A cluster of pancreatic cancer cells (Image: Dr. Stanley Flegler/Visuals Unlimited, Inc./SPL)

It’s the sneakiest of cancers – and as many as 80 per cent of cases are identified too late. But we now have a way to test for pancreatic cancer before it spreads.

The disease has one of the worst cancer survival rates, with less than 4 per cent of people living for five years or more after diagnosis. A major cause of this is that by the time symptoms start appearing, pancreatic cancer is often too advanced to treat successfully.

The disease is only identified in time for curative surgery in about 15 per cent of people, so early diagnosis is crucial for improving survival rates. Now, researchers have identified a protein that is present in the blood at much higher levels when a person has the disease, giving us a way to test for it.


The protein, glypican-1, sticks out from the surface of exosomes – little globules that are thought to bud off from pancreatic cancer cells. Other cells in the body also produce these exosomes, but they seem to carry much less of this protein.

Raghu Kalluri of the University of Texas MD Anderson Cancer Center in Houston found that there is so much more glypican-1 in people with pancreatic cancer that a blood test can be used to accurately distinguish them from both healthy controls and people with the disease pancreatitis. “The margin is always large enough to detect cancer exosomes,” says Kalluri.

When to test?

“If exosomes from cancer cells can be reliably spotted, this technique could be a valuable way to spot and analyse genetic mistakes found in tumours,” says Nell Barrie of the charity Cancer Research UK. “This could, in turn, one day offer a way to spot diseases like pancreatic cancer at a much earlier stage, although there is much more work to be done to develop this into an actual test,” she says.

But Kalluri hopes a test for pancreatic cancer based on his team’s findings can be made available soon. One use for it could be to screen those at particular risk, such as obese over-60s who smoke and have a family history of the disease.

The test could also be used for tracking the progress of therapies and recovery, says Kalluri. His team found that the concentration of glypican-1 increases with the disease’s severity, potentially providing doctors with a measure for how advanced the cancer is and a way to monitor the effectiveness of treatments.

Former Apple CEO Steve Jobs and actor Patrick Swayze both had pancreatic cancer, which is so deadly partly because of its limited treatment options, with few new and effective drugs and therapies available.

Journal reference: Nature, DOI: 10.1038/nature14581