Good news everybody
March 9, 2025 9:51 AM Subscribe
The most common variant of pancreatic cancer is very deadly with a five year survivability of just 15%. Promising news on two fronts in the fight against it: Oregon Health and Science University scientists have developed a simple blood test using protease activity-based assay using a magnetic nanosensor (PAC-MANN) that can detect it early. And Memorial Sloan Kettering doctors are testing a mRNA vaccine that shows promise as a treatment.
This is good news.
About 20 years ago, our neighbor across the street, (who designed the REI building in Seattle), got Pancreatic Cancer. Killed him in like 6 months. Just brutal.
posted by Windopaene at 10:35 AM on March 9 [3 favorites]
About 20 years ago, our neighbor across the street, (who designed the REI building in Seattle), got Pancreatic Cancer. Killed him in like 6 months. Just brutal.
posted by Windopaene at 10:35 AM on March 9 [3 favorites]
this is wonderful! my cousin died of pancreatic cancer in his early 50s. he held out for 3 years, which I think was just his utter tenacity.
a test and a vaccine. go science!
posted by supermedusa at 10:46 AM on March 9 [7 favorites]
a test and a vaccine. go science!
posted by supermedusa at 10:46 AM on March 9 [7 favorites]
This is absolutely amazing. My FIL died from pancreatic cancer. When he was diagnosed, due to some leg pain, it was already stage IV. Early detection is a godsend. And mRNA hitting its stride with cancer vaccines is precisely what I've been hoping for!
posted by grumpybear69 at 10:59 AM on March 9 [2 favorites]
posted by grumpybear69 at 10:59 AM on March 9 [2 favorites]
This is certainly progress. I'll note that this test fails to detect 27% of pancreatic cancers. And it falsely suggests cancer in 2%, meaning that most positive results will be false positives. So, how we (doctors) use this test will require thoughtful discussion with our patients. Ultimately, we'll need to study whether this test leads to increased survival.
posted by neuron at 11:19 AM on March 9 [10 favorites]
posted by neuron at 11:19 AM on March 9 [10 favorites]
Man, a treatment would be nice. My maternal grandfather died in his 50s of pancreatic cancer, and while his prognosis was not great, it was technically the treatment that killed him. And my dad died a few weeks ago of the same thing, after a year spent suspecting it with regular interventional endoscopies - they just couldn't find it until it had metastasized. He died almost exactly a month after he was finally diagnosed, and there wasn't much of anything that could have been done even if they'd caught it earlier.
posted by restless_nomad at 11:24 AM on March 9 [19 favorites]
posted by restless_nomad at 11:24 AM on March 9 [19 favorites]
sorry about your dad, restless_nomad. we lost my dad last year. it was different cancer but still cancer. yay! fuck cancer.
posted by supermedusa at 11:38 AM on March 9 [4 favorites]
posted by supermedusa at 11:38 AM on March 9 [4 favorites]
I’ve been under surveillance for pancreatic cancer since my maternal grandmother was diagnosed, and my RN aunt called me and told me exactly what imaging to request and how to find an oncologist. My maternal grandfather died of pancreatic cancer in his early 50s, my mom in her 40s, her mom in 2016.
In 2020 I grudgingly decided to go in during the pandemic for my annual imaging because I’d missed it the year prior, and they found a cyst on my pancreas, so I had an EUS biopsy. My RN aunt flew out to hold my hand for the biopsy and the following week she had an MRI that showed metastasized pancreatic cancer. They attempted a Whipple that turned into a pancreatectomy and when she started chemo I went in and had half my pancreas removed along with my spleen. She died a few months later at 59. We weren’t ready.
We have all had genetic testing and we don’t carry the genes currently associated with pancreatic cancer. I’m 45 now, the same age my mom was when she died of it. A test would be amazing. A vaccine is beyond imagining. Our best data right now indicates this may be environmental exposure from my grandfather’s Army service in the ‘50s so it’s probably too much to hope that the government that caused this particular family legacy will fund the cure but I’m alive right now so I choose hope (and action - at least seven family members have provided data to researchers).
posted by annathea at 11:54 AM on March 9 [24 favorites]
In 2020 I grudgingly decided to go in during the pandemic for my annual imaging because I’d missed it the year prior, and they found a cyst on my pancreas, so I had an EUS biopsy. My RN aunt flew out to hold my hand for the biopsy and the following week she had an MRI that showed metastasized pancreatic cancer. They attempted a Whipple that turned into a pancreatectomy and when she started chemo I went in and had half my pancreas removed along with my spleen. She died a few months later at 59. We weren’t ready.
