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On Pavarotti and pancreatic cancer

Luciano Pavarotti, possibly the most famous classical singer on earth, received a final sendoff this past weekend in his hometown of Modena, Italy. Pavarotti died last week of pancreatic cancer. More than 100,000 people filed through the cathedral and plaza, more than 700 guests attended the funeral mass and millions watched the live broadcast on television.

Pavarotti underwent surgery for a malignant pancreatic mass in July 2006. A month later, after his surgery, Pavarotti told the Italian newspaper Corriere della Sera, "I was a fortunate and happy man. After that, this blow arrived. And now I am paying the penalty for this fortune and happiness."

One could not be surprised that Pavarotti felt this way. Pancreatic cancer is one of the most deadly cancers, with a five-year survival rate here in the U.S. of less than 5%, although surgery can improve survival greatly. Pancreatic cancer is also one of the most underfunded research areas in cancer. For more information about what you can do to increase funding for pancreatic cancer research and raise awareness of this deadly disease, please see PanCAN's action page.

Italian opera great Pavarotti dies of cancer

Italian opera superstar Luciano Pavarotti, diagnosed with pancreatic cancer in July 2006 and recently hospitalized with a fever, died at his native Modena home on Thursday. With him were his wife Nicoletta, four daughters, and his sister. He was 71.

Friends and family had hoped for a miracle for Pavarotti. Sadly, this was not possible. Though to have survived pancreatic cancer for more than one year is quite amazing. The disease is deadly in most cases and most survive for only months.

Pavarotti was diagnosed with pancreatic cancer just before he was set to resume a farewell tour in July 2006. Instead, he headed for surgery. He never again performed publicly.

Rash caused by EGFR inhibitors, including Tarceva, a positive sign, say researchers

Development of a rash after treatment with inhibitors of epidermal growth factor receptor (EGFR) such as Tarceva (erlotinib) may actually indicate that the treatment is working well, according to an analysis of two phase III trials. According to the analysis, the worse the rash, the more likely patients are to survive their cancers or maintain control of the disease.

The first trial analyzed patients who received erlotinib for stage IIB/IV non-small-cell lung cancer who had failed at least one chemo regimen. The second study looked at erlotinib plus gemcitabine (Gemzar) for patients with locally advanced, unresectable or metastatic pancreatic cancer. The team concluded that those patients who do not develop the characteristic rash within 2 to 4 weeks are less likely to benefit from erlotinib.

This study was conducted by researchers from OSI pharmaceuticals, the company that manufactures Tarceva.

U of Georgia researchers seek early detection of pancreatic cancer through the study of glycans

University of Georgia Cancer Center researchers are studying glycans, the sugars that are on the outside of proteins, to determine if changes in glycans can indicate the presence of cancerous or precancerous pancreatic cells.

According to the director of the center, Michael Pierce, there is evidence that when cells become cancerous they change their glycans in subtle ways.

Glycomics is the study of the types and amounts of glycans expressed by cells and their biological roles. According to Pierce, glycomics is the "wave of the future" of cancer diagnostics.

Pierce adds that the use of glycomics in cancer diagnostics is a relatively new field but has already led to the approval of an early diagnostic test for primary liver cancer. Pierce says that if there are such markers in pancreatic cancer, he and his team will find them.

Pavarotti released from hospital

Italian opera great Luciano Pavarotti, in the midst of a battle with pancreatic cancer that began in July 2006, was released from the hospital Saturday after two weeks of hospitalization due to a high fever.

The 71-year-old Pavarotti is now at home where he will be closely monitored by doctors.

Pancreatic cancer is one of the deadliest forms of cancer, often detected in its latest stages and affording patients only months of survival. Pavarotti has survived the disease for more than one year.

Low levels of IGFBP-1 protein may indicate pancreatic cancer risk

A protein that decreases due to obesity and lack of exercise may also indicate pancreatic cancer risk, according to researchers at the Dana-Farber Cancer Institute and collaborators.

The researchers found that people with the lowest levels of a protein called IGFBP-1 were twice as likely to develop pancreatic cancer as those with higher levels.

According to the study's lead author, Brian Wolpin, MD, the levels of insulin and insulin-like growth factor (IGF) are changed by obesity and lack of exercise. There is evidence that these hormones may stimulate the growth of pancreatic cancer cells. When IGF binds to IGFBP-1 and other proteins, there may be less IGF to promote the growth of the pancreatic cancer cells.

Hospital stay extended for Pavarotti

Italian opera superstar Luciano Pavarotti, who had surgery for pancreatic cancer in July 2006 and then was hospitalized this August 8 due to a high fever, will stay in the hospital for further testing related to his disease.

Pavarotti, 71, is now fever-free. Still, he will remain hospitalized so his cancer can be fully investigated.

At the time of Pavarotti's surgery, he had been planning to resume his farewell tour. But he has made no public appearances since this time.

Link between gestational diabetes and pancreatic cancer risk

Women who had gestational diabetes when pregnant may be at a greater risk of developing pancreatic cancer, according to a new study.

The researchers looked at the health records of nearly 40,000 women who gave birth between 1964 and 1976 in Jerusalem. The study found that out of the 410 women who had gestational diabetes, 5 developed pancreatic cancer later in life. These finding are statistically significant according to the researchers, but further study needs to be done and the absolute risk still remains low.

Previous studies have shown that people with type-2 diabetes have an increased risk of pancreatic cancer, but this is the first study to show a link between gestational diabetes and pancreatic cancer.

