Soft drink consumption and pancreatic cancer

Consuming two or more soft drinks per week increased the risk of developing pancreatic cancer by nearly twofold compared to individuals who did not consume soft drinks, according to a report in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

Although relatively rare, pancreatic cancer remains one of the most deadly, and only 5 percent of people who are diagnosed are alive five years later.

Mark Pereira, Ph.D., senior author on the study and associate professor in the School of Public Health at the University of Minnesota, said people who consume soft drinks on a regular basis, defined as primarily carbonated sugar-sweetened beverages, tend to have a poor behavioral profile overall.

However, the effect of these drinks on pancreatic cancer may be unique.

"The high levels of sugar in soft drinks may be increasing the level of insulin in the body, which we think contributes to pancreatic cancer cell growth," said Pereira.

For the current study, Pereira and colleagues followed 60,524 men and women in the Singapore Chinese Health Study for 14 years. During that time, there were 140 pancreatic cancer cases. Those who consumed two or more soft drinks per week (averaging five per week) had an 87 percent increased risk compared with individuals who did not.

No association was seen between fruit juice consumption and pancreatic cancer.

Pereira said that these results from Singapore are likely applicable to the United States.

"Singapore is a wealthy country with excellent health care. Favorite pastimes are eating and shopping, so the findings should apply to other western countries," said Pereira.

Susan Mayne, Ph.D., associate director of the Yale Cancer Center and professor of epidemiology at the Yale School of Public Health, said these study results are intriguing but have some key limitations that should be considered in any interpretation.

"Although this study found a risk, the finding was based on a relatively small number of cases and it remains unclear whether it is a causal association or not. Soft drink consumption in Singapore was associated with several other adverse health behaviors such as smoking and red meat intake, which we can't accurately control for," said Mayne, an editorial board member of Cancer Epidemiology, Biomarkers & Prevention.

Pereira points out that the findings are biologically plausible, held up in non-smokers, remained similar after taking other dietary habits into account and are consistent with findings in Caucasian populations.

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Herbal extra to against pancreatic cancer

An herb recently found to kill pancreas cancer cells also appears to inhibit development of pancreas cancer as a result of its anti-inflammatory properties, as per scientists from the Kimmel Cancer Center at Jefferson. The data were presented at the AACR 100th Annual Meeting 2009 in Denver. (Abstract #494).

Thymoquinone, the major constituent of the oil extract from a Middle Eastern herbal seed called Nigella sativa, exhibited anti-inflammatory properties that reduced the release of inflammatory mediators in pancreas cancer cells, as per Hwyda Arafat, M.D., Ph.D., associate professor of Surgery at the Jefferson Medical College of Thomas Jefferson University and a member of the Jefferson Pancreatic, Biliary & Related Cancers Center.

Nigella sativa seeds and oil are used in traditional medicine by a number of Middle Eastern and Asian countries. It helps treat a broad array of diseases, including some immune and inflammatory disorders, Dr. Arafat said. Prior studies have also shown it to have anti-cancer effects on prostate and colon cancers.

Based upon their previously published findings that thymoquinone inhibits histone deacetylases (HDACs), Dr. Arafat and her colleagues compared the anti-inflammatory properties of thymoquinone and trichostatin A, an HDAC inhibitor that has previously shown to ameliorate inflammation-associated cancers.

The scientists used pancreatic ductal adenocarcinoma (PDA) cells, some of which were pretreated with the cytokine TNF-alpha to induce inflammation. Thymoquinone almost completely abolished the expression of several inflammatory cytokines, including TNF-alpha, interleukin-1beta, interleukin-8, Cox-2 and MCP-1, an effect that was more superior to the effect of trichostatin A.

The herb also inhibited the activation and synthesis of NF-kappaB, a transcription factor that has been implicated in inflammation-associated cancer. Activation of NF-kappaB has been observed in pancreas cancer and appears to be a factor in pancreas cancer's resistance to chemotherapeutic agents. When animal models of pancreas cancer were treated with thymoquinone, 67 percent of the tumors were significantly shrunken, and the levels of proinflammatory cytokines in the tumors were significantly reduced.

