2024-04-05 17:00:00
Jean-Yves Le Fur, the businessman invested in the world of media who relaunched the legendary “Lui” with the writer Frédéric Beigbeder, died at the age of 59, on March 31.
The ex-husband of director and actress Maïwenn died of pancreatic cancer. This cancer remains among the most feared today.
An increase of 2% per year
In France, nearly 16,000 new cases were recorded in 2023, with an incidence increasing by approximately 2% each year. Nine out of ten pancreatic cancers diagnosed are “ductal adenocarcinomas”.
This means that they develop from the cells that produce pancreatic juice. These cells secrete essential digestive enzymes. The remaining 10% are rare tumors of the pancreas.
Between 1990 and 2018, the incidence rate of pancreatic cancer increased at an average rate of 2.7% per year among men and, more sustainably, by 3.8% among women.
The causes: still at the hypothesis stage
The reasons for the increasing incidence of pancreatic cancer are not completely understood. It might be due to better detection thanks to advances in imaging techniques, better recording of cases and probably an increase in well-demonstrated risk factors such as obesity, diabetes and smoking.
If chronic pancreatitis (inflammation of the pancreas) and genetic susceptibility factors contribute, all of these factors alone cannot explain the increase in incidence.
This is why researchers are exploring other avenues, notably radical lifestyle changes in the 1980s, such as the industrialization of food (additives, excess fats and carbohydrates, etc.).
Specific molecules like nanoparticles (titanium dioxide) might also play a role, as might the increased use of pesticides and heavy metals (cadmium) in food and water.
The trail of pesticides becomes clearer
Exposure to pesticides would be linked to an increased risk of pancreatic adenocarcinoma, according to two French studies presented at the congress of the French National Society of Hepato-Gastroenterology (JFHOD), in March 2024.
Although small in magnitude, this association is robust, especially with regard to three specific substances: mancozeb, glyphosate and sulfur spray.
For every 2.5 kg increase in pesticides per hectare over an 11-year period, the risk of pancreatic adenocarcinoma increases by 0.9 to 1.4 percent.
The use of pesticides is massive in France, where around 300 substances are authorized and where nearly 65,000 tonnes are applied each year, which places France at the top of consuming countries in Europe.
In addition, a second study concerned four other substances associated with an increased risk of pancreatic cancer. Although their use has been banned since the 1990s, they are still present in the soil and in the air!
The challenge: intervening at the localized stage
The increase in the number of pancreatic cancers is particularly worrying given the absence of truly effective treatment at the metastatic stage (50% of cases at diagnosis) or at the locally advanced stage (30% of cases). Surgery and chemotherapy (sometimes combined with radiotherapy) are the main treatments for pancreatic cancer.
This intervention involves removing the part of the pancreas where the tumor has developed (head, tail of the pancreas, etc.), and possibly neighboring organs or parts of affected organs.
However, it is only beneficial when the tumor is located only in the pancreas. Unfortunately, at the time of diagnosis, a minority of pancreatic cancers are operable (10% to 20%), a situation linked mainly to the silent and insidious evolution of the disease.
Indeed, as a general rule, pancreatic cancer develops without causing symptoms. Also, when the first manifestations occur (loss of appetite and progressive weight loss, jaundice, etc.) the tumor is often already very developed.
All stages combined, the 5-year survival rate is around 7%.
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