Pan­cre­at­ic can­cer is a dis­ease in which ma­lig­nant (can­cer­ous) cells form in the tis­sues of the pan­creas. This type of can­cer is quite lethal; it shows no signs and can spread very rapid­ly, leav­ing it usu­al­ly un­di­ag­nosed un­til the very late stages. Na­tal­ie Sab­ga is the founder of the John E Sab­ga Foun­da­tion for Pan­cre­at­ic Can­cer. She start­ed this foun­da­tion in hon­or of her late hus­band John who passed away from pan­cre­at­ic can­cer. His time with the dis­ease was very brief and he passed quite swift­ly, Na­tal­ie ex­pressed. In a re­cent in­ter­view, here’s what she had to say.

Why did you start the foun­da­tion?

“I start­ed the foun­da­tion be­cause I am haunt­ed by the dis­ease- that in 2018 peo­ple could get a dis­ease like can­cer and not have much hope. Every­one knows that once you hear pan­cre­at­ic can­cer, it’s ba­si­cal­ly a death sen­tence. It’s a very dif­fi­cult can­cer to treat and de­spite go­ing to many places and many world-renowned doc­tors, my hus­band still suc­cumbed to this dis­ease. Even those that we met on our jour­ney have now al­so passed on.

As I start­ed ad­vo­cat­ing in Trinidad and To­ba­go, a lot of peo­ple start­ed reach­ing out to me. I was com­pelled to start this foun­da­tion to bring aware­ness and ed­u­ca­tion to the peo­ple, to ed­u­cate our doc­tors and raise mon­ey for re­search. The pur­pose of re­search is sim­ple, we need to bring new ther­a­peu­tic agents of pan­cre­at­ic can­cer to Trinidad and make it avail­able to every­one. Al­so, world­wide doc­tors and pa­tients alike are scram­bling for re­search be­cause pan­cre­at­ic can­cer is grow­ing.

25 years ago Breast Can­cer was a death sen­tence, with the help of aware­ness and re­search, that is no longer the case. Pan­cre­at­ic can­cer nev­er had that op­por­tu­ni­ty, but you know what? We’re go­ing to start it. Not just in Trinidad, but glob­al­ly- to give hope to our fu­ture gen­er­a­tions by fund­ing re­search and bring­ing aware­ness and ed­u­ca­tion.

We have brought Dr Dou­glas Evans to give a lec­ture at the Hy­att to­day to con­tin­ue the ed­u­ca­tion process for our med­ical fra­ter­ni­ty.”

Dr Dou­glas B Evans is chair of the de­part­ment of surgery at the Med­ical Col­lege of Wis­con­sin, and has de­vot­ed his en­tire life to pan­cre­at­ic can­cer re­search and treat­ment. Af­ter his surgery train­ing at Dart­mouth, Dr Evans gained 20 years of ex­pe­ri­ence in the med­ical field and as a spe­cial­ized on­col­o­gist he was the best per­son to give us some more in­for­ma­tion on this par­tic­u­lar dis­ease.

What is pan­cre­at­ic can­cer, what are the caus­es and how can it be pre­vent­ed?

“The pan­creas is a lit­tle or­gan that is stuck way in the back of the up­per ab­domen, and it has two main func­tions. First­ly, it makes di­ges­tive en­zymes which helps di­gest food and sec­ond­ly it makes hor­mones- the most com­mon be­ing in­sulin. You can get a can­cer of the en­zyme-pro­cess­ing cell, which is the most com­mon type of pan­creas can­cer. You can al­so get can­cer of the hor­mone pro­duc­ing cells and that's what Aretha Franklin and Steve Jobs both suc­cumbed to. Can­cer of the en­zyme-pro­cess­ing cell is the most com­mon and prob­a­bly about three of four per­cent is due to to­bac­co use, an­oth­er three or four per­cent is di­et and obe­si­ty re­lat­ed. The ma­jor­i­ty of peo­ple get pan­cre­at­ic can­cer for no ap­par­ent rea­son, it’s a dis­ease that knows no face and there­fore we need bet­ter treat­ments.

Right now we have made tremen­dous ad­vances in un­der­stand­ing the bi­ol­o­gy of the dis­ease. In the cen­ter I work at for ex­am­ple, we do com­plete DNA se­quenc­ing on every pa­tient that gets pan­creas can­cer, and with the right tech­nol­o­gy you can do that here in Trinidad. Just like in all the shows on TV, you swab the cheek and we can se­quence their en­tire germ line DNA. We al­so biop­sy the tu­mor and look at the mu­ta­tions in the tu­mor and one of things I am go­ing to talk about this af­ter­noon, is how we’ve then di­rect­ed the treat­ment based on the mu­ta­tion­al sta­tus of the tu­mor.

Right now, we treat the pa­tient based on where the can­cer is in their body, when in re­al­i­ty we re­al­ly need to be treat­ing the in­di­vid­ual ge­net­ic mu­ta­tions that are in the tu­mor."

Are there are any pre­ven­ta­tive mea­sures that can be put in place?

It’s al­ways good to watch your weight, ex­er­cise and don’t smoke, these things will de­crease your like­li­hood. It’s a rel­a­tive­ly rare dis­ease but it’s al­so one that’s hard to cure, so right now in Trinidad if the pop­u­la­tion is one mil­lion, ap­prox­i­mate­ly 150 peo­ple will have pan­creas can­cer at any one time. I think the hope is that since this can­cer is not go­ing away, re­search is nec­es­sary. It’s very un­like­ly in my life­time and yours that there will be a sim­ple test for ear­ly di­ag­no­sis. While di­ag­no­sis would be dif­fi­cult, what we do need to fo­cus on is prop­er treat­ment.