– I was a little shocked when I was told that I had pancreatic cancer. In autumn 2019, Trond Niemi was diagnosed with pancreatic cancer. A type of cancer where only 15 percent of patients survive after five years. On average, patients live only one year after receiving the diagnosis. Pancreatic cancer is considered the fourth deadliest type of cancer. – I was advised by the cancer nurse not to Google the disease, and I actually didn’t do that. But eventually I heard from others about the poor prognosis. Trond Niemi discovered the cancer at an early enough stage. Now he is checked regularly to see if the cancer has returned. Photo: Åse Karin Hansen / news – I am an optimist by nature, and thought that a hundred out of a thousand would survive. Then it became a little easier to believe that this would go well, says Niemi. He was lucky, because he had not spread to other organs in the body. He had an operation to remove the pancreas, and is now healthy. The problem for patients who get this type of cancer is that it is detected far too late to be cured. The disease has few and non-specific symptoms. When it is useless to operate on the pancreas because the cancer has spread to other organs, only palliative and life-prolonging treatment is given. Little traces in the blood In Stavanger, there is a group of researchers who want to do something about both the life-extending treatment and the possibility of detecting the type of cancer earlier. The answer lies in the blood. – We have taken samples from the patient every month during treatment to monitor the level of cancer DNA, says Professor Oddmund Nordgård. Photo: Erik Waage / news – We have had a breakthrough in our research, and we have made discoveries that we believe can extend the lives of patients, says Professor Oddmund Nordgård at Stavanger University Hospital. Together with the rest of the researchers, he has again found the genetic material or DNA of the cancer cells in the blood. Among other things, it shows whether the treatment is working. – If the treatment works, the level of cancer DNA decreases. If that doesn’t work, the level increases. Today, there are two types of treatment for patients with pancreatic cancer with spread. If one does not work, the other can be used. With the help of the blood tests that the researchers have now developed, it can be discovered earlier whether the treatment given is working or not. – We can detect whether the tumor is growing a few months earlier than with X-rays or diagnostic imaging. This means that we can change treatment earlier. It saves the patient both unnecessary side effects and prolongs life. Finding cancer DNA in the blood is not easy. Compared to the DNA found in the blood cells, the level of cancer DNA is microscopic. It can be as little as one part per thousand of all the DNA in the blood. Thousands of blood samples in the research project are stored in freezers that hold minus 80 degrees. The temperature cannot be higher if the quality of the samples is to be maintained. Photo: Erik Waage / news Using sensitive methods and new technology, Nordgård and the researchers have managed to find the cancer DNA. It’s almost like looking for a needle in a haystack. – It is very exciting and very meaningful. We are working on research for a patient group with very poor survival, says Nordgård. Detective work Pancreatic cancer is not the most researched type of cancer. An overview from the American National Cancer Institute from 2018 shows that only 5 percent of the funds went to this type of cancer. – We hope to contribute to providing a better quality of life and a longer lifespan for the patients who are affected, says project manager Bjørnar Gilje. Photo: Erik Waage / news – I think it is because there is little treatment to offer. It is difficult to find good studies that can really mean something. That is part of the reason why we have taken a great interest in analyzing blood both to detect the cancer earlier and to follow the treatment further, says project manager for the study, Bjørnar Gilje. He is also senior physician at the department for blood and cancer diseases at Stavanger University Hospital. There, he sees at close range how much pain comes with such a diagnosis for the patient and family. – If we can contribute with treatment that is slightly better, produces fewer side effects and provides a longer lifespan, then that is very satisfying. – Are you a bit like detectives? – There are many elements in blood. I think we will use blood tests to a much greater extent in the future. New technology provides new ways of looking for many types of cancer. Enjoying life Now further research is to be done. Because last autumn they received NOK 8 million from the Norwegian Cancer Society. Among other things, they hope to find a method to detect the cancer earlier. Also this time through blood samples from cancer patients, healthy control subjects and people at high risk of developing pancreatic cancer. – We will collaborate with researchers from Oslo and Bergen. We will do further research on the treatment effect of what we have found so far, but we will also see if there are signs of cancer in people at risk, i.e. detect the cancer earlier, says Nordgård. At Ålgård, Trond Niemi is back in full time work as assistant principal at Gjesdal secondary school. Without the pancreas, he has to take insulin and enzymes for the rest of his life, but otherwise he is healthy. He goes for a check-up at Stavanger University Hospital every six months. When Trond Niemi goes for a check-up at Stavanger University Hospital, he is photographed in a CT with contrast liquid. Photo: Åse Karin Hansen / news – I have been lucky and had few after-effects of chemotherapy. Now I enjoy every day. – What do you think about the research that is now being done at Stavanger University Hospital? – I think it’s fantastic that there are people who dedicate their professional lives to this. The research shows that progress is being made in all types of cancer.
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