Sir John Hurt Battled Early Stage Pancreatic Cancer
Legendary British Actor Says He Has a "Fantastic Prognosis"
Actor Sir John Hurt, 75, has fought pancreatic cancer, a disease that is often caught late due to a lack of effective screening methods.
Because pancreatic cancer is often detected in an advanced stage, the disease has a high death rate. Hurt has expressed optimism that his case has been successfully treated.
Hurt released a statement to the media in June 2015, saying that he had been diagnosed with early stage pancreatic cancer, that he had begun treatment, and that he was continuing to work:
“I am continuing to focus on my professional commitments and will shortly be recording Jeffrey Bernard Is Unwell (one of life’s small ironies!) for BBC Radio 4.”
In October 2015, Hurt told reporters that treatment had gone very well and that he has a "fantastic prognosis."
The veteran actor, whose career has spanned more than 50 years, was twice nominated for an Academy Award, for Supporting Actor in Midnight Express, and as Best Actor for The Elephant Man. He also starred in A Man for All Seasons, Alien, and the Harry Potter series, among many other films.
What is the Pancreas and What Does It Do?
The pancreas is a fish-shaped organ which lies behind the stomach. It is made up of two types of cells:
- Exocrine cells: These cells produce a pancreatic juice that includes enzymes which aid in the digestion of food in the small intestine, breaking up proteins, carbohydrates and fats.
- Endocrine cells: These are clustered in small groups (called the islets of Langerhans) scattered throughout the pancreas. These cells produce important hormones such as insulin, glucagon, and somatostatin.
Two Types of Pancreatic Cancer
Pancreatic ductal adenocarcinoma (PDAC) is the most common and deadly type of pancreatic cancer, accounting for 95 percent of all cases, according to the National Cancer Institute (NCI). PDAC is a cancerous overgrowth of pancreatic cells arising in the exocrine ducts of the pancreas.
The less common form of pancreatic cancer is pancreatic neuroendocrine tumor (often called pancreatic NET). Apple founder and CEO Steve Jobs died from pancreatic NET in 2011.
Pancreatic Cancer is the Fourth Leading Cause of Cancer Death for Both Men and Women
- In 2015, the NCI estimated that 49,000 Americans will be diagnosed with pancreatic cancer and about 40,560 will die from it.
- Pancreatic cancer is more treatable when caught early, but the vast majority of cases are not diagnosed until late stages of the disease.
- Five-year survival rates approach 40 percent if the cancers are surgically removed while they are still small and have not spread to the lymph nodes.
Pancreatic Cancer is Difficult to Diagnose
There is no reliable screening test for the early detection of pancreatic cancer. What's more, the symptoms are often vague and easily confused with other diseases. Symptoms include:
- Dark urine and clay-colored stools
- Fatigue and weakness
- Jaundice (a yellow color in the skin, mucus membranes, or eyes)
- Loss of appetite and weight loss
- Nausea and vomiting
- Pain or discomfort in the upper part of the belly or abdomen
- Back pain
- Blood clots
Who Has the Greatest Risk?
Inherited genetic disorders cause 5 percent to 10 percent of cases of pancreatic cancer and certain genes can increase the lifetime risk up to 80 percent, according to the NCI.
Those who are at higher risk include:
- Cigarette smokers
- People with two or more relatives who have had pancreatic cancer
- People of Ashkenazi Jewish descent
- People who have the BRCA2, STK11 gene mutation
- People with chronic pancreatitis (inflammation of the pancreas)
- People over the age of 50
How is Pancreatic Cancer Treated?
Because pancreatic cancer is often advanced when it is first found, very few tumors can be cured by surgery alone. The standard surgical procedure is called a pancreatico-duodenectomy.
When the tumor has not spread beyond the pancreas and cannot be removed entirely, radiation therapy and chemotherapy together may be recommended.
When the tumor has spread (metastasized) to other organs such as the liver, chemotherapy alone is usually used. The standard chemotherapy is a drug called gemcitabine. FOLFIRINOX is a drug combination that significantly improves overall survival compared with gemcitabine.
Managing pain and other symptoms is an important part of treating advanced pancreatic cancer. Palliative care teams and hospice can help with pain and symptom management, and provide psychological support for patients and their families during the illness.
New Breakthroughs on the Horizon
A relatively new class of drugs, called immune checkpoint inhibitors (or PD-1 blockers), has been effective for some GI cancers. Although these drugs (nivolumab and pembrolizumab) are not yet FDA-approved to treat pancreatic cancer, clinical research trials are currently recruiting patients with the disease.
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