Thursday

23rd Mar 2023

Opinion

EU 'Beating Cancer Plan' must not ignore deadliest type

  • EU Commission president Ursula von der Leyen at last year's event (Photo: 04/02/2020)
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As the EU embarks on the EU Beating Cancer Plan, a key focus will be placed on quality of life and increased screening opportunities.

The second Mission on Cancer call, released in December 2021 and open until April 2022, is also searching for solutions for quality of life for cancer patients.

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An improved quality of life is often a pipe dream for pancreatic cancer patients. This type of cancer is usually found at a late stage, when it has already progressed too far to be tackled.

A person diagnosed with pancreatic cancer can expect to live for one more year at most. This disease has a lower survival rate than any other cancer in Europe, with more than 95 percent of patients dying because of it.

The death rate for pancreatic cancer in Europe has doubled. Over 95,000 people lose their lives to pancreatic cancer every year in Europe, and the numbers of both cases and deaths are expected to increase by 40 percent by 2035.

Despite these horrific facts, funding for pancreatic cancer research is thin on the ground. It accounts for only two percent of total cancer funding in Europe.

Unlike for other cancers, there are no immunological treatments for pancreatic cancer. The only options are chemotherapy – which is largely ineffective against this type of cancer – and surgery, which carries heightened risks because of the biological make-up of the pancreas.

If, by chance, you are one of the so-called 'lucky' pancreatic cancer patients who is deemed suitable for surgery – only 20 percent – you're not out of the woods yet.

The fluid that fills the pancreas – the so-called pancreatic juice – is extremely corrosive. Surgical stitches can be eroded by this juice, allowing the juice to spill into your organs and cause even more damage.

What's more, the tendency of pancreatic cancer cells to travel via the nervous system makes the surgeon's job incredibly difficult.

As the pancreatic cancer cells entwine themselves in the nerves, sometimes in microscopically small quantities, it is close to impossible for the surgeon to successfully remove them all, meaning that the chance of relapse is high.

There are answers to this complex problem. At Humanitas hospital in Milan, we are exploring a wide range of possibilities.

For instance, jaundice is one of the most well-known symptoms of pancreatic cancer, and it often presents because the pancreatic cancer cells are pressing on the bile duct. A stent is put into the patient to open up the bile duct and relieve the pressure from the pancreatic cancer cells, reversing the jaundice.

The problem is that these stents can develop a microfilm of bacteria, which can cause a bile duct infection, which is dangerous for an already-compromised patient. So how long do we have before the stent develops a dangerous microfilm?

So far, the answer has varied from patient to patient, and Humanitas Research Hospital is using big data and artificial intelligence to determine the optimal length of time to leave a stent in for, as well as the type of antibiotics which act best against the microfilm bacteria.

Investment will increase survival odds

We are also investigating two new type of biomarkers that could potentially signal pancreatic cancer at a much earlier stage, thereby making it easier to treat. The most well-known biomarker for pancreatic cancer currently is CA 19-9, but it appears when a tumour has already formed. The two potential biomarkers being examined by Humanitas would appear long before that.

Together with Politecnico Milano's engineers, Humanitas Research Hospital is developing an artificial tissue that is as similar as possible to the pancreatic cancer tissue.

The idea is that surgeons and students can practice sutures on the artificial tissue, so that they are better prepared when faced with a pancreas full of corrosive juice on the operating table. There are unique challenges with pancreatic surgery which will make this tool extremely valuable to surgeons.

Even though there are no fast and easy solutions, funding of pancreatic cancer research should be a priority for the European Union, especially as Mission Cancer is launched and the Beating Cancer Plan gets underway.

The fight against pancreatic cancer is tough, but extremely worthwhile. Today, a diagnosis of pancreatic cancer gives the average patient less than a year to live. This should not be the case. Investment into innovative research pathways could dramatically improve those odds.

We have a chance, under the Europe Beating Cancer Plan and Mission Cancer, to focus on innovative, groundbreaking and disruptive research into pancreatic cancer that could dramatically improve the outlook for patients. We must not miss this opportunity – the cost in loss of life will be too great.

Author bio

Alessandro Zerbi is professor of general surgery at Humanitas University in Milan and head of the pancreatic surgery operating unit.

Disclaimer

The views expressed in this opinion piece are the author's, not those of EUobserver.

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