Inflammation has been implicated in the development of several solid tumor malignancies. Chronic pancreatitis, both hereditary and sporadic, is linked to the risk of developing pancreas cancer.

"These are very exciting and novel results," Dr. Arafat said. "Not only patients with chronic pancreatitis could benefit from this, but also several other groups with risk of development or recurrence of pancreas cancer, such as high-risk family members and post-surgical patients. These potent effects show promise for the herb as a potential preventive and therapeutic strategy for pancreas cancer. More importantly, the herb and oil are safe when used moderately, and have been used for thousands of years without reported toxic effects".

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Pancreatic Cancer Discovery Offers New Hope For Patients

Editor's Choice
Main Category: Pancreatic Cancer
Also Included In: Cancer / Oncology
Article Date: 25 Oct 2012 - 12:00 PDT Current ratings for:
Pancreatic Cancer Discovery Offers New Hope For Patients

A set of mutated genes responsible for causing pancreatic cancer have been discovered by Australian researchers and revealed in a new study published in the journal Nature.

This is the first time a collaboration of the world's best experts has been carried out to determine the genetic factors that influence 50 different types of cancer.

According to the report, pancreatic cancer accounts for more deaths than any other major type of cancer. Survival rates have not improved over the last 40 years, acting as the fourth-leading cause of death from cancer. Common symptoms of pancreatic cancer include: NauseaVomiting Appetite LossPain in the upper part of the stomach (abdomen), which can spread to the backUnusual weight lossDiabetes mellitus or high levels of blood sugarDepression Trosseau sign (when blood clots pop up out of nowhere in the deep veins of a person's extremities, superficial veins anywhere on the body, or in the portal blood vesselsExperts noted that early pancreatic cancer sometimes does not come with any symptoms what-so-ever. According to previous research, pancreatic cancer patients' lives can be saved if they visit more experienced hospitals and facilities.

The international team of more than 100 researchers was led by Professor Sean Grimmon, from the Institute for Molecular Bioscience (IMB) at The University of Queensland, and Professor Andrew Biankin from The Kinghorn Cancer Centre at Garvan Institute of Medical Research / St. Vincent's Hospital in Sydney.

The experts sequenced the genomes from 100 pancreatic tumors and analyzed them in comparison with non-cancerous tissue to discover which genetic alterations may have caused the cancer.

Grimmon said:

"We found over 2,000 mutated genes in total, ranging from the KRAS gene, which was mutated in about 90 per cent of samples, to hundreds of gene mutations that were only present in 1 or 2 per cent of tumors. So while tumors may look very similar under the microscope, genetic analysis reveals as many variations in each tumor as there are patients. This demonstrates that so-called 'pancreatic cancer' is not one disease, but many, and suggests that people who seemingly have the same cancer might be to be treated quite differently."

Biankin commented that in the future, independent diagnoses and treatment plans for each patient will be the "norm". He said, "In this study, we found a set of genes, the axon guidance pathway, that is frequently damaged in pancreatic cancer patients and is associated with potentially poorer outcomes for those patients. It is a new marker of pancreatic cancer that can be used to direct prognoses and treatments."

Biankin continued: "'Personalized medicine', where the molecular profile of a patient is matched to the best treatment, is the way the world is moving for many diseases, not just cancer. The challenge now will be moving from population healthcare and a 'one drug fits all' model to personalized healthcare. First, we must take the time to develop the necessary genetic knowledge and implement health systems to translate that knowledge effectively."

The Professors noted that the Australian Pancreatic Cancer Genome Initiative, which involves over 20 hospitals and research facilities, of more than 200 nurses, surgeons, pathologists, and experts, played a large part in their study.

Professor Warwick Anderson, from the National Health and Medical Research Council of Australia, which funded the study with a $27.5 million grant, said: "NHMRC is proud to have been the major funding contributor to this research, and I am delighted that breakthroughs have been made in understanding the genetic basis of this disease. This positive outcome is evidence of NHMRC supporting the very best research and researchers, and the importance of our involvement in strong national and international collaborations. The ultimate goal of our funding is healthier citizens, both in Australia and overseas, and this research will certainly lead to a better understand of this issue."

