A vital test for pancreatic cancer is becoming underused.
According to a study conducted by Mayo Clinic, an inexpensive and readily available test for pancreatic cancer that is very helpful in predicting progression and is a good tool for guidance in treatment is only being used by 1 out of 5 patients in the US. Patients who turn out positive for this particular biomarker usually tend to have worse tumor progression. However, if they are supposed to undergo surgery and will receive chemotherapeutic treatment before getting their operation, this treatment sequence eliminates the elevated tumor marker's negative effects.
Mark Truty, M.D., gastrointestinal surgical oncologist at Mayo Clinic in Rochester, Minnesota, says that This is another argument for giving chemotherapy before surgery in all pancreatic cancer patients and ending the old practice of surgery followed by chemo. He also says that the results of their study is very helpful in clinical practice and is quite applicable to all pancreatic cancer patients that are being considered for surgery.
The study was based on data from the National Cancer Data Base. It is the first of its kind in that the researchers used national data, and is also the largest of its kind.
CA 19-9, An Important Biomarker
Subjects that were involved in the study amounted to around 97,000 patients. They followed the tumor progressions of these patients in related to a tumor biomarker, named CA 19-9. This biomarker is connected to many types of cancers, which of course includes pancreatic cancer, and its presence can be detected through the analysis of a blood sample. However, there are around 10% who do not produce this particular biomarker. In the study, the researchers took this into consideration and also followed the outcomes of pancreatic cancer patients who did not produce CA 19-9.
Patients with elevated levels of CA 19-9 had a tendency to have worse outcomes than those who had normal levels at the same stage of cancer. Unexpectedly, the biomarker's negative effect on survival was observed to be highest if the patient was diagnosed at an early stage.
Dr. Truty says that after taking note of how these patients fared after surgical removal of their tumors, the best treatment sequence that was able to eliminate the risk posed by the high level of CA 19-9 was chemotherapy followed by surgery.
Another important piece of information found by the study is that only around 19 percent of the total number of pancreatic cancer patients have their CA 19-9 levels checked during diagnosis, and this is quite fewer than they expected.
If patients are not checked for their CA 19-9 levels during diagnosis, patients with high levels of the tumor biomarker may undergo immediate surgeries that may as well be not beneficial in the long run.
In the US, around 50,000 people are diagnosed with pancreatic cancer each year and only around 7 percent are able to survive after 5 years from diagnosis. Thankfully, advances in diagnosis and treatment such as the CA 19-9 test, improved chemotherapy, radiation and surgical techniques are raising the survival odds for patients.
Dr. Truty says that all pancreatic cancer patients should be tested for CA 19-9, especially since it is a cheap and widely available test that will become an invaluable tool for effectively treating a patient. Of course, patients with a high level of CA 19-9 should opt to be subjected to preoperative chemotherapy to lessen the negative effects posed by elevated CA 19-9 levels.
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Written by: Yevgeny Aster Dulla, MSc.