Obesity drug boom brings the pancreas into focus... What signs of pancreatic cancer, the “silent cancer,” should not be missed?

[Financial News] The boom in obesity drugs such as Wegovy and Mounjaro is drawing more attention to the pancreas, which regulates blood sugar and digestion. But pancreatic cancer, a malignant tumor that develops in the pancreas, is difficult to detect early: nearly half of patients are found to have cancer that has already spread by the time they are diagnosed. That is why weight loss without dieting and pain in the upper abdomen that radiates to the back should not be dismissed as simple indigestion.

According to the National Cancer Registration Statistics released this year by the Ministry of Health and Welfare and the Korea Central Cancer Registry (KCCR), 9,748 new pancreatic cancer patients were recorded in Korea in 2023, accounting for 3.4% of all cancer cases. The five-year relative survival rate for patients diagnosed from 2019 to 2023 was 17.0%, markedly lower than the rate for all cancers (73.7%). During the same period, 48.5% of pancreatic cancer patients for whom stage information was available already had cancer that had spread to other organs at the time of diagnosis.
Most pancreatic cancers are pancreatic ductal adenocarcinomas, which develop in the cells that make up the pancreatic ducts. They often cause no clear symptoms in the early stages. Because the pancreas is surrounded by other organs, including the stomach and duodenum, it is difficult to see the entire organ with a standard abdominal ultrasound. And even when symptoms do appear, they can resemble common digestive conditions such as indigestion or abdominal pain, making delayed detection more likely. Surgery may be difficult if the cancer has invaded major nearby blood vessels or spread to other organs by the time of diagnosis.

Lee Jae-min, a professor of gastroenterology at Korea University Anam Hospital, explained, “Pancreatic cancer is difficult to detect because its early symptoms are not clear, and the chances of treatment can vary greatly depending on when it is diagnosed.” 

Common symptoms include unexplained weight loss, persistent abdominal pain, jaundice and loss of appetite. The cause should also be checked if the whites of the eyes and the skin turn yellow or the urine becomes darker. Caution is also warranted when middle-aged or older adults suddenly develop diabetes and lose weight. However, these symptoms can also occur with other conditions. If jaundice develops for the first time or weight loss continues, it is best to seek medical care promptly and have the cause of any other symptoms checked as well.
Major risk factors include smoking, obesity, diabetes, chronic pancreatitis and family history. Of these, smoking is a major risk factor that can be reduced by changing one’s lifestyle. The risk of developing the disease may also be higher for people who have multiple close relatives, such as parents or siblings, with pancreatic cancer; a family member who had pancreatic cancer before age 50; or a confirmed genetic mutation. It is therefore important to understand your own risk factors, quit smoking, maintain a healthy weight and manage chronic conditions.
Pancreatic cancer can be difficult to detect early through routine health checkups alone. If pancreatic cancer is suspected, contrast-enhanced CT, MRI and endoscopic ultrasound can be used to check for a tumor, determine its location and assess whether it has invaded nearby tissue. Endoscopic ultrasound is especially useful for examining small lesions in detail and, when needed, taking a tissue sample for biopsy. However, routine screening for pancreatic cancer is not recommended for people without symptoms who are at average risk. Those at higher risk because of family history or genetic factors should consult a specialist to determine the appropriate tests and screening intervals.
Treatment depends on how advanced the cancer is and the patient’s condition. If the cancer is found early and surgery is possible, surgery to remove the tumor is the key treatment that offers the possibility of a cure. Chemotherapy before surgery or adjuvant chemotherapy afterward may also be given as needed. Even when surgery is difficult, palliative chemotherapy can help slow the cancer’s progression, and some patients may be considered for personalized treatment based on genetic test results.
The professor stressed, “If you develop unusual symptoms, such as unexplained weight loss, jaundice or persistent upper abdominal pain, don’t take them lightly; find out exactly what is causing them,” adding, “It is important to understand the main symptoms and risk factors for pancreatic cancer and, particularly if you have high-risk factors such as a family history, consult a specialist and develop an appropriate management plan.” 


[email protected] Jung Myung-jin, Medical Correspondent Reporter