Pancreatic cancer can hide in the pancreas until it has spread
His cancer was found only after it had reached his liver, blood vessels, and spine, leaving doctors to try to poison the tumors without poisoning him.
Uncommon Knowledge · Basketball in the Last 60 Seconds: Ben Sasse on Mortality, Meaning, and the Future of America | Peter Robinson | Hoover InstitutionBen Sasse, a historian living with stage 4 pancreatic cancer, puts the grim math in plain language. The disease has a death rate of more than 97%, he says, and one reason is that the pancreas itself is not that important.
The pancreas makes digestive juices, but if it is not working well, Sasse says he has learned from his oncologists, most people do not have any immediate big problem. For context, that is different from organs where sudden failure causes an immediate crisis.
That makes the pancreas a good place to hide. Cancer, in his telling, is stealthy. It looks for somewhere it can linger unnoticed, and Sasse says it "can hide and linger in the pancreas" without setting off alarms.
Sasse says his own cancer was found only after it had already spread. In his case, it is in his liver and blood vessels, with many tumors in his spine that cause pain when he sits, moves, and talks.
That spread is why surgery cannot help him. Because he is so full of tumors, surgeons will not try to remove one tumor here or there. He says he is well past the surgical stage, which he calls a blessing in a way, because it ends the question of whether surgery could help.
So his treatment is an aggressive chemotherapy trial at MD Anderson. Chemotherapy, he says, is a polite word for poisoning. The puzzle is how to deliver the maximum amount of poison to the tumors without also poisoning himself to death.
The cancer stayed quiet in a place his body could ignore, until it had moved elsewhere. That silence is why it was found so late.
Questions people ask
What does the pancreas actually do?
The pancreas makes enzymes that help digest food and hormones, including insulin, that control blood sugar. People can live without it by taking enzyme pills and insulin, which is part of why a failing pancreas does not cause the kind of sudden emergency that heart or lung failure does.
Why is there no early test the way there is for other cancers?
Many cancers are found early because they cause bleeding, a lump, or organ trouble, or because there are routine screens like mammograms or colonoscopies. There is no widely used early screen for pancreatic cancer, so it is usually found only after it causes pain, weight loss, or problems in other organs where it has spread.
What does it mean that the cancer has metastasized?
Metastasis means cancer cells have broken away from the first tumor, traveled through blood or lymph, and started growing in new places. A liver or spine tumor that came from the pancreas is still pancreatic cancer, and once there are many such growths, removing one does not stop the others.