Incidence rates for pancreatic cancer were 6-fold to 10-fold higher among participants in a study who had recent-onset diabetes and weight loss.1 This led the study authors to write: “The coexistence of these symptoms should be recognized by clinicians given that both the relative and absolute risks for pancreatic cancer are high, particularly in individuals with healthy weight before weight loss or those who are not trying to lose weight through changes in physical activity or diet.”
If the symptoms are recognized, what should clinicians do?
The coexistence of symptoms “should prompt a physician to think about pancreatic cancer,” and “if these symptoms persist, an evaluation for pancreatic cancer would be reasonable,” Brian M. Wolpin, MD, MPH, Director of the Gastrointestinal Cancer Center, Dana-Farber Cancer Institute, Boston, and study senior author told The ASCO Post. “I don’t think we have sufficient data yet to say that all patients who present this way should be evaluated, but if these symptoms were to persist and the weight loss does not have a clear explanation, evaluation would be appropriate,” Dr. Wolpin said.
“The main approach we would use to find a pancreatic cancer is through imaging. It obviously depends upon the specific circumstances for that patient, whether it is CT, MRI, or other modality,” Dr. Wolpin said.
“Even in this study, the majority of people who had diabetes and weight loss didn’t have pancreatic cancer, but there was a small subsegment that did, and since early diagnosis is so uncommon in this disease, we want clinicians to be aware of this,” Dr. Wolpin stated.
In general, patients should also be aware that if they “are losing weight and don’t mean to, that is something they should tell their doctor about,” Dr Wolpin added.
DISCLOSURE: Dr. Wolpin has received honoraria from, or consulted for, Celgene, G1 Therapeutics, BioLineRx, Genentech, and GRAIL and has received research funding from Celgene and Eli Lilly.
1. Yuan C, Babic A, Khalaf N, et al: Diabetes, weight change, and pancreatic cancer risk. JAMA Oncol. August 13, 2020 (early release online).
A large cohort study with close to 160,000 men and women reported that “recent-onset diabetes accompanied by weight loss was associated with a substantial increase in risk for pancreatic cancer and may represent a high-risk group in the general population for whom early detection strategies would...