Written by Christine Kearney
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our pancreatic cancer section for the latest news on this subject. "Pancreatic cancer genomes reveal aberrations in axon guidance pathway genes" Andrew Biankin, Sean Grimmon, et.al.
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posted by Kevin on 29 Oct 2012 at 7:47 am

Although this is definitely good news, the time something of real benefit comes out of it usually takes years, dare to say decades. My wife, 30-years old, she is suffering from this terrible disease. Just wish that more research is invested into it as much as any other form of cancer...Good luck with your wife Susanta

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posted by Susanta Kumar Das on 27 Oct 2012 at 6:44 am

We expect the outcome will delight the Patients. I am a badluck husband of a young 34 yeared pancreatic wife.
Presently she is undergoing treatment and 3rd stage of Chemotherapy is continue. Doctor diagonsis this position was not operable, only Chemothery (Paraplatin 450ml)may save her life.

Any new finding in this regards may comunicate to my mail ID. This may save her life.

Susanta Kumar Das

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'Pancreatic Cancer Discovery Offers New Hope For Patients'

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Popular Diabetes Drug Might Cut Pancreatic Cancer Risk: Study

TUESDAY, Jan. 31 (HealthDay News) -- A new Swiss-American study indicates that long-term use of the popular diabetes medication metformin may lower the risk of developing pancreatic cancer, at least among women.

The researchers also found that the long-term use of another class of diabetes medications known as sulfonylureas was associated with a "substantial" bump in pancreatic risk and long-term insulin use was linked to a bump in pancreatic cancer risk in men.

"This result is somewhat unexpected," the team wrote in its paper, which is published in the Jan. 31 online issue of The American Journal of Gastroenterology.

Pancreatic cancer is the fourth most deadly cancer in the United States, with an overall survival rate of less than 5 percent, even though it is fairly rare, according to the U.S. National Institutes of Health.

The researchers noted that previous research has suggested that metformin may lower the risk for other cancers, breast and ovarian cancer in particular.

To explore metformin's protective potential against pancreatic cancer, the team sifted through drug prescription, diagnostic, hospitalization and fatality information that had been collected by the British "General Practice Research Database." The data also included significant demographic information, such as smoking, alcohol use and body mass index.

The team honed in on statistics regarding nearly 2,800 patients (all under the age of 90) who had been diagnosed with pancreatic cancer for the first time between 1995 and 2009. Data concerning almost 16,600 patients who did not have pancreatic cancer was used as a comparison.

The result: Short-term use of metformin or sulfonylureas and/or insulin had no appreciable impact on pancreatic cancer risk.

However, long-term use of each of these medications did appear to have a sizeable impact on pancreatic cancer risk among diabetics. While female patients saw their risk go down with metformin treatment and up with sulfonylureas, male patients saw their risk go up with insulin.

Dr. Michael Choti, a professor of surgery and oncology at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University in Baltimore, stressed the "importance of trying to identify causes for a devastating disease that is often diagnosed late."

"Over the years, many groups have tried to look at a variety of risk factors, dietary and other things, and there have been some reports over the years," he noted. "But nothing has really panned out well. So this is indeed an interesting study."

"But it's also important to say," Choti added, "that while these could be associations, we cannot really say that what we have here is a cause-and-effect. Pancreatic cancer is a multi-factorial disease. So, while it makes sense conceptually that these drugs could have an impact on the pancreas, which is a metabolic organ, it's still too early to be sure what's happening. And it's too early to recommend metformin as a preventive therapy for pancreatic cancer."

"So this is interesting and important," he said. "But it's not definitive."

More information

For more on pancreatic cancer, visit the U.S. National Library of Medicine.

SOURCES: Michael Choti, M.D., professor, surgery and oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore; Jan. 31, 2012, The American Journal of Gastroenterology, online

Copyright © 2012 HealthDay. All rights reserved.

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Balancing Quality And Quantity Of Life For Pancreatic Cancer Patients

Main Category: Pancreatic Cancer
Article Date: 27 Aug 2012 - 0:00 PDT Current ratings for:
Balancing Quality And Quantity Of Life For Pancreatic Cancer Patients

Every year, nearly 45,000 Americans are diagnosed with pancreatic cancer. The odds against those stricken by the disease are truly dismal; pancreatic cancer almost always kills within two years after diagnosis, no matter how it is treated. Even aggressive intervention with chemotherapy, radiation or surgery rarely yields more than an extra month to a year of survival, depending on the stage of the disease.

