Pancreatic cancer kills swiftly and surely, and often goes undiagnosed until it's far too late for doctors to provide the only cure—surgery. But new research being reported by U-M researchers may give patients a better chance at early detection, firm diagnosis and, someday, better treatment options for the fourth leading cause of cancer death.

Researchers from the U-M Comprehensive Cancer Center have announced that they have found a protein which allows them to tell pancreatic cancer from normal tissue better than the current "gold standard" blood test used nationwide. They believe this protein, called CEACAM 1, could be used to detect early signs of cancer, especially in those patients at highest risk for the disease.

The same team also reported new findings about the basic cellular processes that allow pancreatic cancer to develop. In addition, U-M researchers have reported initial results from gene-based efforts to tell pancreatic cancer from its more common imposter: chronic inflammation of the pancreas, or pancreatitis. The technique could lead to new ways of telling pancreatitis from cancer without the need for surgery.

"We're definitely getting closer to the kinds of innovation that will be needed to increase patients' odds of finding and surviving pancreatic cancer," says Diane Simeone, M.D., whose laboratory team made the cell signaling discovery and who co-leads the U-M effort to translate basic genetic research into clinically useful tests.

More research is needed on the ability of serum tests to tell pancreatic cancer from pancreatitis, Simeone says. She hopes that some day, patients may be able to have a blood test for a "panel" of proteins, especially if they are at high risk for the disease because of family history, age or smoking history.

The need for improved diagnosis is great: 30,000 Americans each year die from pancreatic cancer, and 80 percent are diagnosed long after surgery to remove their tumor is possible. The symptoms of pancreatic cancer often mimic other diseases, or are overlooked until it is too late. Only 3 percent of all patients live even five years after diagnosis, and although pancreatic cancer is only the 10th most common cancer, it is the fourth leading cause of cancer death.

"To better understand how things go wrong in cancer, you need a better understanding of the normal signaling process when things are going right," says Simeone, an associate professor of surgery at the U-M Medical School. Eventually, she says, a better picture of the initiation and growth of pancreatic cancer may yield new opportunities for treatments.

Meanwhile, research led by U-M gastroenterologist Michelle Anderson may help spare some patients surgery. By looking for gene expression levels of three genes in samples of pancreatic tissue taken by fine-needle aspiration biopsy, Anderson and her colleagues found that they could pinpoint the nature of previously indeterminate lesions. If the results can be replicated in a larger clinical trial currently being planned, this approach could help prevent surgery for patients whose biopsy shows they have pancreatitis, not cancer.

For more information:

CCC Pancreatic Cancer Diagnosis and Treatment
http://www.cancer.med.umich.edu/learn/pancreas.htm

U-M Health Topics A-Z: Chronic Pancreatitis
http://www.med.umich.edu/1libr/aha/aha_chpan_crs.htm

CCC Multidisciplinary Pancreatic Tumor Clinic
http://www.cancer.med.umich.edu/clinic/pancreaticclinic.htm