In yet another celebrity cancer diagnosis, John Hurt, Academy Award nominee for “The Elephant Man” and “Midnight Express”, recently announced he is suffering from pancreatic cancer. Celebrity cancer stories, though unfortunate, do bring a benefit. They bring awareness to the particular cancer type that often reaches far more ears than the years of advocacy efforts waged by charity organizations. Immediately, people took notice when Angelina Jolie, Rita Wilson and Sheryl Crow made headlines with breast cancer diagnoses. Now it is John Hurt and pancreatic cancer. One may recall the media coverage surrounding movie star Patrick Swayze and Apple founder Steve Jobs, who also were stricken by pancreatic cancer. What is pancreatic cancer and why is it such a killer?

The pancreas is a gland located in the abdomen, adjacent to the stomach and small intestine. It produces enzymes necessary for digestion and is also vital to blood sugar regulation through its production of insulin and glucagon.

There are many type of pancreatic cancer. About 85% of cancers are ductal adenocarcinoma. The remainder are divided among rare types, most notably those arising from the endocrine cells of the pancreas. These are called neuroendocrine carcinoma.

The greatest risk factors are smoking and a family history of the disease. Other risk factors include alcohol abuse and obesity. It is uncertain whether chronic inflammation or diabetes imparts an increased risk. There are rare familial cancer syndromes which also raise the risk. Chief among these is Lynch Syndrome.

Symptoms include pain, weight loss, anorexia, malaise and weakness. Depending on the tumor site, some patients may present with painless jaundice, a yellowish discoloration to the skin.

Diagnosis is through a combination of imaging studies such as CT scan and tissue biopsy. A pathologist will examine a biopsy or cells obtained through a procedure in which the pancreas is sampled. Recently researchers have demonstrated that the gene regulator molecules called micro RNAs might be useful as biomarkers for the early detection of pancreatic cancer.

For tumors that are small and localized, surgery is one option. However, most patients are not candidates for surgery. Treatment often consists of palliative measures including chemotherapy and radiation.

Pancreatic cancer has a very poor prognosis with 5 year survival rates of 2-4%. About 90% of patients die within a year. The poor prognosis is due to early spread to other organs, so called metastases. There is promise though. Recently the immune protein interleukin 17 has been shown to be involved in metastasis. Blocking this protein might prove beneficial in treating the disease. We know that the gene ATDC is involved in tumor progression.

Many researchers, including The Stand Up to Cancer Pancreatic Cancer Dream Team, are actively working towards a cure.

What can you do?

• Stop smoking.
• Know your family history. If you there is a family history of pancreatic cancer you might want to discuss with your doctor the opportunity to see a genetic counselor regarding. Early detection is critical. Researchers have discovered that pancreatic cancer takes 10-20 years to develop. This provides a large window of opportunity for detection in those who might be at increased risk.
• Exercise lowers the risk of pancreatic cancer.
• Eat healthy. Eating a high quality diet has been shown to decrease the risk of pancreatic cancer.

Use these teachable moments that come from celebrity health stories to take control of your own health.​

About Dr. Michael Misialek

Dr. Michael Misialek currently serves as Associate Chair of Pathology at Newton-Wellesley Hospital, Newton, MA. He is the Medical Director of the Vernon Cancer Center, Chemistry Laboratory and Point of Care Testing. He practices in all areas of pathology in a busy community hospital. Holding an academic appointment at Tufts University School of Medicine as a clinical assistant professor of pathology, he regularly instructs medical students and pathology residents. Dr. Misialek is a strong advocate for pathology and is very active in the College of American Pathologists (CAP), serving on the Personalized Healthcare Committee, the political action committee PathPAC, the CAP Foundation and as chair of the Massachusetts delegation in the CAP House of Delegates. He is an inspector with the CAP and has conducted several domestic and international hospital laboratory inspections.

He received his MD from the University of Massachusetts, did an internship in internal medicine at Boston Medical Center and completed his residency in anatomic and clinical pathology at the University of Massachusetts Medical Center. He did a fellowship in general surgical pathology at the University of Florida and is board certified in Anatomic and Clinical Pathology.