This raises a tough question: should patients who know they are going to die soon spend a substantial amount of what little time they have left undergoing aggressive and difficult treatment - treatment likely to bring them only a brief period of additional life?

"It's about balancing quality and quantity of life, really," said Dr. Casey Boyd, a University of Texas Medical Branch at Galveston surgery resident and lead author of a paper analyzing the problem in Annals of Surgical Oncology. "For pancreatic cancer we know the quantity of life is short, so maximizing the quality of life is important - and the best way we can do that is to give patients concrete data that they can look at and use in their treatment decisions."

Boyd and her colleagues approached the issue by drawing on the National Cancer Institute's Surveillance, Epidemiology and End Results database, examining SEER records for 25,476 pancreatic cancer patients and focusing on two factors that directly affect patients' lives: hospital days and days spent in medical care. (Hospital days were days spent as hospital inpatients, while medical care days included days in the hospital as well as other days on which the patient visited a physician, underwent a diagnostic test, or received a treatment).

"This study is the first to bring together hospital and medical care days in pancreatic cancer patients with stage, treatment and survival, and it gives us a quantitative look at the whole experience of a patient with pancreatic cancer," Boyd said. "We hope that physicians can use the information in this paper to give patients what they need to make critical decisions."

For example, Boyd said, a doctor could draw on the paper to counsel a patient with metastatic pancreatic cancer - the most common and deadly type. "The physician could say, if you have chemotherapy you may live four to six weeks longer, but a lot of that time you're going to be in the hospital, or getting a test, or getting a needle poked in your arm for your chemotherapy," she said. "Some patients may say, I want that, I want the most life that you can give me."

Others, she noted, might make a different choice if given an accurate picture of the treatment experience.

"They might say, it's not really worth it to me - it's a few extra weeks, but they may be miserable weeks," Boyd said. "They may decide not to have any treatment and maybe just have hospice, or just spend time with their family."

The ability to help patients make such difficult decisions was the main goal of the study, according to Boyd.

"Really, this paper is about empowering the patient," she said. "We want to provide them with the information they need to make their own personalized treatment decisions."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our pancreatic cancer section for the latest news on this subject. Other authors of the Annals of Surgical Oncology article include medical student Daniel Branch, assistant professor Kristin Sheffield, biostatistician Yimei Han, associate professor Yong-Fang Kuo, Sealy Center on Aging director Dr. James Goodwin and associate professor Dr. Taylor Riall. Support for this research was provided by the NCI; the Office of Research, Development and Information, Centers for Medicare & Medicaid Services; Information Management Services Inc.; the SEER program; and the Cancer Prevention Research Institute of Texas.
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Earlier Onset Of Pancreatic Cancer Likely In Those Who Smoke And Drink Heavily

Main Category: Pancreatic Cancer
Also Included In: Smoking / Quit Smoking;  Alcohol / Addiction / Illegal Drugs
Article Date: 03 Oct 2012 - 0:00 PDT Current ratings for:
Earlier Onset Of Pancreatic Cancer Likely In Those Who Smoke And Drink Heavily

Those who smoke and drink heavily may develop pancreatic cancer at an earlier age than those who don't, according to a study led by a University of Michigan Health System gastroenterologist.

In the study, published in the American Journal of Gastroenterology, heavy smokers with pancreatic cancer were diagnosed around age 62 and heavy drinkers at age 61 - almost a decade earlier than the average age of 72.

Smoking is a strong risk factor for pancreatic cancer and alcohol has been shown to cause oxidative damage to the pancreas, which sets the stage for the inflammatory pathways that can lead to cancer.

The findings only indicate these habits can lead to developing pancreatic cancer earlier in life.

The study of 811 pancreatic cancer patients from the multicenter, international database Pancreatic Cancer Collaborative Registry does not prove the habits caused cancer.

The study does make a step toward understanding at what age screening for pancreatic cancer should begin - once widespread screening is available.

