Bay Biosciences provides high-quality, biopsy tissue samples. FFPE tissue blocks with matching fresh, frozen sera (serum), plasma, peripheral blood mononuclear cells (PBMC) bio-fluids from patients diagnosed with Pancreatic cancer.
The sera (serum), plasma and PBMC biofluid specimens are processed from pancreatic cancer patient’s peripheral whole-blood using customized collection and processing protocols.
The biopsy tissue and matched biofluid samples are collected from unique patients diagnosed with pancreatic cancer and are provided to a valued pharmaceutical customer for research, diagnostics, discovery and drug development.
Pancreatic cancer, sera (serum), plasma and peripheral blood mononuclear cells (PBMC) biofluids are processed from patients peripheral whole-blood using customized collection and processing protocols.
Pancreatic Cancer Overview
Pancreatic cancer is a type of cancer which develops in the pancreas. Pancreatic cancer begins when abnormal cells in the pancreas grow and divide out of control and form a tumor. Pancreatic cancer is a leading cause of cancer death largely because there are no detection tools to diagnose the disease in its early stages when surgical removal of the tumor is still possible.
The pancreas is a gland located deep in the abdomen, between the stomach and the spine. It makes enzymes that help digestion and hormones that control the blood-sugar levels in the body.
Organs, like the pancreas, are made up of cells. Normally, cells divide to form new cells as the body needs them. When cells get old, they die, and new cells take their place.
Sometimes this process breaks. New cells form when the body does not need them, or old cells do not die. The extra cells may form a mass of tissue called a tumor.
Some tumors are benign. This means they are abnormal but cannot invade other parts of the body. A malignant tumor is called cancer. The cells grow out of control and can spread to other tissues and organs.
Even when the cancer spreads to other areas of the body, it is still called pancreatic cancer if that is where it started. Pancreatic cancer mostly spreads (metastasize) to the liver, abdominal wall, lungs, bones and/or lymph nodes.
More than 90% of pancreatic cancer cases are pancreatic adenocarcinoma (PDAC), that develop in the exocrine tissue of the pancreas, which makes digestive enzymes.
Less common are pancreatic neuroendocrine tumors (NETs), which usually develop in hormone-producing endocrine cells, or islet cells. Neuroendocrine tumors often have a better prognosis and younger median age of diagnosis.
Common signs and symptoms for pancreatic cancer may include weight loss, abdominal discomfort, back pain, development of type-2 diabetes and some tumors may cause jaundice leading to earlier diagnosis.
According to the American Cancer Society (ACS) pancreatic cancer accounts for about three percent of all cancers in the US. It is a cause of about seven percent of all cancer deaths in the United States.
Pancreatic cancer has the highest mortality rate of all major cancers. It is currently the third leading cause of cancer-related death in the United States after lung and colon. Pancreatic cancer also has the highest mortality rate of all major cancers.
For all stages combined, the 5-year relative survival rate is 10%. Even for the small percentage of people diagnosed with local disease, the 5-year survival is only 39%. The majority of patients are diagnosed at a distant stage, for which the 5-year survival is 3%.
Function of the Pancreas
The pancreas is a gland, about six inches long, located in the abdomen. It is shaped like a flat pear and is surrounded by the stomach, small intestine, liver, spleen and gallbladder.
The wide end of the pancreas on the right side of the body is called the head. The middle sections are the neck and body. The thin end of the pancreas on the left side of the body is called the tail.
The uncinate process is the part of the gland that bends backwards and underneath the head of the pancreas.
Two very important blood vessels, the superior mesenteric artery and superior mesenteric vein, cross behind the neck of the pancreas and in front of the uncinate process. The pancreas is both an exocrine gland and endocrine gland and has two main functions, that is digestion and blood sugar regulation.
The Pancreas and the Digestion
Exocrine cells of the pancreas produce enzymes that help with digestion. When food enters the stomach, exocrine cells release the pancreatic enzymes into a system of small ducts that lead to the main pancreatic duct. The pancreatic duct runs the length of the pancreas and carries pancreatic enzymes and other secretions, collectively called pancreatic juice.
The main pancreatic duct connects with the common bile duct, which carries bile from the gallbladder, and together they connect with the duodenum at a point called the ampulla of Vater. Here, bile and pancreatic enzymes enter the duodenum to aid with the digestion of fats, carbohydrates and proteins.
Regulating Blood Sugar
The endocrine cells of the pancreas produce hormones. Hormones are substances that control or regulate specific functions in the body. They are usually made in one part of the body and carried through the blood to take action on another part of the body.
