Diabetes and Pancreatic Cancer: Is There a Relationship?
Pancreatic cancer is one of the leading causes of cancer-related death in the United States. In fact, according to Siegel et al., it ranks fourth. According to the National Cancer Institute, the five year survival rate for those diagnosed with pancreatic cancer is 7.2%. Thus, the survival for someone with pancreatic cancer is quite bleak. Nevertheless, some important correlations have been observed recently by scientists that show a relationship between diabetes and pancreatic cancer. Although it will not necessarily provide a direct cure, it can help with pancreatic cancer prevention.
First, it is important to address the type of diabetes and the type of pancreatic cancer of interest. There are two types of diabetes, Type I and Type II. In Type I diabetes, which is commonly known as juvenile diabetes, the body cannot make enough insulin. In essence, the problem here is one of composition. On the other hand, Type II diabetes is when the body cannot use insulin properly. Thus, the issue here is not composition but rather utilization of insulin. Approximately 90% of diabetes cases in the United States are Type II. The research addressing diabetes and pancreatic cancer refer to Type II diabetes.
With regard to pancreatic cancer, there are two main types. The first is pancreatic adenocarcinoma. Because it occurs in about 85% of cases, sometimes the usage of, “pancreatic cancer” refers to just this type. The second type, which is rarer, less aggressive, slower, and has better outcomes, are pancreatic neuroendocrine tumors. In this case, the anomaly lies in the hormones that the pancreas produces. This type of pancreatic cancer is what Steve Jobs suffered from, and to which he eventually succumbed. The research of interest only refers to the first type (adenocarcinoma) not pancreatic neuroendocrine tumors.
Since the pancreas is responsible for producing insulin and using it in digestion, and Type II diabetes is an abnormality in using the insulin, then logically there is a correlation between the two. In addition, pancreatic adenocarcinoma results from the digestive aspect of the pancreas. Therefore, there could be an association between the two. Let's look at some substantial academic research studies and see what can be found.
According to McAuliffe et al., type II diabetes is a major risk factor for pancreatic cancer. Another study by Huxley et al., which is a meta-study of 36 different studies, states that the risk is increased even further for patients who have had diabetes for over ten years. The primary reason for the large mortality rate in patients with pancreatic cancer is because at present, it is difficult to diagnose pancreatic cancer in its early stages. As a result, when it is eventually diagnosed, the cancer has either already metastasized or is aggressive and it's too late. There is growing evidence (such as Pannala et al. and Andersson et al.) which suggests that an initial onset of diabetes could be a warning sign of pancreatic cancer. In addition, the study by Pannala et al. also states that when the pancreas is resected due to cancer, diabetes in the patient improves. A study published last year by Toriola et al. analyzes the chance of survival of patients who have been diagnosed with pancreatic cancer and type II diabetes. The scientists found that the prognosis in diabetic patients with pancreatic cancer is much poorer compared to non-diabetic pancreatic cancer patients. These findings suggest that diabetes does have a correlation with pancreatic cancer. However, more research needs to be conducted before making a substantial conclusion.
As a result of the aforementioned findings in various studies, some scientists are looking to antihyperglycemic medication such as Metformin to help manage pancreatic cancer patients with diabetes. A study published last year by Wang et al. has shown that Metformin actually does help reduce the risk of pancreatic cancer in type II diabetic patients. It is important to note that these patients will still have a higher risk of contracting pancreatic cancer as opposed to non-diabetic patients. However, their risk is quite reduced compared to those who have diabetes without a hyperglycemic medication.
Based on the facts provided, it is evident that having type II diabetes will most likely increase ones risk of having pancreatic cancer. Pancreatic cancer is still shrouded in mystery because it is difficult to detect until the late stages, leading to a high mortality rate. Furthermore, although there has been a push towards pancreatic cancer prevention, there are no definitive preventions for the cause of pancreatic cancer. This makes it even more difficult to deal with. However, the link between type II diabetes and pancreatic cancer does provide some hope for reducing the risk. If one can prevent type II diabetes, then it could by association reduce the risk for pancreatic cancer. If you have diabetes, then it is paramount that you work with your primary care physician and/or endocrinologist in order to control your diabetes. In essence, this is an important subject because of the prevalence of diabetes, and I highly recommend sharing the information and studies provided with others.
About SC Ali
S.C. Ali is an author/editor. He has a degree in Chemistry, and is interested in the study and practice of medicine. His blog can be found here: http://thebronzelifestyle.com/