"As screening programs are developed, an understanding of how personal features influence the age of presentation will be important to optimize the timing of those screenings," says lead study author and gastroenterologist Michelle Anderson, M.D., assistant professor of internal medicine at the University of Michigan Health System. Detecting pancreatic cancer early is difficult and contributes to the poor survival rates. By the time pancreatic cancer is diagnosed, it is frequently at an advanced stage and has spread to other organs.

Currently there are no tests available to easily find it in people who do not have symptoms. In the study, heavy smokers were defined as those who had more than a pack per day, and heavy drinking was measured at more than 39 grams a day, or about three average drinks per day.

Beer drinkers presented with pancreatic cancer earlier than those who drank other types of alcohol, such as wine or hard liquor although when adjusted for the amount of alcohol consumed, the type of alcohol did not affect the age of presentation.

The good news is that the harmful effects of heavy drinking and smoking can be resolved . After 10 years, former smokers and drinkers who quit their habits faced no extra risk of earlier diagnosis.

The registry used for the study gathers information on patients with pancreatic cancer and those at high-risk for developing pancreatic cancer.

Patient data was collected from University of Nebraska Medical Center, Omaha, Neb.; University of Genoa, Italy; Creighton University School of Medicine, Omaha, Neb.; University of Pittsburgh Medical Center; NorthShore University Health System, Evanston, Ill.; University of Chicago, Chicago, Ill.; University of Alabama at Birmingham, Ala.; and the University of Michigan Health System, Ann Arbor, Mich.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our pancreatic cancer section for the latest news on this subject. Funding: This work was supported by the following grants: NIH K23 DK082097, NCI T32 CA 083654, NIH R01 CA140940, and Italian Ministry of Health DGRST.4/4235-P1.9.A.B.
Reference: "Alcohol and Tobacco Lower the Age of Presentation in Sporadic Pancreatic Cancer in a Dose-Dependent Manner: A Multicenter Study," American Journal of Gastroenterology.
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New pancreas tumor registry

Charles J. Yeo, M.D., Samuel D. Gross Professor and Chair, Department of Surgery at Jefferson Medical College of Thomas Jefferson University, announces the establishment of the new Jefferson Pancreas Tumor Registry (JPTR).

"The purpose of the registry is to further study whether pancreas cancer occurs more frequently in families with a history of the disease," said Dr. Yeo, who is the principal investigator of JPTR. "It will also be used to determine the environmental and occupational risk factors to which pancreas cancer patients have been exposed."

The JPTR modeled after the National Familial Pancreas Tumor Registry is a longitudinal study in which participants may engage in long-term follow-up and receive information regarding scientific and epidemiological breakthroughs in pancreas cancer.

Participants are asked to complete a detailed questionnaire and may be asked to submit a blood sample and/or cheek swab. The questionnaires are designed to elicit the family health history of a patient with pancreas cancer or a non-affected family member, and to document exposure to occupational and environmental factors, such as residential radon, asbestos and second-hand tobacco smoke.

Research has shown that certain rare genetic conditions are linked to an increased risk of pancreas cancer, including familial breast-ovary cancer, familial melanoma, familial colon cancer, hereditary pancreatitis and Peutz-Jegher's syndrome (a rare hereditary condition that results in gastrointestinal polyps). "While we have not identified a causative gene yet to allow predictive testing for pancreas cancer, we can offer risk assessments and surveillance via imaging, blood tests and endoscopic ultrasound for patients with a strong family history of pancreas cancer," added Dr. Yeo.

Such high risk patients may be referred to a Jefferson gastroenterologist to discuss the pros and cons of invasive surveillance. The goal is to diagnose pancreas cancer earlier, when more therapy options are available. For persons who do develop pancreas cancer, Jefferson physicians may use the results of genetic testing to select the most effective treatment. Targeted treatment for pancreas cancer is becoming a reality, in part due to recent discoveries made in the laboratory of Jonathan Brody, Ph.D., assistant professor, Department of Surgery at Jefferson Medical College of Thomas Jefferson University, where molecular studies have clearly indicated survival advantages with the use of targeted chemotherapy.

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