Franklin defied odds of survival for pancreatic cancer

Aretha Franklin survived pancreatic cancer for nearly eight years before her death Thursday, defying the odds for one of medicine's most formidable opponents.

The prognosis for pancreatic cancer patients is different for each individual, depending on the type of pancreatic cancer they have and the stage when it's diagnosed. 

But the one-year survival rate for pancreatic cancer is about 20 percent, and the five-year survival rate is 7 percent, according to the Dr. Otis Brawley, chief medical officer for the American Cancer Society and a medical oncologist and epidemiologist at Emory University in Atlanta.

Close friends were reluctant to disclose details of Franklin's medical journey, out of respect for her privacy. She confirmed her diagnosis publicly in late 2010, and asked her audience for prayers following a free performance in Detroit in June 2017.

"I never asked her directly because she was not the type that would want it… she was very private," Greg Mathis, former Michigan 36th District Court judge, said of his friend's illness. "Ultimately it went into remission for some years."

Pancreatic cancer accounts for about 3 percent of all cancers in the United States and about 7 percent of all cancer deaths. The American Cancer Society estimates that about 44,330 people will die of pancreatic cancer in the U.S. in 2018.

The pancreas is a large glandular organ located behind the stomach and next to the small intestine. About six to eight inches long and a couple of inches wide, it secretes enzymes that help break down food, and produces insulin the body needs to regulate sugar and glucose levels.

Pancreatic cancer is rarely diagnosed at an early stage, Brawley said. The pancreas hides deep inside the body, so it's hard to see. And pancreatic cancer can grows secretively with few if any symptoms.

The pancreas has a unique anatomical feature that allows cancer to spread rapidly to other parts of the body.

"It does not have a fibrous outer covering the way the liver, the kidney, the colon and the uterus have," he said. "Other organs have this capsule, and the capsule can help keep the cancer confined for a time. 

"With pancreatic cancer we rarely find it localized. As soon as the tumor develops it’s starting to spread because the organ itself doesn’t have an outer capsule." 

Pancreatic cancers — like some lung cancers, brain cancers and colorectal cancers — are harder to treat than many others because they're caused by a mutation in a RAS gene.

These are from a family of genes that make proteins involved in cell-signaling pathways that control cell growth and cell death — and they don't respond to chemotherapy. Scientists are looking for ways to stop RAS-derived cancers, but progress has been slow, Brawley said. 

"Indeed, if we’re able to come up with a way to control the mutated RAS gene, that drug will be useful for pancreatic cancer, some of the lung and colon cancers, and brain tumors as well," Brawley said. 

Other scientists are trying to create drugs, called immunotherapy, that help the body's own immune system to attack cancer cells.  

Scores of researchers across the country are working to find cures for RAS-derived cancers like Aretha Franklin's, Brawley added.  And about 80 clinical trials are underway across the country.

"We have about 20 researchers working on pancreas cancer," said Nicole Fawcett, director of communications at the University of Michigan Rogel Cancer Center. "It's a very strong, robust program here."

In Detroit, Franklin faced her cancer journey with dignity, grace and courage, said Mathis. 

"One of the more interesting trips we had together was to a Pistons basketball game, and this was after her remission and the rumors were flying everywhere that she was on her death bed," Mathis recalled Thursday. "She wanted to make a point of walking from court-side to the top of the arena so whatever people may have thought, she disproved it.

"I would never ask, but I used to visit with her somewhat frequently, and I could kind of see a little decline over the last 12 months, I would say," Mathis added. "I never asked about anything because she didn’t like those questions."

kbouffard@detroitnews.com

@kbouffardDN