is that ‘Digestive Diseases are very common worldwide’ and the consequences are ‘considerable health care use and expenditures’. ₍₁₎

What are we contributing (in other words creating) that leads to ‘ab-normal and un-controlled growth of cells’ in our pancreas?

There has to be something, because the body is super sensitive and it is always communicating to us with warnings, signals, indications and symptoms when something is off track. Most of us Ignore, override, deny or pretend it’s nothing and continue life as usual, without any further thought or consideration.

What we do know is that Digestive Diseases are disabling with almost 90 million disability-adjusted life years lost. This will continue to rise because we are nowhere near close to finding the root cause of WHY and how this dis-ease is around today.

WHY have Pancreatic Cancer survival rates remained relatively unchanged since the 1960s?

We seem to spend endless amounts of money on research and we have the Intelligence₁ to literally go to another planet, build skyscrapers that were once only in fiction movies and medical advancements that no one dared think were possible, but yet here we are in our modern early 21^st century with nothing much to report, if we were asked more about Pancreatic Cancer.

What we know is it tends to be detected at the advanced stage and at this point, most of the treatments are ineffective.

WHY are we unable to pick up the signs before then?

Do we need to rely on research and the medics to give us answers or can we find a way to tune in and connect deeply to our body so we don’t miss the small whisper or subtle un-comfortableness that our body is communicating because  Something Is Not Right?

If symptoms are abdominal or back pain, do we dismiss or negate this with our own version or listen to the person we live with who suddenly become the medic aficionado on a topic they know nothing about?

• Do we ignore the bloating and as it goes un-noticed we just carry on ‘business as usual’ even though we feel something deep within niggling us?

• Greasy stools – well we never look and if we dare do see anything we completely dismiss it as not worth a trip to the doctor.

• The reduced appetite which in turn leads to weight loss is a huge sign and yet we still continue with the narrative convincing ourselves ‘it’s nothing serious’ and just a phase we are going through or some other nonsense, when in Truth it is very serious.

• Nausea, vomiting and diarrhoea may not be the bug everyone is catching but something else and yet the majority of us have accepted and made these kinds of symptoms very normal in the context that others also get them.

• Constipation may not have anything to do with what we ate last night or the past few days but a bigger sign that things are not moving as they should in our digestive system.

• Fever and shivering we tend to go to the obvious, but what if it is not that and we never bother to make any movements to even Question or consider it could be serious.

• Indigestion has a whole host of possibilities and we generally think it’s linked to the foods we are eating or have eaten but again what if it is not?

The fact that the above pointers are the only signs we may get, then it can be no surprise that it makes it difficult to diagnose if we have Pancreatic Cancer.

What if we did make a big deal and that means getting fully checked out and not just a visit to the doctor and leave it at that, but actually ask for the tests that may detect what is really going on inside us?

Next – 

What the brief history above tells us is that Cancer in the pancreas has been around for over 2 hundred years.

We are also told that while there are major advancements in surgery, the long-term survival rates remain ‘extremely poor’.

Is this because we are unable to detect the early warning signs?

What if the patient was more connected to their body and that means they were sensing and feeling and acknowledging those subtle signs the body is constantly communicating?

For example – we see our teenagers seeking ways to deal with their Exhaustion. No different to seeing their parents pushing and driving themselves to succeed in life and have a ‘better life’ as that’s what life is about – right?

But at what cost is that to the human body if at a young age we are using sugar, Caffeine, Alcohol or any of the variety of Drugs on offer to push past our natural state and ‘make it’ in life?

At what expense to the body is this way of living and if we are to be Honest – how many live in this way?

It is well worth reading our article on Caffeine as we tend to relate this to Coffee drinkers but it applies to much more, including energy drinks and weight loss products.

The ‘pushing’ driving force that becomes our norm and continues and goes un-noticed and we then live with this un-natural behaviour because we are constantly on the merry-go-round of getting the next thing like the university accolade, landing the big Job and of course making sure we appear to be living our potential, but what if all of this is not true and our body is giving us small signs but we are way too busy to pay attention to this thing we move around day in and day out called our Body.

So then something happens and we get symptoms that cannot be Ignored. Simple – we get fixed as that is our go to Solution. Never do we Question or seek anything further, like – did we live in a way that may have contributed to why this body of ours is showing us something is clearly not right?

No, we do not and even if the medics say x, y and z for us going forward, the drive in us is just waiting to take off again. In fact, whilst we take some time off to recover, we are busy in our minds and very active as to what we will be doing as soon as our body is able to get up and move.

To summarise – we are living in a way that is constantly about motion. There is no stillness in the equation. Whilst the symptoms or illness has got us to stop physically, inside we are still racing and we are not interested in stopping properly and bringing a quality of stillness. Instead we reach for more sugar or other stimulants that keep the racy pacy lifestyle momentum going.

Note – Alcohol contains sugar for those that would like to think it is not harmful to use at the end of a day to relax and let go of the buzz and Tension.

If we do not have the answers and 263 years later we are not any closer to understanding WHY and HOW we develop Cancer in the pancreas – is it worth considering that there could be another approach needed and this means a line of questioning as to how the body is operating in daily life?

What if we examined the Lifestyle choices of those that end up with Pancreatic Cancer?

Are they a certain type – i.e. driven, go getters, Exhausted, living on copious amounts of sugar, pushing the body past their natural limit, unable to be still or settle etc?

Pancreatic Cancer – 4^th leading cause of Cancer death in USA and Europe (7)

Pancreatic Cancer – 7^th leading cause of Cancer death worldwide

2025
Projected Pancreatic Cancer will surpass Breast Cancer as the 3^rd leading cause of Cancer death.
Study of 28 European countries (12)

Pancreatic Cancer occurs at all ages but the peak incidence is between age 60 and 80. (7)

Pancreatic Cancer rarely causes any symptoms in the early stages, so it is often not detected until the Cancer is fairly advanced. (8)

The initial symptoms of Pancreatic Cancer are often quite non-specific and subtle. Consequently, these symptoms can be easily attributed to other processes unless the physician has a high index of suspicion for the possibility of underlying pancreatic carcinoma. (13)  

Symptoms of Pancreatic Cancer are insidious in onset and gradually progress over time, including mid-epigastric pain sometimes radiating to the back, weight loss, malaise, nausea and fatigue. (7)

*Mid-epigastric pain may radiate to the mid-or lower back.
Radiation of the pain to the back indicates retroperitoneal invasion of the splanchnic nerve plexus by the tumour. The pain is worse when lying flat. (13)  
*Epigastric pain affects the middle of the upper abdomen, just below the ribcage (14)

Weight loss may be related to cancer-associated anorexia and/or subclinical malabsorption from pancreatic exocrine insufficiency caused by pancreatic duct obstruction by the Cancer. Patients with malabsorption usually complain about diarrhoea and malodorous, greasy stools. Nausea and early satiety from delayed gastric emptying due to gastric outlet obstruction from the tumour may also contribute to weight loss.

