Pancreatic cancer is one of the hardest cancers to treat because it often causes few clear symptoms in its early stages.
By the time it is discovered, the cancer may already have spread, making surgery and other treatments less likely to work.
The most common form is pancreatic ductal adenocarcinoma, or PDAC. It accounts for more than 90% of pancreatic cancer cases and begins in cells that line the small tubes that carry digestive juices from the pancreas.
Researchers at Boston Medical Center have found a possible early clue that could help doctors identify some people who need closer attention. Their research suggests that gallstones may appear more often shortly before a person is diagnosed with PDAC.
Gallstones are hardened pieces of material that form inside the gallbladder, a small organ below the liver. The gallbladder stores bile, a digestive fluid that helps the body break down fats.
Gallstones are common and can range from very small particles to much larger stones. Many people never know they have them, although gallstones can sometimes cause severe upper abdominal pain, nausea, vomiting, or inflammation.
For the study, the researchers examined medical records from more than 18,000 people diagnosed with PDAC. They compared them with records from nearly 100,000 people who did not have pancreatic cancer.
The difference between the groups was striking. During the year before their cancer diagnosis, about 4.7% of people with PDAC had been diagnosed with gallstones, compared with only 0.8% of people without cancer.
Gallbladder removal was also more common among the cancer patients. About 1.6% of people with PDAC had undergone the operation during the previous year, compared with about 0.3% of people in the comparison group.
Overall, people later diagnosed with PDAC were about six times more likely to have had gallstones during the year before their cancer diagnosis. The research was presented at Digestive Disease Week 2022, a major international meeting for specialists in digestive diseases.
Importantly, the findings do not show that gallstones cause pancreatic cancer. Instead, researchers believe that gallstones could sometimes be an early sign of changes in the body that are connected with an undiagnosed pancreatic tumor.
This distinction matters because gallstones are extremely common, while pancreatic cancer is much less common. Most people with gallstones will never develop pancreatic cancer, so having gallstones alone should not be viewed as evidence of cancer.
However, doctors may eventually be able to combine a new gallstone diagnosis with other information, such as age, unexplained weight loss, new digestive problems, blood test results, or unusual findings on medical scans. This could help identify a smaller group of people who may benefit from further testing.
Finding pancreatic cancer earlier is especially important because surgery offers the best chance of long-term survival when the tumor has not spread. Unfortunately, many patients are diagnosed only after surgery is no longer possible.
The Boston Medical Center researchers hope to study the connection further and identify other signs that could separate ordinary gallstone cases from those linked with hidden pancreatic cancer. More research is needed before gallstones can be used as a useful warning sign in routine medical care.
The study offers another possible path toward earlier detection of a cancer that has long been difficult to find. If researchers can identify reliable warning patterns before serious symptoms appear, doctors may have a better chance of finding PDAC when treatment can make the greatest difference.
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