Oncology
Metastatic Pancreatic Cancer
Diabetes and the Diagnosis of Pancreatic Cancer
Overview
Metastatic pancreatic cancer is associated with a low survival rate; however, early screening and detection remains a challenge. The most commonly seen presenting symptoms include weight loss, fatigue, jaundice, pain, and anorexia. Diabetes and pancreatic cancer often arise at the same time in a patient; nearly 45% of patients with pancreatic cancer are likely to present as patients with new-onset diabetes. Recent studies evaluating the relationship between diabetes and pancreatic cancer have shown that long-standing diabetes is a risk factor for pancreatic cancer, while new-onset diabetes appears to be a manifestation of the disease. In fact, a meta-analysis examining the association of type 2 diabetes with pancreatic cancer in 14,399 patients concluded that new-onset diabetes is possibly a manifestation of pancreatic cancer, while long-term diabetes is likely a risk factor. In addition, prospective epidemiologic studies have suggested that new-onset diabetes is a potential platform for the early diagnosis of pancreatic cancer because of metabolic pathways associated with pancreatic cancer–related diabetes mellitus. Because approximately 50% of all patients develop diabetes mellitus before their cancer diagnosis, screening individuals with new-onset diabetes might allow earlier diagnosis of metastatic pancreatic cancer.
Expert Commentary
Margaret A. Tempero, MD
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Diabetes is very complex, and it has a very complex relationship with pancreatic cancer. Longstanding diabetes is a risk factor but new-onset diabetes is actually caused by the disease. So, a subset of patients with new-onset diabetes will have an underlying pancreatic cancer. Therefore, we have a nationwide effort to establish a cohort, a very large cohort of patients with new-onset diabetes from whom we are going to be collecting biospecimens for later analysis and following them to understand which of those patients develop pancreatic cancer. |
“Diabetes is very complex, and it has a very complex relationship with pancreatic cancer.”
References
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