New Genetic Clues to Pancreatic Cancer

MRCP scan of a patient with innumerable pancreatic cysts
MRCP scan of a patient with innumerable pancreatic cysts

September 1, 2017

A lot can happen in 15 years. Gastroenterologist Michael Goggins can attest to it.

“Fifteen years ago,” says the principal investigator of the Early Detection of Pancreatic Cancer Laboratory at the Johns Hopkins University School of Medicine, “we had no idea whether we’d be successful at all with any kind of clinical detection program for pancreatic cancer.”

Today, Goggins says, he and his colleagues know a lot more about which genes are involved in inherited pancreatic cancer.

Goggins and the pancreatic cancer early detection team which includes gastroenterologists Mimi Canto, Anne Marie O’Broin-Lennon, Eun Ji Shin and others, follow patients whose risk for inherited pancreatic cancer is high, monitoring their health and trying to combat the disease before it starts.

Meanwhile, Goggins and other researchers continue to study the genes they’ve implicated as related to the cancer. They’re working on new tests of blood or pancreatic fluid samples in hopes of identifying inherited genes or mutations.

He stresses that there remains much work to be done, adding that researchers are seeking ways to screen the general population for pancreatic cancer.

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“There’s not a good way to screen for it with a blood test yet like there is for, say, breast or prostate cancer,” he says.

 Though the general risk for pancreatic cancer is low, the mortality is high. Goggins cites that pancreatic cancer is the third-most common cause of cancer death in the United States.

“It’s hard to detect the early signs using imaging,” he says. “But it’s also more likely to spread to other places than most other cancers.”

The greatest research successes in screening so far, says Goggins, have been in following people with a significant family history of the disease and screening them using pancreatic imaging tests.

“We’ve been able to identify several of these genes that make some people more susceptible to pancreatic cancer,” he says. “Each time we identify one, it helps us crack the likelihood of who in the family is more at risk.”

Over the years, he says, many patients have had worrisome pancreatic lesions surgically resected.

“Probably some of those patients would not have developed pancreatic cancer,” says Goggins. “But a lot of them would have. Intervening at the right time to prevent cancer development is a success we’re hoping to build on.”