We have all had genetic testing and we don’t carry the genes currently associated with pancreatic cancer. I’m 45 now, the same age my mom was when she died of it. A test would be amazing. A vaccine is beyond imagining. Our best data right now indicates this may be environmental exposure from my grandfather’s Army service in the ‘50s so it’s probably too much to hope that the government that caused this particular family legacy will fund the cure but I’m alive right now so I choose hope (and action - at least seven family members have provided data to researchers).
posted by annathea at 11:54 AM on March 9 [24 favorites]
This is huge. PDAC is extremely difficult to catch early, and that’s part of why it is so deadly.
Although PDAC comprises only 3% of new cancer cases in the United States, the prediction that by 2030 it will become the second leading cause of cancer death reflects its high mortality. The primary reason for this high mortality is that only a minority (11%) of patients are diagnosed with localized disease, and 52% of PDACs are already metastatic at presentation, with little hope of cure. This stage distribution implies that any successful strategy in improving PDAC mortality should include screening and early detection of potentially curable cancers. The long-term survival of patients with PDAC is greatly dependent on small tumor size and early disease stage. - Source
I'll note that this test fails to detect 27% of pancreatic cancers.
When combined with CA19-9 tests, the sensitivity increases to 85%. Also, I am obligated to point out research scientists being a bunch of nerds with their naming of the test (PAC-MANN). I’m not sure which researchers love more, acronyms or puns/dad jokes.
posted by bluloo at 12:03 PM on March 9 [8 favorites]
Although PDAC comprises only 3% of new cancer cases in the United States, the prediction that by 2030 it will become the second leading cause of cancer death reflects its high mortality. The primary reason for this high mortality is that only a minority (11%) of patients are diagnosed with localized disease, and 52% of PDACs are already metastatic at presentation, with little hope of cure. This stage distribution implies that any successful strategy in improving PDAC mortality should include screening and early detection of potentially curable cancers. The long-term survival of patients with PDAC is greatly dependent on small tumor size and early disease stage. - Source
I'll note that this test fails to detect 27% of pancreatic cancers.
When combined with CA19-9 tests, the sensitivity increases to 85%. Also, I am obligated to point out research scientists being a bunch of nerds with their naming of the test (PAC-MANN). I’m not sure which researchers love more, acronyms or puns/dad jokes.
posted by bluloo at 12:03 PM on March 9 [8 favorites]
Please note that this work was funded, in part, by the National Cancer Institute which is part of the National Institutes of Health (NIH). About a month ago, NIH unilaterally announced that they were changing how their grants work, including grants currently awarded, to significantly reduce the "indirect" rate of grants that pay for things that are necessary for research but not always directly related to a specific research project e.g., support of the staff who support the research team and larger institution, building maintenance, utilities, some disposable materials, office supplies. For many projects, teams, and institutions, this move makes research impossible as it would literally cost them money to conduct the research. The move has been temporarily halted by a lawsuit but this ignorant attack on scientific research, alongside the many other cuts proposed and carried out by the executive branch of the US government (many of which are blatantly illegal and are being halted by lawsuits), will halt these life-saving advancements. If you're a US citizen, make sure your representatives and their staff know this.
posted by ElKevbo at 12:08 PM on March 9 [28 favorites]
posted by ElKevbo at 12:08 PM on March 9 [28 favorites]
Boosting the immune system against cancer cells needs to be done early before the tumors really take over. So early vaccination is paramount. I wonder if the vaccine can target other types of cancer cells, too, not just pancreatic. There would need to be cross reactivity of the antigens expressed on the tumor cells for the vaccine to work as a general anti-tumor intervention. That’s just me speculating.
posted by waving at 12:20 PM on March 9
posted by waving at 12:20 PM on March 9
Thanks ElKevbo for adding that important context. The PAC-MANN assay was developed at Oregon Health and Science University’s Cancer Early Detection Advanced Research Center. Until last fall, I worked there doing oncology research. I saw some former coworkers last week, and they said OHSU has established a committee to start planning for cutting entire programs to stay afloat. This comes after OHSU went through layoffs last year (I left of my own accord, thankfully). None of what the Trump administration is doing is good, but being in the industry, academic medicine is in trouble.
posted by bluloo at 12:56 PM on March 9 [8 favorites]
posted by bluloo at 12:56 PM on March 9 [8 favorites]
We are so damn close to medical revolutions on a number of fronts. I'm excited by the progress and terrified we will have defeat forced on us while in the jaws of victory.
