Cancers of the pancreas: Patrick Swayze, Ruth Bader Ginsburg, (Steve Jobs)

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Pancreatic cancer seems to be in the news a lot lately. Most recently, Supreme Court Justice Ruth Bader Ginsburg was diagnosed with stage 1 pancreatic cancer (single spot in pancreas without any spread elsewhere). Her early stage cancer was found on a screening CT scan done as follow up for colorectal cancer she had in 1999. The Justice was indeed fortunate to have found this at such an early stage, as most pancreatic cancers have such nonspecific symptoms, such as fatigue, weight loss, upper abdominal pain and jaundice, that they are frequently not diagnosed until they are further advanced and/or have spread to other areas. Early diagnosis has a much better prognosis than late stage pancreatic cancers. Patrick Swayze is an example of someone diagnosed later and has stage 4 disease. This means that the cancer has spread beyond the pancreas.

Patrick Swayze — adenocarcinoma
Date of diagnosis: February 2008
Age at time of diagnosis: 55

Ruth Bader Ginsberg — adenocarcinoma
Date of diagnosis: January 2009
Age at time of diagnosis: 75

Estimated new cases (42,470) and deaths (35,240) from pancreatic cancer in the U.S. in 2009

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Steve Jobs, Apple’s founder, also has a pancreatic tumor, although it is of an entirely different type than Justice Ginsburg and Mr. Swayze. His tumor type, called neuroendocrine (islet cell) tumor, is much rarer and starts in a different type of pancreatic cell – one that produces hormones, such as insulin. These hormones often lead to early symptoms, making diagnosis easier and often there are better results with treatment.
Steve Jobs — islet cell neuroendocrine tumor
Date of diagnosis: October 2003
Age at time of diagnosis: 48

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What is the pancreas and what does it do?

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The pancreas is a fish-shaped organ (with a head to the right and tail to the left) which lies behind the stomach. It is made up of two types of cells:
1. 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.
2. 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.

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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