Deaths due to pancreatic cancer on the rise
Pancreatic cancer is an extremely lethal cancer that is predicted by the National Cancer Institute to be the second leading cause of cancer mortality behind lung cancer by 2030.
By the time pancreatic cancer is diagnosed, the cancer has most likely spread to other organs, therefore, treatment is limited, making the only cure surgery.
However, approximately 15 percent of patients are eligible for surgical resection at the time of diagnosis, and with complete surgical removal, five-year survival can approach 25 to 30 percent.
The goal of doctors is to diagnose it at an earlier stage to adequately treat and provide a cure, and with newer advances in CT and MRI technology, hopefully this goal can be realized.
Who’s at risk?
Risk factors for pancreatic cancer including smoking, diabetes, obesity and a family history of pancreatic cancer.
The initial signs and symptoms of pancreatic cancer are often non-specific, making the diagnosis less apparent. Most patients present weight loss, new onset diabetes, jaundice and pain in the back, and often the pain is constant and not related to any other factors.
Treatment options
Surgery is the main treatment for pancreatic cancer because as we have become more successful in removing pancreatic carcinomas, we have been able to slightly improve survival rates.
Patients who are considered borderline resectable now can be adequately resected, which sometimes involves removing portions of the portal vein that leads to the liver.
Many surgical lessons are learned from liver transplantation that are applicable to pancreatic cancer, which has allowed physicians to be much more aggressive in their surgical approach.
Adjuvant therapy after surgical removal has a role in patients who have positive lymph nodes or positive resection margins. In those patients, they are usually considered for a combination of chemotherapy and radiation therapy.
The chemotherapy usually utilizes Gemcitabine or 5-FU – drugs used as radio-sensitizers to weaken tumor cells that may be present, which also allow radiation therapy to be more effective.
If patients are found to have the cancer spread outside of the pancreas, surgery cannot be performed and the only option is chemotherapy. Recently, a combination of drugs known as Folfirinox has also shown to improve survival rates, but not increase cure rates.
There are also many ongoing studies trying to improve long-term survival in patients, as well as trial with immunotherapy and vaccines attempting to trick the patient’s own immune system into fighting off the cancer.
Some of these are promising, however, clinical trials are just beginning and the results are not yet known.
Handling the diagnosis
If you are diagnosed with pancreatic carcinoma, it is important to go to a center that has expertise in treating the disease.
With surgical resection the only chance for a cure, it is important to seek out a center where surgeons perform this operation on a relatively routine basis because it has been show that if you are seen at a center that does more than 10 pancreatic resections per year the results are much improved.
In addition, I believe that if you are diagnosed with pancreatic cancer and are not deemed a surgical candidate, you may want to seek a second opinion. We have improved at being able to remove this cancer in patients who are considered borderline resectable.
Overall, the results continue to remain dismal for pancreatic cancer, but the goal is to be able to diagnose it much earlier.
If you notice symptoms that may be attributable to pancreatic cancer, seek a physician’s opinion.
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About the Author
Dr. John Brems‘ is the director of the Center for Advanced Liver and Pancreatic Care at Elgin-based Advocate Sherman Hospital and specializes in the surgical treatment of liver and pancreatic diseases. Over the years, he has performed thousands of liver transplants, major liver resections and liver-heart transplants. He helped create the center, which opened in 2011 and offers progressive procedures and techniques to treat a wide range of liver and pancreatic cancers and diseases.
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My mom died from pancreatic cancer and I am fearful of it. I would like to know more specifically about the early symptoms of it. My mom had a back problems for years; I would say 25 years prior to knowing she had pancreatic cancer. She even went thought back surgery.way back then. Another sign that we didn”t know at the time was a sign was that my mother had pancretitis 2 times. My brother also has pancreatitis a few times as well but he was a heavy drinker. We just laughed and thought that maybe this was from my mom’s past minimal drinking. She was never a heavy drinker but drank on occassion. I think now looking back that this was a sign that she was getting this disease the pancretitis. This was probably 15 years ago I think. The other signs as it got closer were dietary changes and a feeling of fulness after eating very little. She also got very picky about what she wanted to eat and there was hardly anything that could satisfy her appetite. She always had back pain so I never thought of that as a symptom; however, it was one. My mom also was a diabetic for many years prior to being diagnosed. She ending up with a tail in mass on her pancrease and it had already spread to her liver and lungs. She had been to Advocate’s urgent care a few time and they diagnosed it as a really bad blatter infection. I don’t know of anyone in her family dying of parcreatic cancer. Her uncle had some form of stomach cancer but I am not sure of exactly what they called it. He had his stomach removed is what I use to hear them saying not sure of exactly what that meat. He had a bag or something to catch his food. I would like to keep this topic alive and continue the conversations. The medical field needs to seariously reasearch statistics on this form of cancer. I looked at the statistics a year ago in comparison to other cancers and pancreatic research was only up by 2% in comparision to breast, lung, colon and all other cancers. Many of which were up by as much as 50% to 60%. They are saying by 2030 pancreatic cancer will be the 2nd leading cancer there is and they need to act like it and show some serious signs and strides in research. I lost my mom in a matter of approximately 2 weeks from the time of the pancreatic cancer diagnosis. I think that people that are diabetic and those that are severely obease should be tested for pancreateic cancer. After all, being diabetic has everything to do with the pancreas and insulin because it keeps the pancrease operating correctly. The problem is there are so many individuals that are diabetic throughout the would that they don’t want to take the time or should I say money to test them for this disease. As we all know everything is about dollars and sense. I am discussing this because I feel my mom’s life was cut short because of a lack of research, proper testings based on prior conditions and misdiagnosis. Please let us strive to fight this cancer that is so deadly and is taking the lives of innocent victims. HELP! HELP! HELP! HELP! HELP! HELP! HELP! HELP!
My husband was diagnosed last April. The only symptoms he had was a discomfort in mid section after eating, but not every day, nor every meal. We thought it might be colitis or something like that. He went to his primary Dr, who ordered a CT scan right away. In that we were lucky. It came back showing a mass and we went to an oncologist. He started the FU-5 chemo right away. After six treatments of that, we sought another Dr. Our surgeon did a laproscopy and found that the tumor had feelers around the iliac artery, and thus no surgery could be done. There were also very tiny nodes in diaphragm area, so no radiation either. He has been continuing with chemo, and the med cocktail has been changed twice since last year. He continues to have scans every three months, and we were told this is a slow growing tumor. For us, tumor staying same is good news. He has been fortunate in that he was in great health before this started, and has not had a lot of the side effects that others have gone through. It has not been easy, believe me, but a positive attitude and our faith in our God have helped, along with all the prayers of family and friends. We will continue on this journey until it ends, and we pray that trials, and new ways of treating this deadly disease will possibly come through or be FDA approved, before it is too late. Early detection is the key, before you have lost too much weight and energy to fight this disease.