Researchers scramble to discover why so few people beat pancreatic cancer

The day-to-day battles, though, are about numbers - daunting, deadly numbers:

This year, 44,030 Americans are expected to be diagnosed with pancreatic cancer.

Just one in 20 will be alive five years later.

"It's hard to accept that you can't do anything," said Kandi Wood, whose husband of 29 years, Ken, died at age 48 in 2007.

Ken Wood, a delivery driver, had been diagnosed with pancreatic cancer 22 months earlier. Now Kandi Wood of Brownstown Township and others have zeroed in on a different kind of number: research dollars.

In 2010, the most diagnosed cancers in the U.S. were breast, lung and prostate. So, not surprisingly, the National Cancer Institute set aside nearly one-fourth of its $5.1-billion fiscal year 2010 budget to study them.

Wood sees the numbers with a different nexus: "When you look at the charts, there's a correlation between funding and survival rates."

Detected early, breast, prostate and lung cancer have five-year survival rates of 98%, 100% and 53% respectively. But even those pancreatic cancer patients with the best odds of survival -- those whose cancer is detected early -- have just a 22% chance of surviving five years.

Pancreatic cancer, which draws less than 2% of the NCI's budget -- will kill all but 6% of those it strikes within five years. More often than not, it's because it is caught too late. There is no screening tool for pancreatic cancer.

Plus, pancreatic cancer's symptoms are vague -- a stomachache, indigestion, backache and weight loss.

"I had been sick for a year, literally," said Sheila Sky Kasselman, 70, who is a 3 1/2-year survivor in part because hers was a slow-moving cancer that was caught when the tumor collapsed her bile duct, triggering the telltale symptom of jaundice. Until then, she said, "every test was fine."

And even after doctors rule out other causes of pain, the 6-inch-long pancreas is tucked among several other organs, and tumors there are difficult to detect.

Finally, pancreatic cancer is resistant to traditional chemotherapy and radiation. Even if it appears to be localized, the cancer may have micro-metastasized elsewhere and show up months or years later, said Dr. Philip Philip, leader of the Gastrointestinal Oncology Multidisciplinary Team and professor of Internal Medicine and Oncology at the Barbara Ann Karmanos Cancer Institute and Wayne State University School of Medicine.

It's why Kasselman's refrigerator at her West Bloomfield Hills home carries a two-word yellow sticky note to herself. "One cell," it reads.

The bad odds mean there aren't a lot of pancreatic cancer survivors to whip up the type of support that raises millions of dollars each year for breast cancer or to lobby Congress or to encourage researchers, Philip said.

In June, Philip and others traveled to Washington, D.C., to lobby members of Congress for greater research money for pancreatic cancer.

"Let me blunt. Patients who have prostate or breast cancer -- many survive. They can walk and do a lot of fund-raising. Those with pancreatic cancer die," he said.

Among the recipients of NCI research dollars is Dr. Diane Simeone, who performs about five dozen surgeries each year to excise pancreatic tumors at the University of Michigan Health System.

In her remaining work hours, she's in her laboratory, where staff takes the excised tumors from willing patients, growing them in mice to study their morphology.

In the same building, researcher David Lubman is trying to develop a blood screening tool using the protein haptoglobin, which leaves telltale biomarkers when a person has pancreatic cancer. And at Karmanos, Dr. Michael Tainsky, a Wayne State University professor and Karmanos' program leader for molecular biology and genetics, is also trying to ID biomarkers.

There are two forms of pancreatic cancer; the deadlier one is an adenocarcinoma that comes from exocrine cells, a many-fingered cluster that infiltrates surrounding tissue, digging in and becoming entwined.

Understanding the cancer on a molecular level will help answer a number of questions that, in turn, may save lives.

Even without a major breakthrough in screening or treatment drugs, there are some bits of better understanding: Risk factors for pancreatic cancer increase with age, but also if you're a smoker or obese, or have diabetes. Genetics plays a role for some.

It also has been linked with chronic pancreatitis and cirrhosis of the liver.

Warren Hanson beat the numbers.

Today, eight years after Hanson's doctor noticed a yellowish coloration in Hanson's eyes -- jaundice -- the retired private investigator says he knows he's lucky to be here.

In 2003, a lima-bean sized tumor took hold around his hepatic duct, choking off the release of bile from his liver: "The tumor actually saved my life because of its position," Hanson, 71, of Detroit said.

But it was hardly a foregone conclusion. The investigator was used to scouring the Internet and doing everything possible to gather information for the task at hand. But when he peeked at the odds that he'd survive, he did something he wasn't used to: He stopped digging for information.

"It's analogous to a soldier going into the battle," he said. "You wouldn't go into the battle if you knew the odds."

But after surgery -- a procedure for which just 15% of pancreatic cancer patients are eligible -- and follow-up radiation and chemotherapy, Hanson has remained cancer-free. He knows three others who have been diagnosed with pancreatic cancer.

"I never tell people the odds," he said. "You just have to put your nose to the grindstone and start the work."

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