Pancreatic cancer - a continuing challenge in oncology

Abstract

Pancreatic cancer is still one of the major health problems because of its rising incidence and the modest therapeutic results. The paper surveys the statistical data, the risk factors, the preneoplastic ductal lesions, the hormonal sensitivity, the possible transdifferentiation in the endocrine and exocrine parts and the possibilities for chemoprevention. Hungary is peculiar among the European countries because during the last 50 years the incidence of pancreatic cancer has displayed a 15-fold increase. Apart from smoking, additional risk factors seem to be important, and recently a puzzling association between Helicobacter pylori seropositivity and pancreatic cancer was found. First-degree relatives of patients with pancreatic cancer are also at increased risk of this tumor. The term pancreatic intraepithelial neoplasia (PanIN) seems yet to be established, but the dynamics of these lesions needs to be further elucidated. Several lines of firmly established data indicate the hormonal sensitivity of this tumor, but still an unexplained discrepancy exists between the experimental and the clinical results. In addition to the somatostatin analogs, anti-gastrin vaccine is being tested. The mixed exocrine-endocrine tumors might suggest a real possibility of transdifferentiation between different compartments of the pancreas. Finally, the paper outlines the available data about the possibility of chemoprevention, including the role of cyclooxygenase inhibitors.

Biochanin A reduces pancreatic cancer survival and progression

“…Some of the risk factors associated with pancreatic cancer include cigarette smoking, chronic pancreatitis, age, diet, and occupational exposure [5,6]. A diet high in fruits and vegetables has been shown to reduce the risk of pancreatic cancer, whereas a diet high in carbohydrates and fat has been shown to increase the risk [7].…”

Role of inflammation in pancreatic carcinogenesis and the implications for future therapy

“…The exact genetic abnormalities underlying familial pancreatic cancer are unknown in up to 80% of cases [194] . It is possible that in certain individuals, inherited defects in DNA repair enzymes may contribute to their development of pancreatic cancer.…”

H pyloriinfection causes chronic pancreatitis in Mongolian gerbils

“…Several reports considered changes in gastric hormones (increased gastrin and reduced somatostatin), N-nitroso compounds produced by gastric bacteria that flourish in the hypochlorhydric stomach, and the cagA-status of H pylori [2,29] . These reports are supported by our recent data, showing that an infection with H pylori typeⅠstrain contributes to severe inflammation in the antral and corpus mucosa over time, leading to corpus-dominant atrophic gastritis [15] .…”

“…Interestingly, H pylori infection has been described as a risk factor for developing pancreatic cancer [29] . Pancreatic cancer is among the most fatal cancers worldwide.…”