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Pancreatic cancer metastasizes in the later stages of tumor development, according to a study published in the journal Nature (2010;467:1114). Study investigators from Johns Hopkins Medicine collected tissue samples during autopsies of seven patients who died from pancreatic cancer that had metastasized to other organs.

“The results of the study show that many pancreatic cancer cases have a long lag time before they are detected through conventional tests,” revealed Bert Vogelstein, MD, professor and director of the Ludwig Center for Cancer Genetics & Therapeutics at the Johns Hopkins Kimmel Cancer Center and an investigator at the Howard Hughes Medical Institute. Specifically, researchers found that in all patients, metastatic deposits were found in two or more sites in the body, most often the liver, lung, and peritoneum. In addition, similar mutations were found to be present in both the areas of metastasis and in the primary pancreatic tumors from which the metastasis arose.

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During their study, researchers were also able to identify and classify those mutations that had occurred before metastasis and those that had occurred after the cancer had spread.

To study the timing of pancreatic cancer progression, researchers used a mathematical model to estimate an average of 11.7 years before the first cancer cell develops within a high-grade pancreatic lesion, an average of 6.8 years as the cancer grows and at least one cell has the potential to spread, and an average of 2.7 years until a patient’s death.

“For the first time, we have a quantifiable estimate of the development of pancreatic cancer and when it would be best to intervene, so there is potentially a very broad window for screening,” said Christine Iacobuzio-Donahue, MD, PhD, associate professor of pathology and oncology at Hopkins’ Sol Goldman Pancreatic Cancer Research Center. ■