The most characteristic sign of pancreatic carcinoma of the head of the pancreas is painless obstructive jaundice. Patients with this sign may come to medical attention before their tumour grows large enough to cause abdominal pain. These patients usually notice a darkening of their urine and lightening of their stools before change in skin pigmentation.

Pruritus (itching) may accompany and often precedes clinical obstructive jaundice. Pruritus can often be the patient’s most distressing symptom. (13)

Jaundice is a characteristic sign of cancers in the head of the pancreas due to compression of the common bile duct. (7)

As a Pancreatic Cancer tumour grows, it may block the common bile duct, which leads to a build up of bilirubin in the blood causing jaundice. (4) 

Depression is reported to be more common in patients with Pancreatic Cancer than in patients with other abdominal malignancies. In some patients, Depression may be the most prominent presenting symptom or its onset may precede that of somatic symptoms.

Researchers have proposed that the Depression associated with Pancreatic Cancer is a *Paraneoplastic Syndrome caused by the dysregulation of inflammatory cytokines.

In addition, although patients may not communicate it to their families, they are often aware that a serious illness of some kind is occurring in them. (13)
*Paraneoplastic Syndromes (PNS) are a group of rare disorders caused by the presence of tumours in the body.
PNS are caused by an altered immune response to a tumour in the body. They are a set of symptoms distinct from cancer. (15) 

Men with Pancreatic Adenocarcinoma have a risk of Suicide that is almost 11 times higher than the remainder of the population.

Migratory Thrombophlebitis (inflammation of a vein due to a blood clot in association with an often un-diagnosed malignancy) and venous thrombosis also occur with higher frequency in patients with Pancreatic Cancer and may be the first presentation.

Marantic Endocarditis may develop in Pancreatic Cancer and is occasionally confused with subacute bacterial endocarditis. (13)  

Marantic Endocarditis is a rare non-infectious endocarditis that mostly affects the aortic and mitral valves. It is often an autopsy finding that is most commonly seen in advanced malignancies thought to be due to a hypercoagulable state. (16) 

Sometimes a tumour may extend to the duodenum or stomach, leading to gastric outlet obstruction. The diagnosis of Pancreatic Cancer usually depends upon the symptoms. Therefore, the diagnosis is often late when there is no chance for cure.

If the tumour is suspected in individuals with an increased risk of Pancreatic Cancer or with a family history of Pancreatic Cancer, earlier diagnosis may be possible.

90% of all Pancreatic Cancer cases are sporadic (7) –
Cancer that occurs in people without a family history

What Causes Pancreatic Cancer

There is evidence that Smoking and Family history are associated with an increased risk of Pancreatic Cancer.

There is strong evidence that:

Overweight or Obesity INCREASES the risk of Pancreatic Cancer

There is some evidence that:

Consumption of red meat might increase the risk of Pancreatic Cancer

Consumption of processed meat might increase the risk of Pancreatic Cancer

Consumption of foods containing saturated fatty acids might increase the risk of Pancreatic Cancer.

Consumption of alcoholic drinks might increase the risk of Pancreatic Cancer

Consumption of foods and beverages containing fructose might increase the risk of Pancreatic Cancer. (17)

In most cases, Pancreatic Cancer cannot be completely prevented but risk can be decreased by reducing or eliminating cigarette Smoking and following a diet low in animal products and high in fruits and vegetables.

In those at risk for familial Pancreatic Cancer, routine endoscopy can be used to monitor changes in pancreatic tissue. If tissue abnormalities arise, the pancreas can be removed before Cancer develops. (13)   

Smoking is the most important environmental risk factor for Pancreatic Cancer, while Obesity has been associated with a higher incidence of Pancreatic Cancer in epidemiological studies. (7)

Central Obesity, which is accumulation of fat primarily around the abdomen, can increase the risk of Pancreatic Cancer by 70% in some postmenopausal Women. (4) 

The etiological role of Alcohol in Pancreatic Cancer has been hard to ascertain because of the close association between Alcohol and chronic pancreatitis, a known risk factor for Pancreatic Cancer.

Recent pooled analyses of case-control and cohort studies suggest that heavy Alcohol consumption may increase the risk of Pancreatic Cancer independent of pancreatitis or Tobacco Smoking.

The link between Diabetes and Pancreatic Cancer has been studied for many years.

Long-standing Diabetes Mellitus is a modest risk for Pancreatic Cancer, while new-onset Diabetes Mellitus may be a manifestation of Pancreatic Cancer, especially in individuals over the age of 50. (7)

Excessive Insulin “directly contributes” to Pancreatic Cancer Initiation

Excessive insulin common in people with Obesity and Type 2 Diabetes “directly contributes” to Pancreatic Cancer initiation, according to experts.

The new research has provided, for the first time a comprehensive explanation of why there is a greater risk of developing Pancreatic Cancer in people with Obesity and Type 2 Diabetes.

Researchers from the University of British Columbia found that high insulin levels lead to the over-stimulation of pancreatic acinar cells. This causes inflammation that changes these cells into pre-cancerous ones.

The team behind the study hope their findings could pave the way for Lifestyle intervention or medication to control insulin levels, in the face of an “alarming” rise in Pancreatic Cancer rates. (18)

“Alongside the rapid increase in both Obesity and Type 2 Diabetes, we are seeing an alarming rise in Pancreatic Cancer rates.
These findings help us understand how this is happening and highlights the importance of keeping insulin levels within a healthy range, which can be accomplished with diet, exercise and in some cases medications.”
Dr. James Johnson – Professor in the Department of Cellular and Physiological Sciences (19)

Researchers concentrated their efforts on Pancreatic Ductal Adenocarcinoma (PDAC), a common and aggressive type of Pancreatic Cancer. It is predicted that this type of Cancer will become the second leading cause of Cancer deaths by 2030.

The link between Obesity and Type 2 Diabetes and increased risk of Pancreatic Cancer is well known. What has been less clear is the process by which this happens. This latest research highlights the role of insulin in this link. (18)

“We found that hyperinsulinemia directly contributes to Pancreatic Cancer initiation through insulin receptors in acinar cells. The mechanism involves production of digestive enzymes, leading to heightened pancreatic inflammation.”
Dr. Anni Zhang – First Author (19)

The results of the study could lead to novel ways to prevent Cancer, which could specifically target the insulin receptors in acinar cells. (18, 20)

Most of us are not aware that Pancreatic Cancer is the 4^th leading cause of Cancer death in the United States and in Europe.

What kind of demographics reside in these countries, so that we can learn more of why and how this dis-ease happens?

If a study of 28 European countries is telling us that next year (2025) Pancreatic Cancer will surpass Breast Cancer and become the 3^rd leading cause of Cancer death, do we need to get on the front foot and demand answers as to WHY on earth this is happening and WHY there is such little public awareness?

