Promising Strategies in the Fight Against Pancreatic Cancer

Pancreatic cancer is on the rise. The number of cases and deaths are increasing year after year.^1,2

In 2018, there were 458,000 new cases diagnosed and over 432,000 deaths due to pancreatic cancer globally.³

The prognosis for most cases of pancreatic cancer is dismal. At time of diagnosis, 80% of patients have locally advanced or metastatic disease.⁴

It is extremely aggressive and often resistant to treatment.

There is a desperate need for new treatments.

In the meantime, healthy dietary and lifestyle choices can significantly reduce one’s risk of contracting this deadly malignancy.

What Is the Pancreas?

The pancreas is an organ located in the abdomen, near the stomach and small intestine.

It plays two major roles.

Exocrine tissue in the pancreas produces a liquid that enters the small intestine through ducts. This liquid and its enzymes aid in digestion.

It is from these ducts that most pancreatic cancers arise.

The pancreas also contains endocrine tissue. These cells produce hormones, including insulin, which are released into the bloodstream and regulate blood sugar levels.

Why Pancreatic Cancer Is So Deadly

Pancreatic cancer is only the 11^th most-common cancer in the U.S. But it’s the third-leading cause of U.S. cancer deaths.⁵

The overall five-year survival rate for pancreatic cancer is only 10%. Survival depends on how early the cancer is caught and treated. When caught early, the five-year survival rate can be close to 40%.

Unfortunately, more than half of all pancreatic cancers aren’t diagnosed until the disease has metastasized. The five-year survival rate for these patients is a frightening 3%.²

There are three main reasons why this form of cancer is so deadly.

First, early pancreatic cancers often do not cause symptoms. That means the tumor can continue growing unnoticed for a long time.

Second, pancreatic cancers are aggressive. They grow rapidly and quickly invade nearby tissues. They also metastasize—spread through the bloodstream or lymphatic system—to distant organs or tissues quite easily.

Third, pancreatic cancers are notoriously difficult to treat. Only the earliest, localized tumors can be effectively treated with surgery.¹ In advanced stages, pancreatic cancer tends to be long-term resistant to chemotherapy drugs and radiation.

Lowering Risk Factors

There are some known ways to lower the risk of developing pancreatic cancer.

Poor diet, excessive alcohol intake, smoking, obesity, diabetes, and certain nutrient deficiencies have been identified as factors that increase risk for cancers.^1,4,6,7

For example, compared to never-smokers, pipe smokers have a 1.6-fold greater risk of developing pancreatic cancer than non-smokers, and cigarette smokers have a 1.5-fold greater risk of developing pancreatic cancer.⁸

Recent onset of diabetes is associated with a four-to-seven-fold greater risk of developing it within three years of diagnosis.⁹

Heavy drinking and diets high in animal fats and saturated fats also significantly increase the risk of pancreatic cancer.⁷

Quitting smoking, improving diet, losing weight, and controlling blood sugar all help lower the risk of developing different types of malignancies, including pancreatic cancer.

Inadequate intake of various nutrients commonly found in fruits and vegetables also contributes to cancer risk. Studies show that high intake of these foods reduces risk of pancreatic cancer.⁶

Protective Nutrients

Several nutrients and vitamins have indicated protective properties against pancreatic and other cancers.

These are often lacking in standard American diets. Supplemental intake of these compounds can correct deficiencies and raise levels to more beneficial amounts.

Carotenoids

The carotenoids are a group of nutrients found in fruits and vegetables.

The most studied as it relates to risk reduction are alpha-carotene, beta-carotene, lycopene, astaxanthin, lutein, and zeaxanthin.

Most of the carotenoids, either alone or in combination, have remarkable impact on various aspects of health. Numerous studies have drawn a link between carotenoid intake and prevention of cancer.^10,11

Cell studies show that some carotenoids reduce pro-inflammatory signaling in cancers and induce cell death by apoptosis.¹²

A number of epidemiological studies have evaluated whether intake of carotenoids impacts risk for pancreatic cancer. Most of the common carotenoids have been shown to be associated with reduced pancreatic cancer risk, including alpha- and beta-carotene, vitamin A, lycopene, lutein, and zeaxanthin.^13-17

