Georg Koch is incurably ill with pancreatic cancer. The former Bundesliga goalkeeper announced this in an interview. The medical background to the most treacherous of all types of cancer.

Georg Koch is incurably ill with cancer. The former Bundesliga goalkeeper announced this in an interview. Accordingly, he was diagnosed with pancreatic cancer in April last year.

“The whole mess was discovered during a routine examination. “I wasn’t feeling so well before and my blood values ​​were noticeably bad,” Koch reported. “At some point the doctor told me the diagnosis and gave me another six months – but he was very wrong.”

The medical background to the rare but extremely treacherous type of cancer.

Pancreatic cancer is medically known as pancreatic cancer and is not a common type of cancer. But no other is as treacherous: those affected and their doctors often only become aware of pancreatic cancer when it is too late for a cure.

And while survival rates for most types of cancer have increased significantly in recent years, for pancreas patients they are still only eight percent five years after diagnosis. The average life expectancy after diagnosis is only two to three years; patients often only have months left.

The reason: There have been hardly any medical advances for pancreatic cancer, which have caused survival rates to constantly rise for other types of tumors in recent decades.

As if that wasn’t depressing enough, the number of those affected in industrialized countries is continually increasing. In Germany, around 17,000 people develop pancreatic cancer every year, and the same number die from the cancer every year. According to the European Association of Gastroenterologists (UEG), the number of deaths increased by five percent between 1990 and 2016. Experts blame our modern lifestyle for the increase in illnesses in industrialized countries.

Lifestyle: Smoking, being overweight, eating a diet high in fat and meat, and excessive alcohol consumption are risk factors for pancreatic cancer. However, the connection is not quite as clear as that between smoking and lung cancer. Conversely, you should avoid alcohol and nicotine and pay attention to a balanced diet, for example along the lines of the Mediterranean diet.

Inflammation: The influence of chronic pancreatitis on the risk of pancreatic cancer is clear.

Diabetes: Diabetes is not a direct precursor to pancreatic cancer, in the same way that polyps are for colon cancer. But diabetes often precedes a cancer diagnosis. In an interview with Die Welt, Volker Ellenrieder, director of the Clinic for Gastroenterology and Endocrinology at the University Medical Center Göttingen, said that diabetes could perhaps even be an early detection feature. It has been found that when pancreatic cancer is diagnosed in a patient in their mid-50s, they have often been diagnosed with diabetes a few years previously.

Predisposition: Genetic factors play a role, especially hereditary forms of chronic pancreatitis. If one or two close relatives suffer from pancreatic cancer, it makes sense to seek medical advice.

Lack of early detection: Another type of risk factor is the fact that there are no early detection methods for pancreatic cancer, unlike breast or colon cancer. In the future, research will rely on blood tests (“liquid biopsy”). But so far no approach has been sufficiently developed to enable reliable early detection of cancer in the blood.

Doctors usually discover the malignant tumor late and often by chance during another examination of the abdominal cavity. If pancreatic cancer is suspected, the family doctor will first carry out a physical examination with an ultrasound of the abdomen. For further examinations such as a computer tomography and an endoscopic examination, the family doctor will refer you to a suitable specialist, if necessary to a cancer center.

A biopsy, which confirms the diagnosis of many other types of cancer, is not useful for pancreatic cancer. Removing tissue from the pancreas is difficult and not without risk.

If the tests carried out suggest pancreatic cancer and the tumor has not yet spread, doctors may recommend immediate surgery at a certified pancreatic cancer center.

1) Operation

If the tumor is detected early enough for surgery to be an option, there is a chance of a complete cure. The operation is almost always followed by supportive chemotherapy for six months. Sometimes chemotherapy before surgery is intended to shrink a tumor. After the pancreas is removed, the patient must replace the vital enzymes and hormones (such as insulin) produced there with medication.

2) Chemotherapy

In most patients, the disease is so advanced when diagnosed that the tumor can no longer be operated on. It has then grown into the surrounding tissue or has already formed metastases. The standard treatment here is chemotherapy with the aim of extending survival and increasing quality of life.

3) Personalized cancer therapy

Pancreatic cancer often does not respond to standard chemotherapy. But until this becomes clear, valuable time passes. A therapy that is precisely tailored to the respective tumor can help with this dilemma. Because of the cancer’s genetic fingerprint, oncologists can choose promising active ingredients and not even use those to which the cancer will not respond anyway.

4) Experimental therapies

New therapeutic approaches are being used in studies at the centers specializing in pancreatic cancer. Certain new drugs can complement chemotherapy or achieve success in patients for whom the usual cell toxins do not work. Patients can take part in such studies if their illness makes them eligible.

Immunotherapy, which is currently the main hope for cancer treatment, has so far failed to treat pancreatic cancer. Unlike most other types of cancer, the immune system does not recognize pancreatic cancer. Research must first find out how an immune reaction can be triggered.

Good palliative care support is important for the quality of life of patients with a poor prognosis. This includes clarifying the symptoms associated with the tumor, but also supporting the family, social and psychological situation of the patient and their relatives. In addition to the important and often necessary pain therapy, it also takes aspects such as nutrition and exercise into account.