What if articles like this are available so more of us can become aware and at least begin to consider we are not all going to be immune and this may just land on our doorstep – be it us or family, a friend, colleague or neighbour?

What we seem to lack is awareness and this in itself brings about un-necessary Stress, Tension and Anxiety when we find out we have symptoms that could be Cancer. Being equipped is to know what it actually is and we all know our medics have limited time to give us as they are so busy – hence the long waiting lists for doctors and hospital appointments.

What if we could be educated or receive an article such as this one in the form of a booklet so we could have some time to reflect on how we have been living that has got us to this point, where we are displaying symptoms of Pancreatic Cancer? Chances are it is advanced as we Ignored those small subtle signs that our body was communicating when it was ‘all systems go go go’ with no proper rest, as we were so driven in how we wanted to live and do things and be this or that.

What if the ‘insidious’ symptoms as mentioned in onset are simply Ignored because our over-riding the pain we feel, radiating to the back, weight loss, nausea or fatigue seem to be happening to others and so we just see it as normal, when it is not normal at all?

Again – to repeat from the text above

Symptoms of Pancreatic Cancer are insidious in onset and gradually progress over time. (7)

We simply cannot ignore and move on from this.

How is it that we can have harm-full effects from the start and yet it goes un-detected, un-noticed, un-felt and un-sensed?

What is that telling us about our true connection to our own body?

For the record –
A new analysis of data, covering 65% of the U.S. population suggests that the incidence of Pancreatic Cancer among individuals younger than 55 years is increasing more rapidly than in those 55 years or older and also more quickly in Women than in men.

The uncertain causes of this increased incidence suggest that the epidemiology of Pancreatic Cancer warrants closer attention. (21)

Next –

The following are important to note taken from the text above.

Men with Pancreatic Cancer – 11 x higher risk of Suicide than the remainder of the population. (13)

90% of all Pancreatic Cancer cases are sporadic (7)

Next –

We have STRONG EVIDENCE so this means the scientists are telling us they know –

OVERWEIGHT and OBESITY increases the risk of Pancreatic Cancer AND the following ‘might increase’ the risk:

• Cigarette Smoking

• Consumption of processed meat, foods containing saturated fatty acids, Alcohol, foods and drinks with fructose (fruit sugar).

We also have studies saying heavy Alcohol consumption can increase the risk of Pancreatic Cancer, regardless of Tobacco Smoking.

What do we do when we read or receive these 2 words STRONG EVIDENCE?

Is that enough to make the movements to Change now or are they simply just words on a page, which if we carry on reading, we get to turn over to the next page?

We have experts warning us that excessive insulin is common for those with Obesity and Type 2 Diabetes and DIRECTLY CONTRIBUTES TO PANCREATIC CANCER initiation.

If we keep it super simple – there are foods that we need to keep away from so that we do not go there when it comes to high insulin levels.
Candy, cookies, cake, ice cream, cereals, white bread and pasta anyone?

All the foods that we crave and say we love, that are void of any proper nutrients and generally deemed not good for our health are the ones we ought to pay attention to.

Another important common sense approach is to get active in the true sense. That means ditch the drive and push and force to exercise – all in the name of appearance and get going with a simple exercise routine and walking.

Consistency is key – daily will deliver results not an ad hoc and sedentary Lifestyle – TV butt and Screen Time buff where the only movement may not be for hours.

Most of us are aware that “Lifestyle” Changes must be made if we are to ever see any proper Changes. Yet we seem to be on the back foot peddling in a different direction as it suits our life which is clearly not taking responsibility for our Health and Well-Being.

‘ALARMING RISE IN PANCREATIC CANCER RATES’ (19)

This is not suddenly going to disappear or not continue and if we are reading this then it could be that we are going to be diagnosed, already are, or it is in our radar or someone we know.

Lifestyle intervention that the researchers mention to control insulin levels does not need to apply to us if we are Getting On with It and that means attending to daily life and having a sensible approach when it comes to all matters regarding our Health and Well-Being.

This website with 300 articles presents many Questions about human life and it brings awareness to the reader so that we are not left in the dark to figure things out or google our way out of life with apps and a plethora of Internet research, all of which may not apply to us, but we went seeking and so we find whatever we want and that includes news and studies that will claim that Alcohol is ok to continue with, when we all know it is a scientific proven poison.

How long do we need to be told Diet and Exercise are KEY to daily life, but yet we continue to Ignore and make little or no Changes?

Take a look at our younger generations and start asking WHY is Obesity and Diabetes starting at younger and younger ages now?

How serious does it need to get when we have this –

PDAC which is a common and aggressive type of Pancreatic Cancer is predicted to become the 2^nd leading cause of Cancer deaths by 2030. (18)

We can be assured that to publish anything remotely like this, those that have made this prediction KNOW it is inevitable. We are way down the track and this is what is coming BECAUSE we as individuals are not calling for Real Change and therefore not doing anything about it.

Our pancreas is super sensitive, just like our other organs. We cannot play around with our organs by overloading it so it cannot do its job properly. This is the level of Responsibility we all need to be aware of, but there are no Education systems out there teaching more on this and bringing lessons at school, with the understanding as to what happens when we trash the body with harmfull drinks and foods, excess Screen Time, Smoking, Vaping, indulging in our fantasies and staying up Late with no solid Sleep routine in place.

What we know is there are plenty of Solutions and the medics will fix us, so we carry on operating with our ‘business as usual’ and never bother to Question WHY and HOW on earth we create illness and dis-ease in the body that can lead to great harm and could end in death.

Certain precursor lesions have been associated with the development of Pancreatic Cancer, including:

• Pancreatic Intraepithelial Neoplasia (PanIN)
• Intraductal Papillary Mucinous Neoplasm (IPMN)
• Mucinous Cystic Neoplasm (MV) (7)

Pancreatic Cancer progresses from non-invasive precursor lesions to invasive Cancer over a variable time period.

It takes on average 10 years from when a mutation occurs until a primary tumour forms and another decade before the patient dies of the disease.

The tumour usually grows in silence for a long time, which means that there is an opportunity for early diagnosis. (7)

Cancer of the Pancreas is difficult to treat.

The Cancer is more difficult to treat if the tumour is large.

3 main treatments for Pancreatic Cancer are:

• Surgery
• Chemotherapy
• Radiotherapy

Some types of Pancreatic Cancer only require one form of treatment.
Others may require 2 types of treatment or a combination of all 3. (8)

Improving survival will require the accurate diagnosis of early Pancreatic Cancer.

Currently, most patients with Pancreatic Cancer are diagnosed with distant metastases and have a poor 5-year survival rate.

There is strong evidence that the detection of Pancreatic Cancer at an earlier, resectable stage has a favourable impact on long-term survival and even with the potential for micro-metastases the survival is better for patient with surgical resection than patients who do not undergo surgery.