For example, men with the highest intake of lycopene were 31% less likely to develop pancreatic cancer than men with the lowest intake.¹⁷ Beta-carotene and zeaxanthin intakes (highest vs. lowest) have been associated with a reduced risk of 48% and 47%, respectively.¹⁶

Even in existing cancer, carotenoids provide benefits. For instance, in pancreatic cancer cells that have become resistant to chemotherapy, astaxanthin blocked the cancer cell progression and increased their sensitivity to chemotherapy, aiding in killing of the cancer cells.¹⁸

Curcumin

Curcumin is the active compound found in the spice turmeric. It has been shown to act against cancer by several different mechanisms, affecting cancer cells at multiple points in their development.¹⁹

Studies in cell cultures and animals demonstrate that curcumin has the ability to inhibit pancreatic cancer growth.^20,21

It works by stopping the tumor from growing new blood vessels, essentially starving it of nutrients. It also has direct toxic effects in cancer cells, killing them while being healthy for normal cells.^20,21

Curcumin also blocks the ability of cancer cells to migrate and spread, preventing metastases to other organs.²²

One of the major hurdles in the treatment of pancreatic cancer is that it develops resistance to chemotherapy. The most commonly used chemotherapy drug, gemcitabine, often becomes useless after a short time because the tumor stops responding to it.

Curcumin has been shown, in a laboratory study, to turn off this resistance, allowing chemotherapy to have a greater impact.²³

If future preclinical and clinical studies confirm this result, curcumin could not only help to prevent pancreatic cancer, but also to improve its treatment in patients who do develop this deadly disease.

Vitamin D

Vitamin D deficiencies are extremely common, especially in older adults. Inadequate levels of vitamin D have been found to be associated with increased risk for several chronic diseases, including cancer.

Research also suggests a positive association between vitamin D intake or status and lower total cancer risk and mortality.^24-26

One analysis found that higher vitamin D intake (600 IU/day or more) was associated with a 41% lower risk for pancreatic cancer when compared to the lower intake (less than 150 IU/day).

Exposure to sunlight—which helps the body produce vitamin D—is also associated with a reduced risk of pancreatic cancer.^27-29

Green Tea Catechins

Green tea and its extracts contain compounds called catechins that have numerous health benefits.

In observational studies, higher tea consumption is associated with lower risk of developing pancreatic cancer.^30-32 In one study in China, regular tea drinkers had a 51% lower risk of pancreatic cancer compared to people who did not drink tea regularly.³²

Like curcumin, green tea has direct effects on pancreatic cancer cells. In preclinical studies, it has been shown to reduce tumor cell growth, invasion, and migration, and to cause cancer cells to die off.^33,34

Also, like curcumin, catechins increase the impact of chemotherapy drugs.

EGCG (epigallocatechin gallate) is the most common catechin in green tea. In one preclinical study, it reduced pancreatic cancer growth by 40% on its own. The chemotherapy drug gemcitabine reduced growth by 52%.

But together, the two compounds reduced cancer growth by 67%.³⁵ EGCG has shown this ability for other cancer cell types and with other chemotherapy drugs as well.³⁶

Omega-3 Fatty Acids

Omega-3 fatty acids from fish oil act by numerous mechanisms to help fight a wide array of cancers.^37-39

For example, abnormal activation of two key signaling proteins, STAT3 and NF-kB, contribute significantly to the survival and growth of pancreatic cancer cells. Omega-3 fatty acids suppress their activity.⁴⁰

In mice, omega-3s prevent the formation and viability of pancreatic cancer, while unhealthy fats accelerate tumor formation.^41,42

In people, greater intake of omega-3 fatty acids, particularly DHA, has been associated with reduced risk of pancreatic cancer compared to lower intake.^{43 44}

Omega-3s also work with other nutrients and medications.

The combination of omega-3 fatty acids and the cancer drug gemcitabine was found to completely block the secretion of a cancer growth factor called platelet-derived growth factor in pancreatic cancer cells.⁴⁵

Combining omega-3s and curcumin has also been found to enhance the killing of pancreatic cancer cells.⁴⁶

A review of trials that included omega-3 use in humans with advanced, terminal pancreatic cancer found that they helped to maintain body weight and approximately doubled patients’ survival time.⁴⁷

Magnesium

Magnesium is a critical mineral required for many different processes in the body, including metabolism. Low levels of magnesium contribute to many chronic diseases, particularly cardiovascular disease.^48,49

There is mounting evidence that suboptimal intake of magnesium contributes to the development of cancers as well.

