How pancreatic cancer arises, based on complexity theory
26 February 2021
This is the third paper in a series discussing the top 20 causes of US cancer death and how they arise based on complexity theory (see How Lung Cancer Arises-Pernick 2021 (PDF), How Colon Cancer Arises- Pernick 2020 (PDF)). We first discuss the population attributable fraction of pancreatic cancer risk factors and their mechanism of action, then integrate these mechanisms into our theory about how cancer arises in general and in the pancreas, and finally suggest curative treatment approaches for pancreatic cancer.
Highlights:
- Countering pancreatic cancer requires optimizing all factors affecting it, even if not directly part of the malignant process.
- Five “super promoter” mechanisms cause pancreatic cancer: random chronic stress (bad luck or cellular accidents); chronic inflammation; DNA alterations; immune system dysfunction (individual and “societal”) and hormones (insulin-IGF system).
- The 5 major causes / risk factors of pancreatic cancer are random chronic stress (causes 25-35% of cases); non O blood group (17% of cases); excess weight, particularly at younger ages (15%); cigarette smoking (15%) and type 2 diabetes (9%).
- Cancer arises in part because risk factors activate embryologic and inflammatory pathways in a manner that cannot be turned off.
- In the pancreas, tumor cell spread may occur even before a primary malignancy arises, explaining why advanced disease is often found at diagnosis.
- Treatment approaches should focus on network dysfunction not mutations; combinations of combinations of treatment to block multiple webs of network abnormalities; treating and monitoring key systemic network changes outside the primary tumor; enrolling all patients in clinical trials and creating stronger public health programs to prevent these cancers or detect them earlier.
