Harvard Men's Health Watch

On call: Pancreatic cancer prevention

Q. Every time I open a newspaper, I seem to read about another VIP with cancer of the pancreas. It sounds like a dreadful disease. Is there some way I can be tested to see if I'm at risk?

A. Cancer of the pancreas is relatively uncommon; only about 43,000 cases are diagnosed in the United States each year, putting it far behind prostate cancer (218,000 a year), breast cancer (209,000 a year), and colorectal cancer (143,000 a year) — yet because pancreatic cancer is so hard to treat, it has a much higher mortality rate than any of these more common malignancies. It is indeed a dreadful disease, and its poor prognosis explains why it gets so much publicity.

Early on, cancer of the pancreas is clinically silent. Later, patients may develop back pain, abdominal pain, weakness, weight loss, depression, or jaundice. Imaging studies such as ultrasounds, CTs, and magnetic resonance imaging scans may detect abnormal tissue in the pancreas, but a definite diagnosis depends on a biopsy. Unfortunately, imaging studies are not sensitive enough or specific enough to be useful for screening, and the CA19-9 blood test that is sometimes used to check for the disease is even less reliable.

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