Aretha Franklin Died From Pancreatic Neuroendocrine Tumor, Not Pancreatic Cancer. There Is A Difference

When is pancreatic cancer not pancreatic cancer? The answer: when it Is a neuroendocrine tumor. And that’s a source of concern for me, especially in light of Aretha Franklin’s death.

A woman who enjoyed a very special place in the hearts of many in this country and throughout the world, her death was bound to be covered extensively in the media. For those of us who are concerned about these things, much of the coverage was frankly wrong in my opinion when it came to describing the disease Ms. Franklin suffered with for seven years.

You see, she did not have pancreatic cancer. Her tumor may have been located in the pancreas, but the cancer Ms. Franklin had was different: it was what we call a neuroendocrine tumor (NET). It is not the same as the typical pancreatic cancer.

The typical pancreatic cancer is almost always fatal, and unfortunately life is too frequently short following a diagnosis. NETs can be cured, or if extending beyond the pancreas can still be associated with a survival much longer than typical pancreatic cancer. The treatment is different, the outcome is different, the cure rate is different.

What has driven me to share these thoughts with you was an email I received today from an NET advocate, someone who has been in touch with me about this topic in the past. Her point was well taken:

“Mrs. Franklin in her own words in 2011 interview stated ‘I do not have pancreatic cancer’ which was an accurate statement then and now. If ever a case is to be made to define neuroendocrine cancer by its own terms and not under any other cancer’s subgroup…surely today makes that argument even stronger.”

Let me make this even more relevant to me personally:

I received a couple of interview requests yesterday to discuss pancreatic cancer research and treatment. That’s not unusual, especially when someone well known is diagnosed or dies from cancer. Like many of you, I thought Ms. Franklin had pancreatic cancer and that’s what the reporters wanted to talk about. Other time commitments prevented me from taking the requests. After the fact, I am glad I didn’t do those interviews. If I did do the interviews based on the information I had at the time, I would have provided wildly inaccurate information about Ms. Franklin and her illness, just like so many others did.

And what about people with pancreatic NET who are trying to get accurate information about their illness?

If you were someone who had a pancreatic NET and were told to look at information for “pancreatic cancer,” you would come away with a much different sense of diagnosis, treatment, and prognosis than you would have, had you looked at the right information. In my eyes, that is not appropriate.

I am happy to report that our medical editors at the American Cancer Society have given this some thought and agree that our web information needs to address pancreatic NET separately from pancreatic cancer.  So, a rewrite of our information on cancer.org about this tumor was already in the planning before the current news cycle.

Maybe it is time for all of us who communicate about cancer to increase awareness of what neuroendocrine tumors are all about. And maybe it’s time to be more accurate in the advice we offer and when we report on the cancer diagnoses and outcomes for people known to many of us.

As my friend said in her email:

“If ever an opportunity existed to dispel ignorance and medical confusion with regard to neuroendocrine cancer…would be the perfect opportunity and time to do it.”

For me, she makes an excellent point. There are a lot of memorials to Ms. Franklin. Maybe helping the public better understand the illness that she had could be one of them.

 

 


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J. Leonard Lichtenfeld's Biography

Dr. Len

J. Leonard Lichtenfeld, MD, MACP: Dr. Lichtenfeld currently serves as Deputy Chief Medical Officer for the American Cancer Society in the Society's Office of the Chief Medical Officer located at the Society's Corporate Center in Atlanta. Dr. Lichtenfeld joined the Society in 2001 as a medical editor, and in 2002 assumed responsibility for managing the Society's then newly created Cancer Control Science Department which included the prevention and early detection of cancer, emerging cancer science and trends, health equity, quality of life for cancer patients, the science of cancer communications and the role of nutrition and physical activity in cancer prevention and cancer care.  In 2014, Dr. Lichtenfeld assumed his current role in the Office of the Chief Medical Officer where he provides extensive support to a number of Society colleagues and activities. As a result of his over four decades of experience in cancer care, Dr. Lichtenfeld is frequently quoted in the print and electronic media regarding the Society's positions on a number of important issues related to cancer. He has testified regularly in legislative and regulatory hearings, and participated on numerous panels regarding cancer care, research, advocacy and related topics. He has served on a number of advisory committees and boards for organizations that collaborate with the Society to reduce the burden of cancer nationally and worldwide. He is well known for his blog (www.cancer.org/drlen) which first appeared in 2005 and which continues to address many topics related to cancer research and treatment. A board certified medical oncologist and internist who was a practicing physician for over 19 years, Dr. Lichtenfeld has long been engaged in health care policy on a local, state, and national level.  He is active in several state and national medical organizations and has a long-standing interest in professional legislative and regulatory issues related to health care including physician payment, medical care delivery systems, and health information technology. Dr. Lichtenfeld is a graduate of the University of Pennsylvania and Hahnemann Medical College (now Drexel University College of Medicine) in Philadelphia.  His postgraduate training was at Temple University Hospital in Philadelphia, Johns Hopkins University School of Medicine and the National Cancer Institute in Baltimore. He is a member of Alpha Omega Alpha, the national honor medical society.  Dr. Lichtenfeld has received several awards in recognition of his efforts on behalf of his colleagues and his professional activities.  He has been designated a Master of the American College of Physicians in acknowledgement of his contributions to internal medicine.  Dr. Lichtenfeld is married, and resides in Atlanta and Thomasville, Georgia.

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