The 5-year survival rate of localised Pancreatic Cancer is 25%, while being 10% for regional disease and 2% for distant disease, according to the American Cancer Society. (7)

Blood tests that assess various pancreatic and liver functions may suggest Pancreatic Cancer. If Cancer is suspected, a needle biopsy or an endoscopy procedure is usually conducted to examine pancreatic cells or the pancreas itself for signs of Cancer.

However, these procedures are invasive and are associated with an increased risk for serious complications, including pancreatitis. In order to make a correct diagnosis and to determine the stage of Cancer, multiple imaging techniques may be employed that allow doctors to see the pancreas despite its location deep within the abdominal cavity. (4)  

Surgery is considered curative for patients with Pancreatic Intraepithelial Neoplasia, Intraductal Papillary Mucinous Neoplasm or Mucinous Cystic Neoplasm with high grade dysplasia (increase in abnormal cell growth and development) that have not progressed to invasive carcinoma. (7)

Exocrine cancers are often treated with the Whipple procedure – a complicated surgical approach that removes all or part of the pancreas and nearby lymph nodes, the gallbladder and portions of the stomach, small intestine and bile duct. Serious complications often arise following this procedure, which requires an extensive hospital stay and considerable experience on the part of the surgeon. (4) 

Exocrine Pancreatic Cancer develops from exocrine cells, which make up the exocrine gland and ducts of the pancreas. This includes Adenocarcinoma. (22) 

Other exocrine tumours are sometimes treated by complete removal of the pancreas, known as Total Pancreatectomy.

Surgery can also be used to relieve complications of pancreatic cancers, such as obstruction of the bile duct. The bile duct may be re-directed around the tumour or a tube placed in the bile duct to keep it open. (4) 

To be successful, a screening program for Pancreatic Cancer needs to find and treat patients with T1N0M0 Cancer with negative resection margins or highly dysplastic precursor lesions.

According to the International Cancer of Pancreas Screening (CAPS) Consortium, the screening should not be done on a population basis but in groups according to defined criteria, such as those with two first-degree relatives with Pancreatic Cancer or known genetic syndromes associated with an increased risk of Pancreatic Cancer.

Initial screening should include Endoscopic Ultrasound (EUS) or MRI/Magnetic Resonance Cholangiopancreatography. Screening typically begins at age 40 years in PRSS1 mutation carriers with hereditary pancreatitis due to earlier onset of Pancreatic Cancer.

In other high-risk populations, there is no consensus at what age to begin and end screening.

Newly diagnosed Diabetes Mellitus in patients over 50 years is a very interesting group that has so far not been subjected to screening. However, the role of screening EUS/MRI even in high-risk individuals is still unclear.

Abnormal findings are frequent and the management of these detected lesions is still unclear. To be cost effective and practical, easier methods for screening are required – for example, biomarkers that can be measured in blood samples.

CA 19-9, a Sialyl Lewis carbohydrate antigen, is the only serum marker for Pancreatic Cancer that has been used in clinics and has a sensitivity and specificity of around 80%. Its sensitivity for early-stage Pancreatic Cancer is even lower, which means that it cannot be used for screening purposes.

CA 19-9 can be falsely elevated by *cholestasis and some patients lack the Lewis antigen and therefore cannot express CA 19-9. (7)

*Cholestasis – reduction or stoppage of bile flow. Bile is the digestive fluid produced by the liver. (24)

To summarise – there are currently no methods of screening for sporadic Pancreatic Cancer. Novel biomarkers for Pancreatic Cancer are urgently needed as most Pancreatic Cancer cases occur in patients without evidence of a hereditary origin.

The search for Pancreatic Cancer biomarkers is an intense research field. (7)

90% Pancreatic Cancers are driven by a mutation in the KRAS gene. (25)

The KRAS gene belongs to a class of genes known as oncogenes.
When mutated, oncogenes have the potential to cause normal cells to become cancerous. (26)

For those of us that are not aware – a lesion is an area of abnormal tissue. (23)

Anything ab-normal is something we ought to consider and ask sensible Questions about

• How did that happen?
• Do we have something to do with this going on inside our body?
• What is our body communicating to us by giving this symptom?

WHY does Pancreatic Cancer go from mutation to invasive Cancer and by then it’s too late as it is inevitable that death from the disease is accelerated?

WHY the silence, which means there is usually not an opportunity for early diagnosis?

WHY is it that Cancer of the Pancreas is difficult to treat?

WHY is the survival rate so low and what is this telling us?

What if those that are likely to get this form of Cancer are living in a way where there is nothing on their radar that connects them deeply to their body and so subtle signs and the body communicating messages are simply not received or acknowledged? Possible?

Whilst we know there is ‘strong evidence’ that if Pancreatic Cancer is detected at an earlier stage it is in our favour when it comes to the impact on long-term survival, we are being told that rarely is this the case. We generally find out when it is too late for surgical intervention and even if we do have the operation, survival rates are ‘poor’.

Dear World

Would it be a wise move after 263 years to admit that we simply do not have the answers, so just maybe there could be other ways to approach this dis-ease that has recently become more prevalent and that means it is inevitable we will see more cases of Pancreatic Cancer and at younger ages?

Are we ready to demand collectively that whilst screening is great and could support, we have large cohorts in our worldwide population that will never be able to get to an initial screening?

Our overworked, over-stretched and Exhausted health systems worldwide are simply not equipped to deal with the additional resources required for early screening of Pancreatic Cancer.

Abnormal findings are frequent and the management of these detected lesions is still unclear. (7)

This is telling us that the ab-normal is often, but the management remains ‘unclear’.

Next –

To summarise –

There are currently no methods of screening for sporadic Pancreatic Cancer. (7)

Do we really need to add any commentary or do we get it?

Next –

Novel biomarkers for Pancreatic Cancer are urgently needed as most Pancreatic Cancer cases occur in patients without evidence of a hereditary origin. (7)

While we all wait for the ‘urgently needed’ biological markers which means the medical signs with the research and science of measurement, can we at least begin to consider if there is possibly Another Way₁ to look at the whole subject of Pancreatic Cancer?

If we know that most cases are ‘without evidence of a hereditary origin’ can we stop all research going down this road and Change our approach? WHY – Simple really, we already know the results, so why go there when we clearly know the answer.

It is not crazy, stupid, silly, naive or un-intelligent to speak up and say there could be Another Way₂ as we know that the search for Pancreatic Cancer biomarkers is an ‘intense research field’.

Are we feeling settled with the way forward where Artificial Intelligence₂ is going to detect the early stage ‘hidden’ Cancer in the pancreas from scans?

‘Artificial Intelligence is a field, which combines computer science and robust datasets to enable problem-solving.’
University of Illinois System (27)

Artificial Intelligence (AI) – the ability of a digital computer or computer-controlled robot to perform tasks commonly associated with intelligent beings. (28) 

We all know our Body has its own super Advanced Intelligence₁ and we have done very well as a species collectively to advance ways to heal the body and increase life expectancy. Imagine if we had no medical support – where would our Body be?

