Pancreatic cancer could be detected earlier using biomarkers, study finds

Pancreatic cancer is a formidable disease, often diagnosed too late for effective treatment.

However, new research from the US-based Mayo Clinic represents a promising step towards identifying biological signals, or biomarkers, that may aid in early detection.

By tracking changes in body composition and metabolism, researchers are working to identify high-risk patients who could benefit from selective screening for the disease, which kills more than 467,400 people globally each year. (In Hong Kong, 889 people died from it in 2021, accounting for 5.9 per cent of all cancer deaths.)

“Detecting the cancer earlier is the best way to improve survival.”

“Weight loss occurs even before the diagnosis,” says Bi. “A majority of pancreatic cancer patients will lose weight before they discover they have cancer.”

Studies have shown that as the disease progresses, cancer cells promote a wide range of metabolic and physiological changes. Bi and her colleagues wondered if these changes could serve as biomarkers, to enable earlier detection.

They analysed abdominal CAT scans and blood tests taken up to three years before the patients were diagnosed. Using advanced algorithms, the researchers measured changes in body fat, muscle and bone, as well as shifts in blood-based biomarkers like cholesterol and glucose levels.

The findings, published in the journal Clinical Gastroenterology and Hepatology, revealed changes in a variety of physiological and metabolic measurements.

Conversely, the study found that blood glucose levels increased up to three years before patients were diagnosed with pancreatic cancer, confirming a previously described link.

“It is a bizarre condition,” says Bi. “Patients’ bodies are changing – they are losing weight and their total cholesterol levels are going down … many things you think would be healthy, but in this case, they’re not. Nobody knows exactly what is going on, but we aim to find out.”

Bi recently received two grants to investigate how the growth of pancreatic tumours could drive such widespread metabolic changes.

She is also expanding her work on pancreatic cancer biomarkers, searching for the best combination of factors to make an early diagnosis.

Bi has been working on a project that uses artificial intelligence (AI) and wearables such as Apple Watches or Fitbits to track changes in body composition.

The team’s early findings suggest that capturing the subtle yet significant body changes that occur as pancreatic cancer develops could be a key strategy in the fight against the disease. Recognising these changes early could lead to timely diagnosis and treatment, potentially saving lives.

Bi and her colleagues at Mayo Clinic are active in the Pancreatic Cancer Early Detection consortium, a global effort to improve early detection and prevention of pancreatic cancer.

The consortium’s goal is to increase the five-year survival rate to 50 per cent after 10 years.

“It is very ambitious,” she says, “but I hope we can reach that goal by pushing for early detection.”