We talk more about pancreatic cancer, especially because it has affected famous people such as Gianluca Vialli or Fedez. But, unfortunately, this greater media exposure does not correspond to a better capacity for prevention, early diagnosis and treatment. Pancreatic cancer affects a growing number of people every year, both in Italy and around the world: in 2022 the estimated number of new diagnoses in our country was 14,500, 1,200 more than in 2018. And experts expect a further increase by 2025, as well as a progressive reduction in the average age of sick people. Among other things, it is a pathology that tends to manifest itself with non-specific symptoms in the early stages, and which, also for this reason, in 80% of cases is diagnosed only in an advanced stage.
But by improving patient care and general awareness of the disease, much can be done from the point of view of survival and also the quality of life of patients. Hence the importance of the numerous information and awareness initiatives that will take place on the occasion of the world day dedicated to this pathology, which occurs every year on 16 November.
by Sara Carmignani
The campaign “How much does 80 grams weigh?” is underway.
80 grams: this is the average weight of the pancreas, a relatively small organ, but which carries out functions of fundamental importance for the entire organism. And this is precisely the message that the campaign “How much do 80 grams weigh?” aims to pass, thanks to the joint effort of the Valsecchi Foundation and the Oltre la Ricerca ODV Association, which have entered into a partnership with Federfarma, the federation that unites over 19 thousand pharmacies throughout the national territory, and with SIMG, the Italian Society of General medicine. The objective of the collaboration is to activate the necessary exchange between associations, pharmacists and family doctors, as points of reference for patients: “Prevention and screening are part of the daily activities of the community pharmacy. This is why we strongly support the campaign ‘How much do 80 grams weigh?’”, explains Marco Cossolo, President of the national Federfarma. “Every day the pharmacists in the pharmacy welcome and listen to the people who turn to them with trust for guidance and advice on their health problems, thus carrying out the role of informants and trainers in close collaboration with the other healthcare professionals who operate in the area ”.
by Simone Valesini
The role of family doctors
Naturally, these also include the figure of the family doctor, who, as underlined by Claudio Cricelli, president of SIMG, must be able to guide patients to carry out the necessary checks in the presence of suspicious symptoms. Among the tools potentially useful for this purpose, and therefore to promote early diagnosis, Cricelli recalls for example the ENDPAC model (“Enriching New-Onset Diabetes for Pancreatic Cancer”), which helps evaluate the risk of pancreatic cancer in diabetic patients . In fact, recent studies demonstrate that the onset of diabetes or long-standing diabetes that can no longer be compensated for with the therapy in use should be considered as “alert factors” by the doctor who follows the patient. Other risk factors to keep in mind are mutations affecting the BRCA, CDKN2A genes and other genes involved in the development of the disease, as well as the presence of cases of pancreatic cancer in the family.
The pancreas unit
Another fundamental aspect is to immediately refer patients with suspicious symptoms to the so-called pancreas units, units specialized in the treatment of this type of tumor, created in Lombardy starting from April last year. The pancreas units make use of the collaboration between various experts, such as the oncologist surgeon, the gastroenterologist, the radiologist, the nutritionist, the physiotherapist, the psychologist, the palliative medicine expert, and have the aim of guiding the patient in the various phases of own treatment path. Contacting these specialized centers right from the early stages of the disease can make the difference both in terms of the possibility of receiving an early diagnosis, and therefore of starting the most appropriate treatments as soon as possible, and in terms of the patient’s quality of life during the entire duration of the treatments.
Research must be strengthened
“Pancreatic cancer – explains Alberto Mantovani, President of the Humanitas Foundation for Research – represents a challenge for research, given the insufficient progress made in the early diagnosis and treatment of this tumor. Immunological therapies, for example, which represent a real and its own revolution in oncology, have not had a significant impact on the treatment of pancreatic cancer. For this reason we must take up the challenge of all-round research: from improving early diagnosis to the development of innovative therapeutic approaches up to prevention”.
Precisely on the prevention front, the Humanitas multidisciplinary group dedicated to the familiarity of pancreatic cancer collaborated in the publication in The American Journal of Gastroenterology of a study that evaluated the surveillance conducted with magnetic resonance imaging and echoendoscopy for 3 years on 154 people with increased risk of pancreatic cancer enrolled in the Italian AISP registry. Thanks to this study, 8 pancreatic adenocarcinomas and one premalignant lesion were found, and of these 8 patients with tumors, 5 carried mutations in genes involved in the development of pancreatic cancer, the so-called pathogenetic variants. Of the 8 cases of cancer, 5 were operable at diagnosis and even 3 were diagnosed at a very early stage (stage 1). “This is for us doctors, but above all for patients – continues Silvia Carrara, head of the Echoendoscopy Program of the IRCCS Istituto Clinico Humanitas, professor of Humanitas University, and president of the Italian Association for the Study of the Pancreas (AISP) – a message of great hope: the identification of particular groups of people at risk and the surveillance conducted with the right means, and with the correct timing, will lead to early diagnoses of pancreatic tumors and improved patient survival”.
To finance research, Humanitas promotes the “Tulips of Research” awareness and fundraising campaign, active from November to April. Among the ongoing projects, there is also one in collaboration with the Polytechnic of Milan for the creation of a “pancreas phantom”, i.e. the reproduction in artificial material of a physical model of the organ which will allow surgeons and specialists to train to learn the various intervention techniques as best as possible but also to identify specific instruments for pancreatic surgery, such as glues and suture threads with particular characteristics. From 12 to 26 November 2023 it is possible to donate 2 euros by SMS or 5 or 10 euros from a landline to the solidarity number 45591 in support of the research conducted by the Humanitas Clinical Institute.
by Letizia Gabaglio
How to talk to patients
Finally, the Codice Viola association, dedicated to supporting and informing patients suffering from this pathology, touches on a very delicate topic through the video available at this link. The video was created using artificial intelligence tools, and, despite all the limitations of the case, aims to make people reflect on the topic of communication between doctor and patient, especially when the latter is informed of the diagnosis of breast cancer. pancreas. It is essential, say the association, to illustrate the treatment strategy in a clear and transparent way, to point out any ongoing clinical studies and the possibility of being part of them, as well as to communicate reasonable hope, taking into account all the difficulties relating to the individual case .
Furthermore, Codice Viola will organize a conversation with Massimo Falconi, head of pancreatic surgery at the San Raffaele hospital in Milan, to talk not only about the medical aspects but also about the more intimate and personal aspects of the disease. The conversation will be available live at this link starting from 5pm on November 16th.