Is AI the way forward for all of us to evolve or is there an inward movement needed by us and that means we need to go inside – within us, Connect to our inner-most where we may find the answers that are ultra-specific and designed to inform us precisely what is needed and what is not, when it comes to our body’s ultimate Health and Well-Being?

For many this may be wayward, too much or flaky but what if it is not?

Are we really in a seat to Ignore our vehicle – our Body any longer and wait for science to come up with answers and Solutions to cure but not find HOW and WHY the root cause has arisen to display the symptoms we now have?

Is this making sense?

Next –

We have an ‘experimental therapeutic vaccine’ on clinical trial that could be of benefit to patients with the most common form of Pancreatic Cancer.

When we are actually in the situation, most of us would say yes to any treatment, including a vaccine that offered us the avoidance of relapse, which would then increase survival. We know that.

Patients who have undergone surgery for Pancreatic Cancer are still at risk for relapse of the disease, even after they finish chemotherapy.
Dr. Shubhan Pant, Study Lead – Associate Professor of Gastrointestinal Medical Oncology at the University of Texas M.D. Anderson Cancer Center in Houston (29)

What we all must note is absolutely anything that is introduced to our Body to medicate us will come with side effects. That is inevitable.

Radiological Examination

Computed tomography (CT) remains the standard examination for Pancreatic Cancer.
The direct sign of Pancreatic Cancer on a CT is a low attenuation and hypo vascular lesion.

Indirect signs of Pancreatic Cancer are the dilation of the biliary tree and the main pancreatic duct, as well as atrophy (wasting away) of the distal pancreas. MRI and endoscopic ultrasound (EUS) may be of value in uncertain cases.

MRI has poorer spatial resolution and tissue diagnosis than CT but is good for the imaging of ductal structures. Stenosis (narrowing) of the main pancreatic ducts is suggestive of underlying malignancy and should always be followed up. MRI is also useful for the detection of cystic tumours of the pancreas.

The high resolution of EUS enables the visualisation of lesions as small as 1mm, which is useful for the detection of early Pancreatic Cancer; however, the poor specificity of EUS imaging remains a challenge. EUS-guided fine needle aspiration (FNA) may aid in the differentiation of benign from malignant lesions but false-negative and false-positive diagnoses are common and may be attributed to sampling error and cytological misinterpretation. (7)

Operability Assessment

The pre-operative evaluation of Pancreatic Cancer includes the assessment of the relationship between the tumour and the adjacent major vessels, portal vein (PV), superior mesenteric vein (SMV), superior mesenteric artery (SMA), celiac axis (CA), hepatic artery (HA), together with the presence of metastases (most commonly liver, peritoneum, lungs).

Operability assessment also involves a comprehensive consideration of the risk-benefit of pancreatic resection. This involves weighing the patient’s physical and mental resources in relation to the Stress caused by surgery. Age in itself is not a factor to exclude patients from potentially curative surgery but with increasing age comes increasing co-morbidity.

Many patients with Pancreatic Cancer are malnourished at the time of diagnosis. In severe cases, malnutrition may progress to Cancer cachexia, which is characterised by the loss of lean body mass, muscular atrophy and impaired function of the immune system. Low pre-operative albumin is a strong risk factor for complications after pancreatic resection.

25% of all patients with resectable Pancreatic Cancer suffer from sarcopenia, a relatively new concept reflecting the degenerative loss of skeletal muscle mass. It has been shown that sarcopenia is a significant predictor of major complications (Clavien grade ≥III), hospitalisation, intensive care unit stay, as well as infectious and cardiopulmonary complications after Pancreatic Cancer surgery. Furthermore, patients with sarcopenia have impaired long-term survival. (7) 

Note – there is a grading of surgical complications from grade I to V.
V = death. III is high. (30)

Perioperative mortality after pancreatic resection is governed by the complications and nearly half of all patients who undergo Whipple’s operation develop one or more complications. Mortality is driven by serious morbidity, which largely depends on pancreatic fistula formation, representing a failure in healing of the pancreatic *anastomosis or a parenchymal leak not directly related to an anastomosis and this leakage can result in sepsis and bleeding. (7)

*Anastomosis is the surgical connection joining two body structures. (31) 

Surgical Treatment

In recent years, fast-track for enhanced recovery after surgery (ERAS) programs have emerged with the aim to accelerate postoperative recovery by decreasing the body’s Stress reaction to surgery. Key constituents of these fast-track programs include preoperative education, avoidance of fluid overload, multimodal analgesia, early oral intake and enforced mobilization. Fast-track programs for pancreaticoduodenectomy are safe and feasible and reduce complications such as delaying gastric emptying as well as length of hospital stay and costs.

Pathological Evaluation

70% of all pancreatic cancers occur in the head of the pancreas.
20% occur in the body of the pancreas and 10% appear in the tail.

Lymph node involvement is a major prognostic factor in Pancreatic Cancer and prognosis has been proposed to be affected by the number of positive lymph nodes.

Given the complex nature of pancreatic surgery, sometimes not all macroscopic tumour tissue can be removed at the time of surgical exploration. This is known as an incomplete resection or R2 resection. The vast majority of patients with Pancreatic Cancer who undergo surgical resection eventually develop local or systemic recurrence. (7)

Looking at the detail here in the Radiological Examination – are we concerned to read that the high resolution ultrasound option is great as it can detect tiny lesions as small as 1mm, BUT this is only useful when it comes to early detection of Pancreatic Cancer?

We all know from earlier on in this article that early detection is very rare.

What we do know is – the poor specificity of EUS imaging remains a challenge. (7)

AND whilst we have the Endoscopic Ultra Sound fine needle aspiration procedure to check if lesions are benign or malignant, we have the following and this is not something we can simply Ignore.

…false-negative and false-positive diagnoses are common and may be attributed to sampling error and cytological misinterpretation. (7)

Next –

How serious is this?

Many patients with Pancreatic Cancer are malnourished at the time of diagnosis. (7) 

ADD to that a quarter of all patients suffer from the ‘degenerative loss of skeletal muscle mass’ and this is a ‘significant predictor of major complications, hospitalisation, intensive care unit stay, as well as infectious and cardiopulmonary complications after surgery. Furthermore, these patients have impaired long-term survival’. (7) 

‘Half of all patients who do undergo the surgery develop one or more complications.’ (7)

Have we stopped to ask WHY is there a ‘failure in healing’ relating to the surgical connection used to join the two body structures?

If we are preparing for any surgery, we need a body that is going to be equipped to deal with the assault that is coming. Let us not make out it is just an operation when we are under general anaesthetic because there is no other way we could endure the pain from what is happening to our body, as it is simply too sensitive. We need to be knocked out consciously so the surgeons can do their job. However, if what is presented is a Body in a 911 state and that means – loss of skeletal muscle mass then it can be of no surprise that what follows is not what we want.

