Trading cancer for diabetes?

If you had the choice between suffering from a type of cancer with a survival rate of only 5%, or living with diabetes and having to inject insulin several times a day for the rest of your life, which would you choose? Which is the lesser of two evils?

Pancreatic cancer is a very serious and painful type of cancer that only rarely responds to treatment. Its diagnosis is often accompanied by a very sombre prognosis, and very few people survive it. Why? No one really knows. Perhaps it is because it is a silent cancer whose symptoms only appear when the disease has reached a very advanced stage. Furthermore, it is impossible for physicians to palpate tumours during a physical examination as the pancreas is located too deeply within the abdomen, behind the stomach, making early detection that much more difficult.

Additionally, not only do pancreatic tumours contain numerous mutations, they also have the capacity to encapsulate themselves in scar-like tissue which protects them from chemotherapy. Furthermore, the pancreas’ natural ability to avoid being dissolved by its own digestive enzymes may also protect it against the effects of chemotherapy.

Some individuals are at greater risk of suffering from pancreatic cancer: those with a family history of this particular cancer; smokers; people over the age of 60; and those suffering from diabetes or chronic pancreatitis. Men and individuals of African descent are also more at risk.

A great number of scientists are currently working at better understanding the biology and genetic of this cancer in the hopes of finding new ways to detect and treat it. And although their knowledge is still quite limited, they are hoping genetic advances will enable them to make compelling discoveries within the next few years.

In the meantime, a special program has been established at the Johns Hopkins Hospital in the United States. Only individuals from high-risk families are admitted into the program. Specialists in this program offer the only preventative measure known to date: surgically removing the pancreas before cancer invades it. It must be noted that physicians will not remove a healthy pancreas. However, they do remove those with numerous cysts, because these cysts are likely to become malignant. Physicians can sometimes remove parts of the pancreas, but when cysts are too numerous, they are forced to remove the entire organ.

Because the pancreas is the organ responsible for insulin secretion, removing it condemns patients to living with diabetes. This is a terribly difficult choice to make, but the only possible one for some very unfortunate individuals.

Cancer is a scary word, but thankfully, medical advances now mean that an increasing number people survive it. With cancer of the pancreas however, we await such advances with bated breath. Let us hope the numerous studies currently underway will soon bring a bit of hope to this deadly disease.