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CAN-Sirs Corner

by Pete Davignon

reprinted with permission from Senior Softball News

Selfies to Screen for Pancreatic Cancer

Winter 2017 Edition

Traditionally cancer prevention means making healthy lifestyle choices like not smoking, using sunscreen, and eating healthy.

Now, researchers are also looking into cancer prevention on a molecular level, writes Cancer Today senior editor Marci A. Landsmann. Techniques like next-generation sequencing could help scientists analyze seemingly normal tissue and identify characteristics of pre-malignant lesions--cells on their way to becoming cancerous. Understanding pre-malignant lesions may help researchers develop drugs to stop pre-cancers from becoming cancers, or screening tests to identify people at risk of developing cancer in the future.

BiliScreen is a new smart phone app designed to screen for pancreatic cancer by having users snap a selfie. Pancreatic cancer has one of the worst prognoses--a five year survival rate of 9 percent--in part because there are no telltale symptoms nor non-invasive screening tools to catch a tumor before it spreads.

One of the earliest symptoms of pancreatic cancer as well as other diseases is jaundice, a yellow discoloration of the skin and eyes caused by a buildup of bilirubin in the blood. The ability to detect signs of jaundice when bilirubin levels are minimally elevated, but before they are visible to the naked eye, could enable an entirely new screening program for at-risk individuals.

"The eyes are a really interesting gateway into the body--tears can tell you how much glucose you have, sclera can tell you how much bilirubin is in your blood," said senior author Shwetak Patel. BiliScreen uses a smart phone camera to detect increased bilirubin levels in a person's sclera, the white part of the eye. Increased levels of bilirubin are an early warning sign for pancreatic cancer. In adults, the whites of the eyes are more sensitive than skin to changes in bilirubin levels.

"The problem with pancreatic cancer is that by the time you are symptomatic, it's frequently too late," said author Alex Mariakakis. "The hope is that if people can do this simple test once a month in the privacy of their own homes some might catch the disease early enough to undergo treatment that cold save their lives." BiliScreen provides estimates of bilirubin levels in a person's blood; elevated levels can be an early warning sign for pancreatic cancer, hepatitis, and other diseases.

The blood test that doctors currently use to measure bilirubin levels is typically not administered to adults unless there is reason for concern, requires access to a health care professional, and is inconvenient for frequent screenings.

BiliScreen is designed to be an easy-to-use, non-invasive tool that could help determine whether someone ought to consult a doctor for further testing. Beyond diagnosis, BiliScreen could also potentially ease the burden on patients with pancreatic cancer who require frequent bilirubin monitoring.

"This initial study shows the technology has promise," said co-author Dr. Jim Taylor, whose father died of pancreatic cancer at age 70.

"Pancreatic cancer is a terrible disease with no effective screening right now," Taylor said. "Our goal is to have more people who are unfortunate enough to get pancreatic cancer to be fortunate enough to catch it in time to have surgery that gives them a better chance of survival." For more information, contact the research team at uwbiliscreen@gmakil.com or Mariakakis at atm15@cs.washington.edu.

Virtual Body

BioDigital Human--a map for the human body. The BioDigital Human is a scientifically accurate cloud based virtual body that empowers everyone to learn about health and medicine in an entirely new visual format. Anatomy disease, and treatments are presented in an interactive 3D format that resembles life itself. Learn more at www.biodigital.com.

Aging and Cancer Intertwined

The median age of diagnosis varies in different cancer types--61 years for breast, 66 years for prostate, 68 years for colorectal, and 70 years for lung--but the disease can occur at any age. Bone cancer for example is most frequently diagnosed in people younger than 20 and neuroblastoma is more common in children than in adults.

Mutations and other changes in the genome--the information written in our DNA--is the root cause of cells becoming cancerous. When mutations disrupt genes that regulate cell division and growth, normal cells begin to grow uncontrollably. A trickle becomes a flood of abnormal cells that form tumors; additional mutations can disable tumor-suppressing proteins further aiding the renegade cells. Usually a series of mutations in cancer-related genes occurs over many years before cells begin their malignant journey.

 

Why an aging body is more susceptible to cancer has no single explanation. One view is that cancer develops in older people simply because of their prolonged exposure to carcinogens such as sunlight, radiation, environmental chemicals, and substances in the food we eat. In addition, changes in tissues and organs with advancing age render cells' microenvironment more favorable to the development of cancer.

The full picture of how aging and cancer are intertwined is still a work in progress. We can't hold back the hands of time, but researchers say that managing chronic conditions and making lifestyle changes in middle age and beyond can modify cancer risk.

These changes include increasing physical activity, spending less time sitting, getting good sleep, eating a health diet, moderating alcohol use, and quitting smoking. Doing so can reduce cancer risk and increase the odds of what researchers call "successful aging"

 

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