Yes – it is great news for those wanting the fast track to get results and that there are programs out there with the aim to accelerate post-operative therapy but we ought to be aware that many, when diagnosed with something so major, may not follow through with the pre-operative education, which includes the avoidance of fluid overload. This is a reality and not something we are able to apply, even with the best efforts and intentions. Alcohol and Caffeine drinks anyone?

AND finally on the topic of Surgery –

The clear sign is we have the majority of Pancreatic Cancer cases occurring in the head of pancreas and surgery is complex and can be incomplete, as not all the tumour tissue can be removed.

The vast majority of patients with Pancreatic Cancer who undergo surgical resection eventually develop local or systemic recurrence. (7)

Is this serious enough and have we asked WHY we have all this so-called Intelligence₂ in our advanced modern world and yet we do not have answers as HOW and WHY the Cancer develops again after Pancreatic Cancer Surgery?

In other words, surgery will not give us anything – just a bit of time.

Palliation: Pain Relief & Nutrition

Pain treatment for Pancreatic Cancer requires a multi-modal approach.

The WHO analgesic ladder proposes that the treatment of pain should begin with non-opioid medication, such as paracetamol or a Non Steroidal Anti-Inflammatory Drugs (NSAID).

If the pain is not sufficiently controlled, a weak Opioid can then be introduced and subsequently a strong Opioid. Steroids have been shown to reduce cancer-related pain. For neuropathic pain, Amitriptyline, Sodium Valproate or Gabapentin may be administered. A celiac plexus block may be used for severe, intractable pain and the procedure can be performed intra-operatively or guided via CT or EUS.

For all pain management, follow up and evaluation are important.

Malnutrition affects most patients with Pancreatic Cancer. Reasons for this include:

• Gastric outlet obstruction
• Pancreatic exocrine
• Endocrine insufficiency
• Pain
• Nausea
• Cachexia

Pancreatic enzymes and nutritional drinks lead to significantly better weight stability. This is important because weight stability has been linked to prolonged survival and improved quality of life in patients with unresectable Pancreatic Cancer.

Steroids have also been associated with improved quality of life and a reduction in cancer-related fatigue.

Conclusion

Pancreatic Cancer remains one of our most recalcitrant and dismal diseases with very few improvements in outcomes over recent decades.

Despite advancements in surgery and oncological treatment for Pancreatic Cancer, very few patients achieve a cure.

The degrading clinical trends for this disease is likely due to the fact that Pancreatic Cancer is a systemic disease already at the time of clinical detection. (7) 

We have been informed that Malnutrition affects most patients with Pancreatic Cancer and this would inevitably lead to weight loss.

Common sense tells us that if we are mal-nourished, meaning that our body is not able to absorb the nutrients it requires, then we are going to have consequences.

The first thing to be aware of is Something Is Not Right and our body is communicating and we need to listen up. If we have got pain, of course we do what is needed with a sensible approach and check with the medics who know best.

But what if we started with acceptance – in other words,

 “Holy moly it’s that C word and we ain’t gotta clue how that relates to the pancreas”.

We have heard of that organ but know zilch about it and Google seems to have a load of stuff and our Stress levels are high as our life seems to flash up and at the same time we feel Exhausted with this constant fatigue that we just can’t seem to shake off and yet we feel that drive and Push Push momentum of how we have lived up to this point still racing us.

Bit like we got 2 things going on at once – body Given Up and unable to do anything and yet the racy driven mind wanting to go somewhere and giving up or giving in or surrendering is simply not on the agenda.

Hello

Do we get this exhaustive narrative and could we relate to any of it?
Maybe we don’t have the diagnosis but we know others that do and it seems to be making sense as that is how they operate in life?

ALL worth considering as we now know this dis-ease has been around for a very long time and we are yet to get the real true root cause of HOW and WHY we get cancerous cells forming in our pancreas.

Next –

Pain, nausea, an obstruction in our gastric outlet, unable to digest food properly and ALL this cause malnutrition.

Cachexia is general physical wasting and malnutrition. The origin of this word translates into “bad condition”. (32) 

Enough said, what is very clear is the body is signalling that it cannot function naturally and something is not right.

Whilst the conclusion is not what we want to hear – it has to be repeated here to bring home how serious this disease is and the Question we ought to be asking is WHY are most of us so unaware of what Pancreatic Cancer is.

Pancreatic Cancer remains one of our most recalcitrant and dismal diseases with very few improvements in outcomes over recent decades.

Despite advancements in surgery and oncological treatment for Pancreatic Cancer, very few patients achieve a cure. (7) 

We are told that the degrading clinical trends are likely because by the time it is detected, this form of Cancer has affected the whole body.

Relatively unknown decades ago but now Pancreatic Cancer features more and it escapes no one.

We recently had front page news headlines about a famous soccer manager that has been given a year to live, following the diagnosis of Pancreatic Cancer.

How many of us fear death or are simply not prepared?

How many of us actually stop to reflect on the possibility that how we are living could be silently contributing to a dis-ease going on inside our own Body that simply goes un-noticed and then becomes a Disease that we call Cancer? This also applies to all other diseases too.

In other words, we are now aware of what is happening inside our body. The world and all the Intelligence₁ Education and advancement we have made has not given us the basic 101 tools to Connect and truly know what on earth is going on inside us.

What if we do have a hand in WHY and HOW we get a disease and therefore we must have the answers within us, but we just do not know the steps to take to activate this movement?

Next –

The following statistics and text confirms the growth in Pancreatic Cancer.

STATISTICS

WORLDWIDE

2020 

466,003 died from Pancreatic Cancer (17)

Pancreatic Cancer is known as one of the most fatal cancers for its malignancy, aggressiveness and low survival rate and its mortality is almost identical to incidence.

According to GLOBOCAN2020, Pancreatic Cancer was

• 12^th most common malignancy
• 7^th leading cause of  Cancer mortality

Highest mortality rates of Pancreatic Cancer are usually observed in developed countries. (33)

Pancreatic Cancer has a higher incidence among the male gender, which has been the trend over the last 2 decades.

This is possibly due to Tobacco Smoking and Alcohol consumption being higher in the male sex leading to chronic pancreatitis, which is a risk factor of Pancreatic Cancer.

Diabetic men who are smokers have an elevated risk.

The prevalence of Pancreatic Cancer in Asia and Oceania mirrors the pattern in Europe and North America, which have the highest Pancreatic Cancer disease burden.

The relative risk of Pancreatic Cancer is highest for those with a history of chronic pancreatitis, idiopathic thrombosis and those with *germ line mutations. (34) 
*germ line = hereditary mutations

UK

2016 – 2018

10,452 new cases of Pancreatic Cancer

29 cases every day

10^th most common Cancer

47% of all new Pancreatic Cancer cases are diagnosed in age 75 and over.

17% increase in Pancreatic Cancer incidence rates since early 1990s.

Head of the pancreas is the most common specific location for pancreatic cancers.

