On March 6, 2019, beloved “Jeopardy!” host Alex Trebek shared news that resonated deeply with millions: he had been diagnosed with stage 4 pancreatic cancer. This announcement placed him among the nearly 50,000 Americans who receive this diagnosis each year. In a video message to his fans, Trebek conveyed both the gravity of the situation and his unwavering resolve. “Normally, the prognosis for this is not very encouraging,” he admitted, “but I’m going to fight this, and I’m going to keep working.” He expressed his determination to defy the odds, fueled by the support of his family, friends, and the prayers of his viewers.
While the typical outlook for stage 4 pancreatic cancer is indeed challenging, Alex Trebek’s journey became an inspiring testament to resilience and the potential of modern treatments. He lived longer than many facing the same diagnosis, ultimately succumbing to the disease at his home on a Sunday morning, at the age of 80. From the day of his diagnosis to his passing, twenty months had passed. This timeframe became a focal point for those seeking to understand pancreatic cancer and the variables influencing survival.
Understanding Pancreatic Cancer: A Deadly Disease
“Pancreatic cancer is not among the most common cancers, yet it holds a grim position as the third leading cause of cancer-related deaths in the United States,” explains Dr. Marco Del Chiaro, MD, chief of surgical oncology at the CU Department of Surgery and CU Cancer Center member. This stark statistic underscores the aggressive nature of the disease. Dr. Del Chiaro further emphasizes the severity, noting, “Its incidence and mortality rates are almost mirroring each other, which means unfortunately almost everyone who is diagnosed with pancreatic cancer will die because of it. Projections from a few years ago suggest that by 2030, pancreatic cancer will ascend to become the second leading cause of cancer-related deaths globally. The trajectory is undeniably concerning.”
Marco Del Chiaro, MD
One of the primary reasons pancreatic cancer carries such a high mortality rate is its insidious nature. The pancreas, nestled deep within the abdomen, is difficult to examine routinely, and unlike some cancers, there are no readily available screening tests like colonoscopies to detect early-stage lesions or pre-cancerous conditions. Consequently, by the time noticeable symptoms manifest, the cancer often has reached an advanced stage. While advancements in treatments, including immunotherapy – the type of drugs Trebek received – offer hope, the overall survival rate for pancreatic cancer remains low. Only about 9% of those diagnosed survive for five years or more, with the majority succumbing to the disease within a year of diagnosis.
Dr. Del Chiaro acknowledges the progress made in treatment, stating, “The treatments available today are significantly more advanced than what we had even a decade ago. However, we are still not able to achieve full control over the disease in most patients.” He draws a parallel to colorectal cancer, where significant strides have been made, offering hope that similar breakthroughs are possible for pancreatic cancer. “We have made substantial progress in the last decade, but there is still a considerable journey ahead of us. In the past, a colorectal cancer diagnosis with liver metastasis was dire. Today, many of these patients experience long-term survival. We aspire to reach that point with pancreatic cancer, but there is still much work to be done.”
Alex Trebek: An Inspiration Amidst Pancreatic Cancer
Alex Trebek’s openness about his battle with pancreatic cancer transformed him into an unexpected beacon of hope for countless others facing similar diagnoses. He shared the realities of his treatment journey, the highs and lows, and the symptoms he experienced. Dr. Alexis Leal, MD, a CU Cancer Center member and assistant professor in medical oncology, highlights Trebek’s profound impact: “Patients that I have had with pancreas cancer have really looked to Alex and what he was going through. He’s really been a source of hope for them because he continued to work and he remained in the public eye.”
Alexis-Leal
Alt text: Dr. Alexis Leal, medical oncologist, discussing the impact of Alex Trebek’s openness about his pancreatic cancer journey.
Dr. Leal emphasizes that Trebek’s continued presence on “Jeopardy!”, even while undergoing treatment, resonated deeply with patients. “I think a lot of patients saw that as very hopeful as they were going through their own journey. It’s inspiring that he loved his work and was able to continue doing it while being so public about his experience.” He taped his final episodes of “Jeopardy!” in the weeks leading up to his death, a testament to his dedication and spirit.
Furthermore, Trebek’s willingness to discuss his participation in clinical trials significantly increased patient awareness and openness to these crucial research avenues. Dr. Leal notes, “Trebek’s openness about his treatment has made patients more aware of – and open to – clinical trials like the ones he was part of during his battle with the disease.” The CU Cancer Center, among others, conducts numerous clinical trials aimed at developing more effective pancreatic cancer treatments.
Advancements and Awareness in Pancreatic Cancer
Dr. Del Chiaro points to another area of progress: the understanding of pancreatic cysts and their potential to develop into cancer. Research into monitoring individuals with non-cancerous cysts may provide vital insights into the cancer’s development process. Currently, individuals with a family history of pancreatic cancer or specific genetic mutations, such as the BRCA mutation, are considered at higher risk and may undergo scans. However, widespread screening for the general population is not yet standard practice due to cost and the relatively low risk of cyst progression for most individuals.
“Pancreatic cystic lesions are quite common in the general population and are often discovered incidentally,” Dr. Del Chiaro explains. “Given the low risk of progression in most cases, population-wide screening for these lesions is not currently cost-effective. However, once a diagnosis of pancreatic cysts is made, surveillance is recommended for certain types, which can be instrumental in preventing pancreatic cancer in these patients.”
The CU Cancer Center exemplifies a comprehensive approach to pancreatic cancer care. Their multidisciplinary clinic brings together a team of up to 50 specialists, including surgeons, oncologists, pathologists, dietitians, and genetic counselors, to collaboratively develop individualized treatment plans for each patient. Dr. Del Chiaro underscores the importance of this specialized, team-based approach, stating, “It’s not just about surgically removing a pancreatic tumor. It’s crucial to determine the optimal timing and identify patients who will truly benefit from surgery. It’s about selecting the most effective treatment strategy for each individual and offering access to cutting-edge clinical trials, especially when standard treatments are no longer sufficient.”
He further highlights the impact of this multidisciplinary expertise: “We frequently see patients in our conferences who were previously told elsewhere that ‘nothing more can be done.’ They come to us and receive effective treatment. This isn’t necessarily because we have superior surgeons or oncologists individually, but because the entire team is highly specialized and focused specifically on pancreatic cancer.”
It is noteworthy that November is Pancreatic Cancer Awareness Month. Alex Trebek, in his final months, recorded a public service announcement to be aired during this month, emphasizing the importance of recognizing the warning signs of the disease. “I wish I had known sooner that the persistent stomach pain I experienced prior to my diagnosis was a symptom of pancreatic cancer,” he shared in the video. He also listed other common symptoms, including mid-back pain, unexplained weight loss, new-onset diabetes, and jaundice (yellowing of the skin or eyes).
Dr. Del Chiaro stresses the importance of seeking prompt medical attention if any of these symptoms arise, even amidst a pandemic. Trebek’s passing serves as “another reminder that cancer doesn’t pause for a pandemic. If individuals experience concerning symptoms or feel unwell, they should not delay seeking medical help due to COVID-related concerns. While the pandemic has placed limitations on hospital capacities and diagnostic resources, it’s crucial to remember that serious health issues beyond COVID exist. This is a vital message to keep in mind.”
Alex Trebek’s twenty-month journey after his pancreatic cancer diagnosis, while ultimately ending in tragedy, provided a powerful platform for education, hope, and advocacy. His story continues to resonate, urging increased awareness, research, and support for those affected by this challenging disease.
