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Comment by jrapdx3 | Hacker News Reader

FWIW it's commonly the case with cancers of abdominal organs: stomach, pancreas, liver, kidney, etc. These cancers are frequently not diagnosed until at an advanced stage. Symptoms tend to be nonspecific, overlap with ubiquitous conditions like constipation, gastritis.

A goal of research is improving early detection of these cancers but it's an uphill battle. It's difficult to increase providers' "index of suspicion" of seemingly "minor" complaints.

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That’s a generalization, pancreatic cancer is often extremely lethal, depending on the type and case the survival rate can be as or more grim than glioma. Bowel and urinary cancers including kidney cancer are often very treatable and survivable when discovered due to symptoms. I don’t think it’s helpful to group all abdominal cancers as being uniquely or especially bad or late discovered. Likewise for the particularly aggressive or advanced cancers these types of announcements and trials rarely translate to major changes in prognosis. More typical if there is any positive result it looks like additional weeks or at best months of aggressive treatments rather than significant ”cure” rates.

It can be disappointing to see that even a successful drug, like this one, is "only" extending life expectancy from 6.7 months to 13.2. But this is what the first steps towards a cure look like.

Childhood leukemia used to be overwhelmingly fatal, and early chemotherapy trials also only managed a couple months of remission. Researchers were even criticized for subjecting patients to harsh side effects to no apparent benefit. But thanks to that research, most patients are now cured; per capita death rates from childhood leukemia are down 14x from the 1950s, mostly driven by improved treatment.

Daraxonrasib is an incredible invention on a technical level, and a meaningful step forwards in the treatment of many cancers. We'll need a couple more equally incredible inventions to be able to cure pancreatic cancer.

Moderna is testing an mRNA vaccine that might be useful against bladder and kidney cancers. Hopefully the same technology can be applied to pancreatic and liver cancers. Fingers crossed.

mRNA vaccines are being studied for pancreatic cancer. To quote a post I wrote in April:

> First, the personalized mRNA vaccine autogene cevumeran, developed by BioNTech and Genentech, just reported 6-year follow-up results from their Phase 1 clinical trial. 16 patients were treated, 8 were responders (showed signs of immune reaction to vaccine), 8 were non-responders.

> 7/8 responders (87.5%) survived 6 years after surgery, 2/8 nonresponders survived (25%).

> AACR meeting notes https://www.aacr.org/blog/2026/04/20/live-updates-from-the-a...

> The most important result in this small trial is that vaccine response is strongly correlated with better outcomes. But for context, the trial was restricted to patients with operable pancreatic cancer. Patients diagnosed with stage 1 or 2 pancreatic cancer have a 5-year survival rate of 12%. Patients who get their pancreatic cancer surgically removed have a 5-year post-surgery survival rate of 20%. This makes the overall 6-year post-surgery survival rate of 56% among the 16 trial patients pretty impressive. Keep in mind that the trial patients may have been healthier than average for other reasons, and small n is small n, so we shouldn't be too hasty until we see Phase 2 and 3 data.

> Source on survival rates https://www.pancreaticcancer.org.uk/information/just-diagnos...

Still early, unfortunately, so it will be a while before we see more updates.

We are able to early detect these cancers right now with routine targeted imaging. Perhaps we should be working to solve or improve on the drawbacks associated with doing this, some of which are:

CT scans emit ionizing radiation.

MRI contrast can buildup and be retained in the body over repeated administrations.

The scans can produce false positives, surface benign abnormalities which result in a wild goose chase, cause severe patient anxiety and healthcare burden, and result in over-treatment.

And of course doing this on a whole population level is not cost or time effective.

> And of course doing this on a whole population level is not cost or time effective.

It will never be cost or time effective if we never try. I'm paying out of pocket every year for an MRI scan, this was my second year this past year.

If you look at what practitioners and informed epidemiologists are saying the incidentaloma problem for any type of screening is huge and underestimated with no clear solution. It’s not only about finding and invasively testing benign masses, which can cause actual serious health problems (the associated anxiety and stress alone can actually kill, not to mention the cost and painful or damaging biopsies). But many true positive cancerous or malignant conditions can progress so slowly relative to the patient’s overall health that they do not shorten the patient’s life and/or the treatment may be worse than the “disease” that was detected. Hence why so many types of screenings that actually work can do positive harm for certain populations.

And once you find something with a screening you can’t unfind it. The patient or at least their doctor now has that knowledge and has to live with it and actively decide what to do about it.

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