Trends in pancreatic cancer incidence, from the SEER program

Data from the Surveillance, Epidemiology, and End Results (SEER) Program was analyzed in a recent study to learn more about the evolution of pancreatic cancer incidence over the past thirty years in the United States.

Pancreatic cancer incidence was found to decrease at a rate of 0.62% per year from 1973 to 2002. Incidence in women rose until 1984 and then slowly declined after. However, there has been a rise in young and middle-aged adults less than 60 years old.

There was also a significant increase in incidence in women in Hawaii and Iowa and older adults in Seattle and Utah.

Opera great Luciano Pavarotti hospitalized

Italian opera superstar Luciano Pavarotti, hospitalized on Wednesday with a fever, is doing better and should be discharged within the next few days, according to his wife, Nicoletta Mantovani.

The 71-year-old tenor underwent surgery for pancreatic cancer one year ago and has since endured at least five rounds of chemotherapy. Although not confirmed, some sources say Pavarotti has pneumonia.

Some patients at risk for pancreatic cancer opt to remove the pancreas

As part of a study with the goal of preventing pancreatic cancer in those who are at very high risk, about 20 people have had their pancreases removed at Johns Hopkins, according to a recent article in The New York Times.

One such individual is Nancy Pratt. Mrs. Pratt has lost both her daughter and mother to the disease. Her daughter was only 37 and lived only three months after diagnosis, leaving two young children. In addition to Mrs. Pratt's family history, an ultrasound revealed numerous pancreatic cysts, leading her to choose the pancreas removal surgery.

The program is under the direction of Dr. Marcia Canto and is limited to high-risk families. Individuals who agree to undergo this removal are "trading the risk of cancer for the reality of diabetes," however, when the reality of pancreatic cancer is taken into account, it seems to be a reasonable choice.

Continue reading Some patients at risk for pancreatic cancer opt to remove the pancreas

A COX-2 inhibitor delays the progression of precancerous pancreatic lesions in mice

A cyclooxygenase-2 (COX-2) inhibitor, nimesulide, delays the progression of precancerous pancreatic lesions in mice, according to researchers at the David Geffen School of Medicine at UCLA.

Inflammation has been shown to be a factor in many forms of cancer. According to the team, this is the first study to demonstrate the effect of an anti-inflammatory COX-2 inhibitor on the development of pancreatic cancer.

This is not the first time that COX-2, an enzyme that causes inflammation, has been studied by cancer researchers. COX-2 has been studied in terms of the development and growth of breast and colon cancer also.

According to the lead author Dr. Eibl, these results do not mean that everyone should take a COX-2 inhibitor to protect against cancer, but they may play a role in prevention in high-risk populations.

Battling cancer AND your insurance company, NY Times cancer feature

More from the New York Times series on cancer this past weekend:

In another article in the feature, Gordon Hendrickson talks about his battle with pancreatic cancer ... and his health insurance company.

Upon his diagnosis, Hendrickson received relatively good news, that his pancreatic cancer was operable and that such an operation would increase his survival greatly. However, he also received bad news. His insurance company said they would only pay for the surgery, the highly-complex Whipple procedure, if he went to one of five surgeons in his hometown.

Hendrickson wanted to have the surgery performed at M.D. Anderson in Houston, as the surgeons there had much more experience with Whipples than those in his hometown.

After bringing his evidence to a state review board, namely that the five surgeons that his plan had recommended had collectively only performed a total of five Whipples in their whole careers, Hendrickson won the case and his healthcare plan covered his surgery in Houston.

Hendrickson's story is yet another example of how patients must be their own best advocates in our challenging healthcare system.

Doctors tired of pancreatic cancer treatment failures

Pancreatic cancer is one of the most deadly forms of cancer there is. Decades of research and treatment, however, have not provided the medical community with the tools needed to effectively combat this type of cancer. Will it get any better soon?

One medical specialist says that the industry "needs to think outside the box" in order for frustrated medical officials to make any new headway in the prevention and treatment of pancreatic cancer.

That one quote could serve as marching orders for all oncologists and cancer specialists if you ask me. Conventional treatment of very deadly cancers does not seem to be going anywhere (and has not for a long while), and if there are breakthroughs on the horizon, conventional thinking will not have placed them there.

Ann Moore's blog on her pancreatic cancer

Ann Moore of Evansville, Indiana, a former television newscaster and the wife of FOX7 anchor Randy Moore, has started a new website to chronicle her experience with pancreatic cancer. Moore was diagnosed with inoperable pancreatic cancer at the age of 50 this past May, according to the Courier-Press.

From a recent post, Moore ponders that "It is hard not to ask why,"

It's hard to do research because the information scares me. A three percent survival rate. Then there is the risk profile: 74 years old, male, smoker, overweight, fatty diet, diabetic. Well, that describes me, huh? The fact is, I don't know why. And maybe it doesn't matter. All I can do is look ahead.

Her husband writes about the website, which he calls a 'labor of love' from their daughter Erin:

Some people approach us easily. Others approach us with hesitation. And others -- even though they care -- just don't know what to do or say. That's okay. It is hard. This website allows people to interact at whatever degree they are comfortable. My prayer is that you'll be strengthened by Ann's strength.

The internet has its pros and cons, that is for sure, but I just love this quote by Mr. Moore. It is hard to know what to say to someone with cancer, or how to approach them, or what you can do to help. While creating a personal blog is not for everyone, websites like Ann's and like those at CaringBridge.org, allow well wishers to send their thoughts and prayers in their own way and allow the recipients to receive them in their own way also.

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