Sunday, February 8, 2009

Pancreatic Cancer Prognosis Is Grim

by Joanne Silberner

Supreme Court Justice Ruth Bader Ginsburg takes part in a swearing ceremony at the State Department.Supreme Court Justice Ruth Bader Ginsburg underwent surgery Thursday after being diagnosed with pancreatic cancer. In this January 2005 photo, she takes part in a swearing-in ceremony at the State Department in Washington.

Cancer of the pancreas strikes more than 38,000 Americans each year and kills 34,000, according to the National Cancer Institute. It's the fourth leading cause of cancer deaths in the United States.

Here's a bit more on this type of cancer:

What is the pancreas, and what's pancreatic cancer?

The pancreas is a 6-inch-long, pear-shaped organ wedged deep in the abdomen. It secretes digestive enzymes and insulin and other hormones. Cancer develops when defective pancreatic cells arise and multiply, crowding out healthy cells.

What's the typical prognosis?

There's no way around this: It's not good. The prognosis varies depending on the stage of the tumor at diagnosis, and whether the patient gets treatment such as surgery, chemotherapy and radiation. That said, about 5 percent of people diagnosed with pancreatic cancer are alive five years after diagnosis. It's a little better if the cancer is discovered when it can be removed. About 10 to 30 percent of people who have had surgery are alive five years after diagnosis.

Who can get surgery?

The cancer is discovered early enough for surgery in only about 1 in 5 cases. And the surgery itself is a difficult one. In various reports, death rates range from 1 to 16 percent.

Why is pancreatic cancer so lethal?

Early pancreatic cancer has few symptoms, so it tends to be discovered after it's already progressed. The cancer spreads easily out of the pancreas because the main functions of the pancreas are to produce enzymes and hormones that are pushed out into the bloodstream and digestive system. The cancer cells have easy access to the rest of the body.

Are there any good treatments?

Surgery, if the cancer is discovered in time, can add months or more to life. There are a number of chemotherapy and radiation treatments that extend life, as well. There are a lot of clinical trials of new drugs, some of which have been shown to extend life by weeks or months.

What are the risk factors?

Smoking. Obesity. Being over 60 years old. A history of colon cancer. A family history of pancreatic cancer, pancreatitis or certain rare genetic conditions. Jewish and black people are at a slightly higher risk. Chemists and coal, gas and metal workers are at higher risk as well.

What are the symptoms?

At first, there's very little — just mild abdominal pain. As the cancer progresses, there's more pain, jaundice, loss of appetite and depression.

Original here

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