Pancreatic cancer is sometimes called a "silent disease" because there are few symptoms at its early stages. Often by the time symptoms appear, the cancer has spread and is difficult to treat. Now there's good news for those patients fortunate enough to discover their cancer at an early stage.
Pancreatic cancer is the growth of malignant cells in the pancreas, a pear-shaped organ located just below and behind the stomach. The pancreas makes digestive enzymes that flow through the pancreatic duct to the small intestine. These enzymes, along with bile from the gallbladder, break down food for use as energy by the body. The pancreas also makes insulin and glucagon, hormones that help regulate blood glucose (sugar) levels. Pancreatic cancer impairs the digestive process and may block the bile duct as it grows.
Pancreatic cancer is extremely difficult to diagnose and has usually spread by the time symptoms appear, so cures are uncommon. Now there's good news for those patients fortunate enough to discover their cancer at an early stage. A study published in the Annals of Surgery (Volume 246, pages 173 and 181) reports that patients who are treated with surgery for early pancreatic cancer have a 30% survival rate after five years, compared with less than 5% for people who don’t undergo surgery.
But nearly 40% of people with early-stage pancreatic cancer aren’t even offered the surgery by their doctors, according to the study. Researchers studied information from the National Cancer Data Base for 1995-2004. During that time, 9,559 people were diagnosed with pancreatic tumors that were potentially operable, but 3,644 of them (38%) were not presented with the option. Patients that were least likely to be offered surgery were over age 65, black, less educated, had lower incomes, were on Medicare or Medicaid, and were treated at small or community hospitals.
The authors say the underutilization of surgery may be due to lack of access to centers experienced in the procedure or to the long-held view that pancreatic cancer -- and surgery to treat it -- have poor long-term outcomes. However, mortality rates for the procedure have fallen from 25% in the 1960s to less than 3% at some high-volume centers today. The importance of offering and encouraging surgery for all people with early pancreatic cancer must be emphasized, since it is the best hope for long-term survival.