2038 

16,000 new cases of Pancreatic Cancer every year projected.

540 cases of Pancreatic Cancer each year in England are linked with deprivation.

2017 – 2019

9,558 Pancreatic Cancer deaths

26 deaths every day

5^th most common cause of Cancer death

51% of all Pancreatic Cancer deaths are age 75 and over

2038

12,600 Pancreatic Cancer deaths every year projected.

Pancreatic Cancer deaths are more common in people living in the most deprived areas.

2013 – 2017

37% preventable cases

5% survive Pancreatic Cancer for 10 years or more in England (35)

Pancreatic Cancer survival has not shown much improvement in the last 50 years. (35)

5 year relative survival for Pancreatic Cancer is generally below the European average in the UK. (35)  

EUROPE

4^th most deadliest Cancer in men and Women is Pancreatic Cancer.

Although Pancreatic Cancer has a low incidence compared to many other cancers, its low survival rate is what places it among the top 4 deadliest cancers both in men and women. (36) 

USA

2023

Pancreatic Cancer estimates in the United States from The American Cancer Society are:

• 64,050 will be diagnosed with Pancreatic Cancer

• 50,550 will die of Pancreatic Cancer (37)
• 3^rd most deadliest Cancer is Pancreatic Cancer (38)

New cases of Pancreatic Cancer have gone up each year since the late 1990s.

5-year relative survival rate is:

44% if the Cancer is detected at an early stage when surgical removal of the tumour is possible. 12% are diagnosed at this stage.

15% if the Cancer has spread to surrounding tissues or organs

3% if the Cancer has spread to a distant part of the body
52% are diagnosed at this stage (39)

CANADA

Although Pancreatic Cancer is not one of the most commonly diagnosed cancers in Canada, it is expected to the 3^rd leading cause of Cancer death this year – 2023.

7,200 will be diagnosed with Pancreatic Cancer this year

5,900 will die from Pancreatic Cancer

4,000 men will be diagnosed with Pancreatic Cancer

3,200 women will be diagnosed with Pancreatic Cancer

3,100 men will die from Pancreatic Cancer

2,800 women will die from Pancreatic Cancer (40)

ASIA-PACIFIC COUNTRIES

Afghanistan; Australia; Bangladesh; Bhutan; Cambodia; China; Democratic People’s Republic of Korea; Fiji; France, New Caledonia; French Polynesia; Guam; India; Indonesia; Japan: Kazakhstan; Kyrgyzstan; Lao People’s Democratic Republic; Malaysia; Maldives; Mongolia; Myanmar; Nepal; New Zealand; Oceania; Pakistan; Papua New Guinea; Philippines; Republic of Korea; Samoa; Singapore; Solomon Islands; South Korea; Sri Lanka; Thailand; Timor-Leste; Vanuatu; Vietnam.

China, followed by Japan and India accounts for the majority of the new cases of Pancreatic Cancer.

China – most populous country in Asia

60% increased risk of developing Pancreatic Cancer in current smokers
pooled analysis in the Asia-Pacific population

A meta-analysis has demonstrated that the risk of developing Pancreatic Cancer is independent of the number of pack years of Smoking and is not dose dependent.

There is also an increased mortality due to Pancreatic Cancer among smokers and former smokers compared to non-smokers. This effect was observed in the Western as well as Asia-Pacific populations and an association was found to be independent of Alcohol use, Body Mass Index (BMI) and history of Diabetes.

With the increase in rates of Smoking among the younger age group, especially in males in China and India, one can expect a rise in the incidence of Pancreatic Cancer in this cohort over the next decade.

Alcohol consumption elevates the risk of developing pancreatitis, which has a strong association with the development of Pancreatic Cancer.

A recent meta-analysis has demonstrated the dose related association of Alcohol with Pancreatic Cancer.

15g/day – consumption of high levels of Alcohol is a strong risk factor, especially in men of developing Pancreatic Cancer.

The strong association between Obesity and Cancer is evident through prior data.
Pancreatic Cancer is no exception.

Obesity is associated with an increased risk of various cancers, which are driven by the following mechanisms:

• Chronic low-level inflammation and DNA damage
• Increased production of oestrogen in the fat tissue
• Increased levels of insulin and IGF-1
• Adipokines which may have a growth promoting effect

Direct and indirect effects on the other cell growth regulators, including mammalian target of rapamycin (mTOR) and AMP-activated protein kinase.

Being overweight or being obese in early adulthood independently increases the risk of Pancreatic Cancer compared to people with normal body weight, as demonstrated by pooled cohort and meta-analysis.

*Central Obesity increased Pancreatic Cancer risk in the Asia-Pacific population (41)
*Central Obesity – excess accumulation of fat around the abdominal area (42)

Australia, Japan and China are predicted to see large increases in the Pancreatic Cancer incidence burden between now and 2040.

60% increase from current levels in Australia predicted (41)

CHINA

Pancreatic Cancer is a growing public health concern.

The disease burden due to Pancreatic Cancer presented a significant upward trend in rural areas and a downward trend in urban areas.

2020

100,427 Pancreatic Cancer deaths

2,166,355 Pancreatic Cancer related years of life lost (28)

YLL – Years of Life Lost

YLL is a measure of premature mortality that takes into account both the frequency of deaths and the age at which it occurs.

One YLL represents the loss of one year of life.
YLLs are calculated from the number of deaths multiplied by a global standard life expectancy at the age at which death occurs.

The total number of deaths from specific causes does not provide a good metric for informing public health priorities.
For example – the same weight to a death at age 80 is assigned to a death at age 30 or at 1 year of age. (43) 

2019

114,964 Pancreatic Cancer cases in China

The burden of Pancreatic Cancer increased significantly since 1990.

Whether in 1990 or 2019, the incidence of Pancreatic Cancer was low before the age of 50 and it substantially increased with age, starting from the 50-54 age group and reaching its peak in the 85 and over age group. (44)  

>2-fold risk of Pancreatic Cancer in people who have had Diabetes for less than 2 years, according to a meta-analysis in China. (29)  

BRAZIL

The Burden of Pancreatic Cancer is rising in Brazil (45)

JAPAN

2020

Japan has an unusually high burden of Pancreatic Cancer

4^th leading cause of Cancer deaths

This Cancer burden will continue to rise in the next 10 years, despite the decrease in the Japanese population, according to Global Data epidemiologists forecast.

2019

42,000 cases diagnosed of Pancreatic Cancer

Incidence of Pancreatic Cancer has increased continuously over the past several decades.

50% higher than in 5 European Union countries – France Germany Italy Spain UK.

Twice as high as in the United States

Age is a risk factor as Japan has an ageing population susceptible to Pancreatic Cancer.

European countries are also experiencing demographic changes with ageing populations but do not have a similar incidence to Japan.

The high rate of Pancreatic Cancer is concerning because the disease is associated with high mortality.

4^th leading cause of Cancer death

60% – 80% of patients already have distant metastasis at presentation with a poor survival rate.

