Genetic testing is essential to patients with pancreatic cancer

Pancreatic cancer

Genetic tests can provide those with pancreatic cancer crucial information such as: why you have developed cancer, what treatment options (including new advanced cancer treatment) are available to you, your risk of developing additional cancers, and if your family is at risk for developing hereditary cancers such as breast, ovarian, pancreatic, or prostate.  

Treatment guidelines that physicians follow state that 100% of patients with pancreatic cancer should be receiving genetic testing.1 However, it is estimated only about 20% of patients are actually receiving this testing.

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Myriad Oncology's Tests for Pancreatic Cancer and What Answers They Provide:

Hereditary cancer testing

myRisk genetic testing

Myriad myRisk® is a gene panel that helps identify your options for treatment, your risk of additional cancers, and if any close family members may be at an elevated risk of developing cancer.

BRca testing - to help determine which patients may be appropriate for parp inhibitor therapy

BRACAnalysis CDx cancer testing
BRACAnalysis CDx® informs you if you’re eligible for advanced pancreatic cancer treatments such as targeted therapies, or clinical trials.

Hereditary cancer risk associated with pancreatic cancer

Inherited genetic mutations account for about 5-10% of all pancreatic cancers.2 By knowing your genetic risk factors, your doctor can better diagnose and treat your pancreatic cancer.

If your cancer was caused by a mutation, your children and siblings have a 50% chance of having that same mutation. Genetic testing helps identify these mutations, and it has been found that individuals with an identified hereditary cancer risk have up to a 36% lifetime risk of developing pancreatic cancer.3 They are also at a much higher risk of developing other cancers, such as breast, ovarian, and prostate cancer, than the general public.

To see if genetic testing will benefit you, take The Hereditary Cancer Quiz. It is time to take control of your health.

What is Pancreatic Cancer?5

The pancreas is an organ that sits behind the stomach and aids in digestion. Pancreatic cancer is out of control cell growth within the tissue of the pancreas. Pancreatic cancer accounts for 3% of all cancers diagnosed and 7% of all deaths.(4)

There are two main forms of pancreatic cancer: 

Ductal Adenocarcinoma

Ductal adenocarcinoma is the most common form of pancreatic cancer. This form of pancreatic cancer begins with the exocrine cells, which help you digest food. 

Pancreatic Neuroendocrine Tumors

Endocrine cells make up less of the pancreas but are important because they make hormones like insulin. Pancreatic neuroendocrine tumors start in these cells. 

It is very important to diagnose pancreatic cancers early, as they’re hard to spot until they become metastatic—growing to other parts of the body. Nearly 80% of pancreatic cancers are metastatic at the time of diagnosis,(5) which can make the survival rate low. Different types of pancreatic cancers have different symptoms and are treated much differently. Make sure to consult with your healthcare professional to learn more.

Pancreatic Cancer Signs and Symptoms5

Pancreatic cancer often does not have early symptoms and when signs of pancreatic cancer do occur, it may have grown to other parts of the body. This is why pancreatic cancer may be difficult to detect early. If symptoms do occur there are some signs that may help recognize them. 

Common signs and symptoms of pancreatic cancer:

  • Jaundice, which is a yellowing of the skin and eyes
  • Dark urine
  • Light-colored or greasy stool
  • Itchy skin
  • Belly or back pain
  • Weight loss and poor appetite
  • Nausea and vomiting

Pancreatic cancer is hard to detect from its symptoms because these symptoms are usually a result of the cancer’s effects on other organs as it grows. Consult with your healthcare professional to identify the root of these symptoms to rule out any other complications.

Pancreatic Cancer Diagnosis and Staging

Pancreatic Cancer Screening5:

Your doctor will begin with your family history. Identifying key genes that you’ve inherited from your parents will reveal an increased risk for pancreatic cancer. Your healthcare provider may also search for signs of other health problems, such as liver or gallbladder swelling, which they may feel during an exam. A doctor will also check for jaundice, which is a yellowing of the skin and eyes. 

There are many ways a doctor may look for the tumor using computer imaging.

Pancreatic Cancer Imaging:

  • An ultrasound uses sound waves to create an image doctors can view. Ultrasound is often used first, as it is the least invasive.
  • Magnetic resonance imaging, or MRI, uses radio waves and powerful magnets instead of x-rays to make detailed images.
  • Computed tomography, or CT scan, is an x-ray test that reveals detailed images on your body. This test is especially helpful if the cancer has spread to other parts of your body.
  • Positron emission tomography, or PET scan, uses radioactive sugar. Cancer cells absorb sugar at a different rate from healthy cells. This allows doctors to see cancer growth.

Other pancreatic cancer tests may include using a small camera to see if pancreatic ducts and bile ducts are blocked, narrowed, or dilated, or conducting a biopsy to study the tissue.

Pancreatic Cancer Staging5:

The staging system used most often for pancreatic cancer is the AJCC (American Joint Committee on Cancer) TNM system, which is based on 3 key pieces of information:

  • The extent of the tumor (T): How large is the tumor and has it grown outside the pancreas into nearby blood vessels?
  • The spread to nearby lymph nodes (N): Has the cancer spread to nearby lymph nodes? If so, how many of the lymph nodes have cancer?

The spread (metastasized) to distant sites (M): Has the cancer spread to distant lymph nodes or distant organs such as the liver, peritoneum (the lining of the abdominal cavity), lungs or bones?

  •  

Pancreatic Cancer Treatment Options5

There are treatment options available for your pancreatic cancer and it is important to discuss your options with your healthcare provider. Different stages and types of pancreatic cancer may require different treatments, such as surgery, radiation, and chemotherapy. Each treatment will try to remove or destroy the cancer cells and your doctor may recommend using one or more of these treatments:

Surgery

Surgery may be an option for pancreatic cancer. Depending on its stage, a doctor may suggest removal of the tumor and surrounding tissue.

Radiation Therapy

This treatment uses high-energy waves to kill cancer cells. It is administered much like a regular x-ray.

Chemotherapy

One or more anti-cancer drugs are introduced to shrink or to stop cancer growth. It can also kill some cancer cells within the body.

With genetic testing you could find that you are eligible for other targeted treatments or clinical trials. Talk with your doctor about genetic testing, and all the risks, side effects, and benefits of each treatment.

References
  1. Walker EJ, et al. Referral patterns and attrition rate for germline testing in pancreatic cancer (PC) patients. J Clin Oncol. 2018;36(15 suppl):1591.
  2. https://www.pancan.org/facing-pancreatic-cancer/about-pancreatic-cancer/risk-factors/genetic-hereditary/
  3. Giardiello FM, et al. Very high risk of cancer in familial Peutz-Jeghers syndrome. Gastroenterology 2000; 119:1447-1453.
  4. American Cancer Society. Cancer Facts and Figures 2020. Atlanta, Ga: American Cancer Society; 2020.
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