HealthONE - August 10, 2021

In 2019, pancreatic cancer made the news nationwide when beloved Jeopardy! host Alex Trebek announced he had been diagnosed with stage 4 pancreatic cancer. Many who knew of the disease and its particularly grim prognosis were encouraged when Trebek successfully battled the cancer for more than a year. Unfortunately, 20 months after the diagnosis, Trebek succumbed to the disease, dying at the age of 80 in 2020.

Early diagnosis of pancreatic cancer difficult

While pancreatic cancer is rare — affecting only three percent (about 60,000 annually) of Americans — it remains third highest cause of cancer-related deaths in the United States. Sujatha Nallapareddy, MD, a board-certified medical oncologist and hematologist with the Sarah Cannon Cancer Institute at Swedish Medical Center, explains the low survival rate is due, in part, to the difficulty of catching the disease early.

“Most of the time, when pancreatic cancer is diagnosed, it is at stage 4; more than 70 percent of pancreatic cancer patients are at stage 4,” Dr. Nallapareddy clarifies. “For cancers, we have screenings for breast with the mammogram, colon cancer with the colonoscopy and lung cancer patients with a history of smoking, the CT screen. But for pancreatic cancer, there are no screening recommendations unless the patient has a family history with more than two family members who have been diagnosed.” Patients with family history are considered high-risk and are encouraged to undergo screenings such as an MRI of the pancreas and endoscopic ultrasound that allow providers to keep close watch on any potential developments.

Pancreatic cancer symptoms often significant

Because of the lack of a screening tool and the ambiguity of early symptoms, diagnosis typically happens once more significant symptoms arise, indicating the disease is at a later stage of progression. Dr. Nallapareddy says most patients who are diagnosed with pancreatic cancer already have experienced:

  • Painless jaundice
  • Severe abdominal pain
  • Unintentional weight loss
  • Diabetes
  • Blood clots in the legs

These symptoms are a cause of concern and should always lead to prompt medical attention. Providers of patients with these symptoms will order additional imaging testing to determine if pancreatic cancer is the cause. If diagnosed, patients are referred to oncology providers for a care plan.

Specialized, collaborative care key to successful treatment

When choosing a medical team to partner with for the battle against pancreatic cancer, Dr. Nallapareddy encourages patients to seek out specialists who collaborate with other specialists to provide the best care possible. “At the Sarah Cannon Cancer Institute at Swedish Medical Center, our pancreatic cancer team consists of providers who are experts in this specific cancer including hepatobiliary surgeons, medical oncologists, radiation oncologists,” she details. “We have what amounts to a specialized mini-university in a community setting.” The benefit of this high-level of collaboration within a community setting, Dr. Nallapareddy reveals, is that care is expedited. “Our patients don’t have to wait long,” she says. “Things move very fast. Patients are often anxious to get care started quickly and we are able to do that very well.” She also implores patients to find a center that is accredited for this type of surgery. “Swedish is well-known for pancreatic cancer treatment and is accredited for pancreatic cancer surgeries.” A high level of experience and concentration on the specific cancer site is unique and vital for excellent outcomes.

Pancreatic cancer treatment advancing

Pancreatic cancer is treated with a combination of surgery, chemotherapy and radiation therapy. As with many types of surgery, pancreatic cancer surgery has advanced in recent years to incorporate the use of minimally invasive techniques, including robot-assisted procedures. These techniques allow surgeons to lessen the impact of surgery on the body, reducing blood loss, complications, scarring and recovery time. In addition, over the last six years, there has been tremendous growth in treatments through medications. “Ten years ago, we had two to three drugs available to treat patients with pancreatic cancer,” Dr. Nallapareddy recalls. “Today, we have seven or eight drugs available. This is helping our stage 4 patients live longer and feel better.”

Additionally, advancements in genetics are helping some patients receive diagnoses earlier. Patients who have family history of pancreatic cancer (two or more close family members) should consider genetic counseling services. This care is often covered by insurance and may help identify markers that increase the likelihood of developing pancreatic cancer. Once the gene is identified, genetic counselors can work with other providers to create a proactive plan.

“Being diagnosed with pancreatic cancer is difficult and frightening,” Dr. Nallapareddy empathizes. “But there is hope. Experts are working continually to perfect treatments and screening tools. We are fighting cancer together.”

Sujatha Nallapareddy, MD is a board-certified medical oncologist and hematologist with the Sarah Cannon Cancer Institute at Swedish Medical Center. She specializes in gastrointestinal cancers, skin cancers, breast cancers, and non-cancerous blood disorders. Dr. Nallapareddy takes a collaborative approach in patient care, taking the time to listen and getting to know her patients and their families as well as educating them on different treatment options, because she believes better outcomes are achieved when patients understand and embrace their care. Dr. Nallapareddy participates in many tumor boards, where she collaborates with other cancer specialists including surgeons, radiologists, pathologists, and radiation oncologists. This allows her to provide a comprehensive, multi-disciplinary approach to cancer treatment recommendations such as chemotherapy, targeted therapies, and immunotherapies. Dr. Nallapareddy has served as a principal investigator for many clinical research trials and emphasizes the importance of participating in clinical research trials when appropriate to ensure her patients are receiving the most up-to-date, cutting-edge treatment for their disease. She does presentations for the community about the risks, treatments, and prevention for colorectal cancers and works closely with Colon Cancer Alliance to increase awareness around cancer prevention.