Magnesium is a required cofactor (or “helper molecule”) for proteins involved in DNA repair.⁴⁸

Without enough magnesium, DNA repair may be inadequate. This leads to more rapid accumulation of genetic mutations, which contribute to the development of cancer.

One large study found a clear association between magnesium intake and risk for pancreatic cancer.⁵⁰ The study followed more than 66,000 older adults for eight years.

Subjects were divided into in three groups based upon their magnesium intake as follows:

• “Optimal” Intake—These authors defined this as consuming greater than or equal to 100% of the government RDA for magnesium (420 mg a day for males and 320 mg a day for females)
• Sub-optimal Intake—Daily intake of 75% to 99% of the government RDA for magnesium
• Deficient Intake—Less than 75% of the government RDA for magnesium (less than 315 mg a day for males and less than 240 mg a day for females)

Compared to those with what the authors called “optimal intake,” subjects with sub-optimal intake had a 42% greater risk of developing pancreatic cancer. Those with deficient intake had a striking 76% greater risk of pancreatic cancer compared with those with intakes greater than or equal to 100% of the magnesium RDA.

Medications with Anti-Pancreatic-Cancer Effects

The standard pharmacologic treatment for existing pancreatic cancer is generally chemotherapy drugs, radiation, or a combination of both. They have little success.

Studies have found that patients who are taking two non-cancer medications, metformin or statin drugs, have some protection against the development and spread of this deadly cancer.

Metformin

Metformin is the most common drug used to control blood glucose levels in type II diabetes.

Research shows that metformin use in diabetics is associated with lower risk of developing pancreatic cancer.^51,52

In a study of records of patients with pancreatic cancer and diabetes treated at the University of Texas MD Anderson cancer center, the two-year survival rate in those taking metformin was nearly twice that of patients not taking metformin.⁵³

A large 2018 meta-analysis included nearly 4,300 diabetic pancreatic cancer patients, over 2,000 of whom had received metformin. This study found metformin use in diabetics with pancreatic cancer was associated with a 19% reduced overall mortality risk compared to those who did not use metformin.⁵⁴

And in a 2020 meta-analysis, compared to no use, metformin use was associated with overall better survival in patients who underwent surgery for pancreatic cancer.⁵⁵

Human trials evaluating the role of metformin in treating pancreatic cancer are currently underway or recently completed.⁵⁶ Depending on the results, metformin may become a more standard component of cancer care.

Statins

The statins are a group of drugs used to lower cholesterol levels, reducing risk of cardiovascular disease.

They work by inhibiting an enzyme important for the synthesis of cholesterol in the body.

Researchers have found that use of statin drugs lowers risk for pancreatic cancer, increases survival, lowers mortality, and inhibits its growth.¹⁹

In cell culture and animal models of pancreatic cancer, treatment with statins stunts the growth of cancer cells and prolongs survival of the animals.^19,57

In one large study of over 12,000 older patients with pancreatic cancer, those who started statins after their diagnosis had a 31% improved overall survival.⁵⁸

Another study looked at the medical records of almost a half million veterans.⁵⁹ Statin use of six months or longer was associated with a 67% lower risk of developing pancreatic cancer. And statin use for more than four years correlated with a reduction in risk up to 80%.

Treatments for pancreatic cancer that include statins are currently being evaluated in five registered clinical trials.⁶⁰

These medications and the many compounds that have shown anti-cancer properties offer new hope for ways to prevent and treat this lethal cancer.

Summary

Pancreatic cancer is one of the deadliest forms of cancer.

Treatment is rarely successful. But evidence shows that increasing intake of certain nutrients and healthier lifestyles help lower the risk of developing it and slow its growth in patients with the disease.

The best documented nutrients are:

• Carotenoids,
• Curcumin,
• Green tea catechins,
• Omega-3 fatty acids, and
• Magnesium.

In addition, the diabetes drug metformin and cholesterol-lowering statins have shown benefits in protecting against pancreatic cancer and in extending life in patients with pancreatic cancer. They have been studied in preclinical models, and are being tested in humans.

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.

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