Diabetes Being Linked to Pancreatic Cancer

Image above: Stained mouse Pancreatic cells.  The cells dyed red are
ductal pancreatic cells infected with cancer.

Hello all,  my partner Michael and I are planning on doing our cancer project on pancreatic cancer.  We have decided to commit our focus on diabetes and its correlation with pancreatic cancer.  I was searching online journals and found a very interesting article on how the sudden onset of diabetes could be linked to pancreatic cancer, and could allow for the early detection of pancreatic cancer.  

This journal article and experiment was performed by doctors of the Gastroenterologoy and Hepatology department of the Mayo Clinic.  The doctor's original premonitions were based on that diabetes is often first found by the primary care physicians, and if diabetes can be linked to pancreatic cancer, this gives doctors a greater advantage in the early detection of pancreatic cancer.  Recent data shows that up to 80% of all pancreatic cancer patients have diabetes or hyperglycemia.  In addition, older people, who have newly-onset diabetes have an eight fold higher risk of having pancreatic cancer.  The first aspect of this study was too see how much earlier new- onset diabetes was diagnosed before pancreatic cancer diagnosis.  To perform this aspect of the study, the doctors reviewed patient's history, who had diabetes and then were diagnosed with Pancreatic Cancer.  The particular screening process they used is detailed below.

Their findings were very interesting.  Averaging all their data together, these doctors found that on average patients developed diabetes two years prior to being diagnosed with pancreatic cancer.  Below is a figure of the doctor's results, which outlines the expected and observed cases of diabetes 60 months before pancreatic cancer diagnosis.  


Another aspect the doctors looked at was if pancreatectomies solved or assisted in improving glycemic status (improved patient's diabetes).  In this study, 41 diabetic pancreatic cancer patients, who had pancreaticoduodenectomies (usually removal of part of the pancreas, stomach, and all of the gallbladder) were looked at postoperatively to see if their glycemic status had changed.  Of these 41 patients, 30 had new-onset diabetes and 57% of these patients had their diabetes resolved postoperatively. The remaining 11 had long- standing diabetes and none of their diabetes exhibited any improvement in glycemic status postoperatively.  From this study, the doctors were given further evidence that suggests pancreatic cancer attributes to glucose intolerance. (This is a great study and really helps to truely show if new- onset diabetes is caused by pancreatic cancer, however, their sample size is very small-- only 41 patients.  While this study is great news, it would give us a better feeling if the sample size was larger.)  


The final aspect of this study was to actually see experimental data that suggest pancreatic cancer induced diabetes.  The doctors placed isolated heptocytes (liver cells) from rats in pancreatic cancer cell lined conditioned media.  In this type of tissue, the doctors found that glucose metabolism was impaired.  In addition, insulin release was reduced when rate pancreatic islet cells were incubated with the same cancer lined conditioned media.  The experimental data obtained from this experiment directly suggest that pancreatic cancer is a direct cause of diabetes.  


The results from each aspect of this study are astounding, promising and set the basis for future studies.  Using what these doctors found could allow for the early diagnosis of pancreatic cancer, which would be a triumphing breakthrough in pancreatic cancer, which up until this point is extremely difficult to diagnosis in it's early stages.  In most cases, pancreatic cancer is diagnosed long after it has already metastasized and it is usually too late.   Using diabetes as a reference frame, hopefully one day, if a person was diagnosed with a new- onset of diabetes we could quickly perform a non-invasive test and find out the status of the pancreas and whether or not there are signs of an early stage of pancreatic cancer.


--Quincy


The full journal article can be viewed here for those who are interested: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2795483/

Edit:  The doctors involved in this study do not mention, specifically, what type of diabetes they are referring too, but I do believe it is type I diabetes.