The two main pancreatic hormones are insulin and glucagon. Islet cells are endocrine cells within the pancreas that produce and secrete insulin and glucagon into the bloodstream. Insulin lowers blood sugar levels while glucagon raises blood sugar levels. Together, these two main hormones work to maintain the proper level of sugar in the blood.
Types of Pancreatic Cancer
Pancreatic tumors are either exocrine or neuroendocrine (endocrine) tumors. This is based on the type of cell they start in. Knowing the type of tumor is important because each type acts differently and responds to different treatments.
About 93% of pancreatic cancers are exocrine tumors. The most common type of pancreatic cancer is adenocarcinoma.
About 7% of pancreatic tumors are neuroendocrine tumors (pancreatic NETs or PNETs), also called islet cell tumors. They often grow slower than exocrine tumors.
The main distinction is whether they affect the exocrine glands or the endocrine glands.
Exocrine Pancreatic Cancer
The exocrine glands produce enzymes that enter the intestines and help digest fat, proteins, and carbohydrates . Most of the pancreas consists of exocrine glands.
Types of tumor that can affect exocrine function include:
- Adenocarcinomas
- Acinar Cell Carcinomas
- Cystic Tumors
Most pancreatic tumors affect exocrine function.
Endocrine Pancreatic Cancer
The endocrine glands are small clusters of cells known as the islets of Langerhans. They release the hormones insulin and glucagon into the bloodstream. There, they help manage blood sugar levels. Problems with these glands can lead to diabetes.
The name will depend on the type of hormone-producing cell where the cancer starts. Knowing the exact type of cancer a patient has will help doctors provide the most appropriate treatment.
Following are some of the examples:
- Gastrinomas (gastrin)
- Glucagonomas (glucagon)
- Somatostatinomas (somatostatin)
- Insulinomas (insulin)
Stages of Pancreatic Cancer
A cancer’s stage refers to how far it has spread, following are the stages of pancreatic cancer:
- Stage 1: The cancer is in the pancreas and it is localized, which means it is limited to one organ.
- Stage 2: The cancer has reached the bile duct and other surrounding structures but not the lymph nodes. It is regional, which means the cancer has spread in the surrounding areas.
- Stage 3: The cancer affects the lymph nodes but is still regional.
- Stage 4: The cancer has reached other organs and parts of the body. It is distant, which means the cancer has reached further distant organs from the pancreas.
About 50% of the patients with pancreatic cancer receive a diagnosis when the cancer has already stage 4. At this stage the doctors are unable to cure the cancer. Treatment aims to prolong the person’s life, improve their quality of life, and manage their symptoms.
Metastatic Pancreatic Cancer
When pancreatic cancer spreads to distant organs, this is known as metastasis. The cancerous cells are still pancreatic cells, even though they are growing in other organs.
Pancreatic cancer can metastasize in many areas, including the following:
- Adrenal Gland
- Bones
- Diaphragm
- Liver
- Lungs
- Peritoneum (lining of the abdomen)
- Stomach
Sometimes, doctors can only identify the stage of cancer by performing surgery.
In determining a person’s outlook, doctors assess and consider the cancer’s stage and how abnormal the cancerous cells are. They also take into account the patient’s overall health.
When the cancer has spread to other organs, surgeons are unable to remove it or cure it. Treatments for stage 4 cancer involve managing pain and other symptoms to improve the quality of life of the patient.
Outlook of Pancreatic Cancer
The outlook for pancreatic cancer depends partly on which stage the cancer is at. According to American cancer society a patient who receives a diagnosis of pancreatic cancer has the following chances of surviving chances of surviving for another 5 years or longer compared with someone who does not have the condition:
- 39% when it is localized
- 13% when it is regional
- 3% when it is distant
In the early stages, treatment may be able to remove the cancer from the pancreas. As the cancer progresses, however, this becomes more challenging. Around 23% of patients with pancreatic cancer, the tumor is localized at the time of diagnosis. However, about 52% of patients receive a diagnosis when it has already spread to other parts of the body.
Signs and Symptoms of Pancreatic Cancer
The signs and symptoms of pancreatic cancer often do not appear until the disease has reached advanced stages. These can also resemble the symptoms of other diseases, which makes the diagnosis even more difficult.