An early diagnosis of Pancreatic Cancer is difficult due to the lack of clear diagnostic tools, which partly explains the low survival rate.

Studies in Japan have reported that median survival for advanced-stage Pancreatic Cancer was 5 months and 1 year for earlier stages, which implies that early diagnosis is key for better prognosis. (46)

NEW ZEALAND

5% – Lowest survival statistics for Pancreatic Cancer (47)

40% increase in rates of Pancreatic Cancer since 1997
Ministry of Health data (48)

The need to improve diagnosis is growing more urgent

Currently, there is no screening programme for Pancreatic Cancer and incidence is higher among men than women.

2019

80% higher Pancreatic Cancer rates among Māori

5^th biggest cause of Cancer deaths in the county

2025

World Health Organization projects that Pancreatic Cancer in New Zealand will surpass Breast Cancer to become the 4^th biggest cause of mortality for Cancer patients. (48)

AUSTRALIA

2022 

4,506 estimated number of new Pancreatic Cancer cases diagnosed

3,669 number of deaths from Pancreatic Cancer estimated (2023)

13% chance of surviving at least 5 years (2015 – 2019) (49)

Pancreatic Cancer is the 4^th most common cause of Cancer deaths in both men and women and has the lowest survival rate of all cancers. (50)  

 

This final section on Statistics starts with –

Pancreatic Cancer is known as one of the most fatal cancers for its malignancy, aggressiveness and low survival rate and its mortality is almost identical to incidence. (33)

This means that the number of deaths is almost identical as the number of new cases. Pancreatic Cancer is an aggressive disease.

WHY is Pancreatic Cancer known for its ‘aggressiveness’?

What are we doing that makes our pancreas react in this way?

Generally, the number of people dying from a disease is not usually as high as the number of new cases and this is because of the treatments that are available.

However, Pancreatic Cancer has a low survival rate from the time of diagnosis, which is why death (mortality) rates are almost as high as incidence rates.

Most other cancers or diseases have preventative measures available, which means that we can live longer with the disease or go into remission. With Pancreatic Cancer it is diagnosed at late state because it does not display symptoms like other cancers.

Next –

WHY are the highest Pancreatic Cancer mortality rates among men in developed countries?

Whilst we cannot negate the risk factors of Tobacco Smoking and Alcohol consumption, are we ready to ask WHY they Smoke or consume Alcohol in the first place?

In other words, work backwards and keep going back until we hit the mark where we can say what happened, what was going on and what triggered the movements at that time to start on the Smoking road or Alcohol or both.

Next –

WHY has Pancreatic Cancer survival rate not shown much improvement in the last 50 years and WHY are we not demanding answers?

WHY are the highest rates of Pancreatic Cancer in developed countries?

WHY is there a trend of 20 years in higher incidence for the male gender?

WHY are we accepting that it could ‘possibly be due to Smoking and Alcohol’?

WHY are smokers with Diabetes at an ‘elevated risk’ and what do we need to do?

If we simply join the dots here and apply a small dose of common sense –

Men seem to be living in a way that is giving rise to a dis-ease in their body that without symptoms is going under the radar until it is too late and they are diagnosed with Pancreatic Cancer.

While we wait for more research studies, more Solutions and more of the new stuff in Artificial Intelligence, we forget that our body has an Intelligence₂ too.

Common sense says the body just knows. When we keep assaulting it by doing harmfull behaviours, there comes a point where we are stopped.

Example –

Late Nights – who cares about the agenda we have the next day and off we go on Alcohol, justifying we are drinking a glass or two only, convincing ourselves we are sensible and ‘drinking responsibly’ (as the billboards remind us) and we use it to simply unwind from a heavy day to relax. Then before we realise – we are doing the same again the next day and the next.

Not once have we done anything about it, but we do the Hot Talk, which means Empty Words and no real Action.

Yes, the plan is – we are going to Change and YES we need to Change but the drive to keep pushing the body every day with a force that even feels hard, just seems to run the show and it’s like we cannot stop as there is no off switch.

Our mind is racy and we’ve got a to do list that follows us around – even when we are supposedly “not working” and even when we need to be Preparing for Sleep and winding down for bed.

We move like we are on auto-pilot functioning, as that is what the body does and we forget how we treat this thing we have got until our last breath.

We know animals never over eat or consume copious amounts of sugar or go out on an Alcohol bender when it’s Sleep time, but we take no notice as we class ourselves as the most Intelligent species walking this plane of life called Earth.

Are we really Intelligent if we bludgeon our body with Caffeine, Cigarettes, Vaping, and Illicit Drugs in the name of recreation, plus Sugar, Binge TV, Social Media Addiction, Video Games and all the other self-medication we have that are our ‘go to’ rewards that we call upon and use as our ‘work life balance’? We call these Lifestyle behaviours.

An important note –
Anything we repeat becomes our Foundation ~ Serge Benhayon

So we keep doing the same thing over and over again and it is now locked in and becomes our Foundation. Late Nights, booze and Caffeine first thing anyone?

Are we getting it and are we prepared to go there with the “Self Care” as a start?

This website has 300 articles published and the whole website is designed to bring awareness to humanity.

Everything is researched and written by the author in a Simple, easy to understand style, so we ALL get it.

There is a whole section on Lifestyle and Self Care – well worth bringing that into our Wind Down routine before we go off to bed.

Whilst we may prefer at the very end of the day – a large tub of our favourite ice cream or a crime book or airy fairy la la escapism fantasy book or stimulating Screen Time – these may all affect the Quality of our Sleep and this means the next day for sure ain’t gonna deliver what we want in the day.

WHY?

Simple – we are not equipped as we went to bed ingesting something that is not actually supporting the Health and Well-Being of our body.

Are we getting this and is it making any sense?

Back to the Stats – most of us are immune to numbers and relating it to actual people around the world.

When it hits home as in someone close, we usually pay attention or we go and campaign as we want Change as we see the horror of the disease unfold in front of our very eyes.

Next –

We are so advanced we actually know the trajectory.
In other words, the way things are going it is inevitable Pancreatic Cancer is on the rise and so we can expect more people diagnosed and more dying.

ADD to that we also now know that the number of Cancer patients who are likely to survive in 5 years is low.

Pancreatic Cancer Survival – not much improvement in the last 50 years (35)

Knowing that we now know we cannot ignore it any longer. We cannot erase this one line and we cannot pretend we did not see it and we cannot un-see, un-read or un-feel anything.

WHY Pancreatic Cancer is among the top 4 deadliest cancers both in men and women is BECAUSE of its low survival rates.

There is nothing more to say.
The numbers speak volumes.

Pancreatic Cancer is not going away and we are not yet going in the direction of demanding WHY and HOW we get this highly aggressive Cancer that shows up once it is at a late stage.

This article gives a brief presentation of the disease and some valuable Questions have been posed for the reader to consider.

 

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