About pancreatic cancer
The pancreas, a pear-shaped gland about 6 inches long located behind the stomach and in front of the spine, has two basic functions. It produces digestive enzymes or juices that are secreted into the small intestine to help break down and digest food. This function is performed by the gland’s exocrine cells. The pancreas also produces hormones that regulate blood sugar levels, a task performed by its endocrine cells.
Pancreatic cancer is a disease in which malignant (cancer) cells appear in the pancreas. Approximately 90 to 95% of pancreatic cancers begin in the exocrine cells and are known as pancreatic ductal adenocarcinomas (PDAC), here referred to simply as PC.
The lack of early-stage symptoms, combined with the gland’s placement deep within the abdomen, make pancreatic cancer difficult to detect and diagnose before it has progressed to a serious health concern. Furthermore, symptoms tend to be similar to other illnesses, rather than pointing specifically toward PC.
Mortality rates have not improved
PC is thus a highly fatal disease and recent clinical developments have not resulted in improved survival; overall mortality rates have changed very little throughout the past three decades. Worldwide, PC is the eighth leading cause of cancer deaths in men (138,100 deaths annually) and the ninth in women (127,900 deaths). In the United States, it affects over 42,000 people and is the second leading cause of cancer death.
Furthermore, PC is usually only diagnosed at an advanced stage. Almost all patients presenting with the disease die from it; its 5-year survival rate is less than 4%. Fewer than 20% of patients are eligible for surgical resection (the removal of all demonstrable PC). This procedure generally improves survival benefit, but in the majority of cases does not translate into long-term 5-year survival. In other words, resection is rarely curative.
May become the second leading cause of US cancer deaths
The annual number of new PC cases in the United States is estimated to double from 43,000 to 88,000 between 2010 and 2030, and the adjusted number of deaths due to PC in that time period is expected to increase from 36,888 to 63,000. Because of rising incidence and poor survival, PC will probably become the second leading cause of cancer deaths in the United States by 2020. Radical improvement in 5-year PC survival is unlikely without a better means of earlier stage detection (and thus improved resectability rates) plus the development of more effective chemotherapeutic agents to prolong survival following resection.
The potential to improve overall survival via earlier detection of PC is thus clear. Moreover, the period between the appearance of detectable cancer lesions and the development of metastatic disease seems to offer the best window of opportunity for detection screening. For example, the median of two months between symptoms and diagnosis could be the difference between disease stages II and III and thereby result in significantly improved survival. Since the size of the primary lesion appears to correlate with long-term survival, diagnosis as early as possible in the tumour progression could reveal a lesion that is 100% curable. Furthermore, the introduction of a diagnostic test that is less invasive and less costly than the expensive imaging-based methodologies commonly used today offers additional opportunities to extend testing to a broader risk group population.
Five facts on pancreatic cancers
- The pancreas plays an important role to convert the food we eat to fuel. Its two main functions is to help in digestion and to regulate blood sugar, by for example releasing enzymes and the hormones glucagon or insulin.
- About 375 000 new cases of pancreatic cancer will be diagnosed worldwide in 2016.
- Complete surgical removal of the tumour is the only cure.
- Less than 10% of all diagnosed cases can undergo surgery to completely remove the tumour(s). About 60-80 percent of all patients with pancreatic cancer are inoperable.
- The average lifetime risk of pancreatic cancers for both men and women is about 1 in 65 (1.5 %). Each person’s chances of getting pancreatic cancers can be affected by certain risk factors, such as diabetes.