Following are some of the common signs and symptoms of pancreatic cancer:
- Abdominal Pain and Back Pain
- Blood Clots (Deep Vein Thrombosis, Pulmonary Embolism)
- Constipation
- Diarrhea
- Depression
- Fatigue
- Fatty Stools (usually gray in color)
- Fever and Chills
- Indigestion
- Itchy skin
- Jaundice (Rashes due to jaundice)
- Loss of Appetite
- Swelling of the Gallbladder and Liver
- Unexplained Weight Loss
Treatment of Pancreatic Cancer
The treatment options for pancreatic cancer will depend on:
- The type of pancreatic cancer a patient has
- Cancer Stage
- The patient’s age, overall health, and other characteristics
- Their personal choices
Treatment for pancreatic cancer usually aims to:
Surgery
If the cancer is localized at the time of diagnosis, it may be possible to eliminate the cancer cells by removing all or part of the pancreas.
Following are the three main surgical procedures fused or pancreatic cancer:
Ablation
Ablation uses heat or cold to destroy a tumor. It may help with tumors that are smaller than one inch across. A surgeon will insert a needle or a probe to apply the treatment. Possible side effects include pain, infections, and internal bleeding.
Distal Pancreatectomy
In distal pancreatectomy, the surgeon removes part of the pancreas and usually the spleen as well. The spleen is the organ that supports the immune system, so there may be a higher risk of infection after its removal.
Embolization
In embolization procedure, a doctor will inject a substance into an artery that stops blood from reaching the cancer cells. Without the blood supply, these cells will die. Side effects of embolization procedure include abdominal pain, nausea, fever, infections, and a risk of blood clots in the area of the injection.
Palliative Surgery
Palliative surgery can help relieve symptoms such as obstructions in the bile duct or duodenum. A surgeon can create a bypass so that bile can continue to flow from the liver. This can minimize pain and digestive problems. Another option is to insert a small stent in the bile duct to keep it open. This is a less invasive procedure using an endoscope.
Total Pancreatectomy
In total pancreatectomy, the surgeon removes the entire pancreas and spleen. A patient can live without a pancreas, but diabetes may develop because the body no longer produces insulin cells.
Whipple Procedure
In a Whipple procedure, a surgeon removes the pancreas head and sometimes the whole pancreas, along with a portion of the stomach, duodenum, lymph nodes, and other tissue. Complications of this procedure includes leaking, infections, bleeding, and stomach issues.
Chemotherapy
Chemotherapy is a drug treatment that can kill cancer cells and stop them from spreading. A doctor may prescribe it alone or with other treatments. This treatment can also help relieve symptoms in the later stages. Usually the patient’s receives treatment in cycles of two to three weeks followed by a rest period. This allows the body time to heal between the chemotherapy doses. The side effects of chemotherapy may include hair loss, nausea, fatigue and vomiting.
Targeted Therapy
This is a newer approach than chemotherapy. It stops cancer cells from developing by targeting substances they need to grow on.
Following are the different types of targeted therapy:
- EGFR inhibitors, which block the EGFR protein
- PARP inhibitors, which block PARP enzymes
- NTRK inhibitors
Unlike chemotherapy, these drugs have specific targets, so their impact on the whole body is lessened. However, they can still have adverse effects, which will depend on the type of treatment the patient receives.
Immunotherapy
Immunotherapy works by helping the body’s own immune system recognize and destroy cancer cells.
PD-1 inhibitors are one type of immunotherapy that may help treat pancreatic cancer. Ptients receive this treatment as an infusion once after every two to three weeks. Possible side effects include a cough, fatigue, a rash, and joint pain.
Radiation Therapy
Radiation therapy destroys cancer by focusing high energy rays on the cancer cells. It can shrink or remove a tumor. In the later stages, it can help relieve symptoms by removing or reducing the blockage caused by the tumor.
Like chemotherapy, it can cause some side effects, such as skin changes, gastrointestinal disturbances, and fatigue. However, these usually pass after completing treatment. The patient may receive radiation therapy either alone or with other combination treatments, usually on five days per week for several weeks.
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Samples available are cancer (tumor) tissue, cancer serum, cancer plasma cancer PBMC and human tissue samples from most other therapeutic areas and diseases.
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Our biobank procures and stores fully consented, deidentified and institutional review boards (IRB) approved human tissue samples and matched controls.
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This critical patient’s clinical data includes information relating to their past and current disease, treatment history, lifestyle choices, biomarkers and genetic information.
Patient’s data is extremely valuable for researchers and is used to help identify new effective treatments (drug discovery & development) in oncology, other therapeutic areas and diseases.
Bay Biosciences banks wide variety of human tissue samples and biological samples including cryogenically preserved at – 80°C.
Including fresh frozen tissue samples, tumor tissue samples, FFPE’s, tissue slides, with matching human bio-fluids, whole blood and blood derived products such as serum, plasma and PBMC’s.
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