My sign for stand up for Science this Friday was:
New Mega Yachts for 1000 Billionaires
or
Cures for Dozens of Cancers.
posted by srboisvert at 1:16 PM on March 9 [8 favorites]
My sign for stand up for Science this Friday was:
New Mega Yachts for 1000 Billionaires
or
Cures for Dozens of Cancers.
posted by srboisvert at 1:16 PM on March 9 [8 favorites]
My mother died of pancreatic cancer - less than a week. She never tested positive. Fuck cancer. Advances in this area are great news.
posted by whatevernot at 1:52 PM on March 9 [4 favorites]
posted by whatevernot at 1:52 PM on March 9 [4 favorites]
Meanwhile Iowa is working on banning mRNA vaccines.
posted by Horace Rumpole at 2:19 PM on March 9 [3 favorites]
posted by Horace Rumpole at 2:19 PM on March 9 [3 favorites]
My condolences to those who have lost people they loved from pancreatic cancer. My SIL, who seldom was ill, felt 'off', went in, was diagnosed, then died 4 months later during the height of COVID. I guess the best you can say is that it was quick, but it's a miserable death I wouldn't wish on anyone.
Yeah, fuck cancer.
We need to push hard on all fronts for this kind of research. It's so incredibly important, and we're learning so much at this point.
posted by BlueHorse at 4:57 PM on March 9 [1 favorite]
Yeah, fuck cancer.
We need to push hard on all fronts for this kind of research. It's so incredibly important, and we're learning so much at this point.
posted by BlueHorse at 4:57 PM on March 9 [1 favorite]
Pancreatic cancer is deeply enmeshed with type 2 diabetes:
posted by jamjam at 10:40 PM on March 9 [1 favorite]
We know that metabolic disease is an independent risk factor for all types of cancer, and there’s longstanding evidence that diabetes and pancreatic cancer are strongly linked,” said Stephen Pandol, MD, director of Basic and Translational Pancreas Research at Cedars-Sinai. “So, it’s possible that new onset of metabolic disease, particularly diabetes, could be the first warning sign of an impending pancreatic cancer diagnosis.”And in type 2 diabetes the immune system is already attacking the islets of Langerhans, which means that those cells surviving the attack have been hardened against the immune system, and the development of cancer is their nuclear option. So immunotherapy looks like kind of a long shot to me for this particular cancer.
posted by jamjam at 10:40 PM on March 9 [1 favorite]
Pancreatic cancer killed my dad in the span of a few months last November, so I hope they kill pancreatic cancer in return.
posted by dmh at 2:59 AM on March 10 [2 favorites]
posted by dmh at 2:59 AM on March 10 [2 favorites]
jamjam, I think you should read the link lalochezia left for Derek Lowe's article about the vaccine under discussion, and immunotherapy in general. I think, gently, your impression is based on the metaphors we use to talk about auto-immune and immunotherapy, but those metaphors have broken down here.
Type 1 diabetes is auto-immune and involves the destruction of the Islets of Langerhans; type 2 is generally not thought to be, it is rather a metabolic issue.
posted by Made of Star Stuff at 4:57 AM on March 10 [1 favorite]
Type 1 diabetes is auto-immune and involves the destruction of the Islets of Langerhans; type 2 is generally not thought to be, it is rather a metabolic issue.
posted by Made of Star Stuff at 4:57 AM on March 10 [1 favorite]
This news (to me) comes just three months after my sister died from pancreatic cancer, just over a year after diagnosis. None of us wanted to believe that the cancer would kill her even though we knew the odds. Fuck cancer and fuck Trump and Musk and every single person who voted for them when this research can't get funding.
posted by cooker girl at 8:43 AM on March 10 [2 favorites]
posted by cooker girl at 8:43 AM on March 10 [2 favorites]
Type 1 diabetes is auto-immune and involves the destruction of the Islets of Langerhans; type 2 is generally not thought to be, it is rather a metabolic issue.
And quite frankly, you can take that condescending 'gently' crap and put it right back where it came from.
posted by jamjam at 9:55 AM on March 10 [1 favorite]
For decades, doctors and researchers believed that type 2 diabetes was a metabolic disorder. This type of disorder occurs when your body’s natural chemical processes don’t work properly.This is from a 2022 article, and I think the evidence is stronger now, though I couldn't say definitive.
However, some research now suggests that type 2 diabetes may be an autoimmune disease. If so, it may be possible to treat it with new approaches and preventive measures.
Currently, there isn’t enough evidence to fully support this idea. For now, doctors will continue to prevent and treat type 2 diabetes primarily with lifestyle changes and then introduce medication and insulin as options over time.
And quite frankly, you can take that condescending 'gently' crap and put it right back where it came from.
posted by jamjam at 9:55 AM on March 10 [1 favorite]
Yep. Lost my brother David to pancreatic cancer. As horrible as that was, it was worse watching my parents lose their son. It hit him out of nowhere, no family history of cancer. I miss him every minute of every day. Even though it's been almost 4 years, I can still see him in my mind, walking into the house with that smile and those bright blue eyes.
posted by Kangaroo at 4:22 PM on March 10 [1 favorite]
posted by Kangaroo at 4:22 PM on March 10 [1 favorite]
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posted by coffeecat at 10:07 AM on March 9 [25 favorites]