Pancreatic Cancer

Actor Patrick Swayze, a famous pancreatic cancer patient.

Pancreatic cancer is insidious, often dubbed as "silent killer." It is difficult to treat since a majority of patients have advanced tumors by the time they tell doctors symptoms. It is interesting to know that atypical diabetes mellitus, glucose intolerance occuring in a thin older adult, precedes pancreatic cancer in many cases [Gastroenterology 2005 Aug;129(2): 504-11].

Common symptoms of pancreatic cancer are poor appetite, weight loss, bloating abdomen or abdominal pain, jaundice (yellow skin), change in color of stool.

When a patient presents with suspicious symptoms, a doctor may recommend a variety of diagnostic studies such as ultrasound, CT scan, ERCP, MRCP, endoscopic ultrasound (EUS), serum tumor marker CA 19-9. Staging laparascopy is also used to determine whether a tumor is resectable.

When a suspicious pancreatic tumor is seen on scan or ultrasound, doctors may recommend resection before an absolute diagnosis of cancer is established. However, some resected tumors may turn out benign, as in the case of U.S. Supreme Court Justice Ginsburg.

Surgical resection is the only curative treatment. However, only 15 to 20 percent of patients are candidates for surgery. The prognosis is poor even in patients with resectable cancer: the 5-year survival following surgery is about 10 to 30 percent. The use of adjuvant chemotherapy and radiotherapy may help some patients live longer after tumors are resected.