Hello tmr1948,
I?m sorry to hear of your family member?s diagnosis. Learning that a
family relative has been diagnosed with cancer can put the entire
family into a tailspin. I?m pleased you want to know about this
disease, as an informed patient, or family member can make informed
medical decisions.
You may already know there are as many as 20 different types of
pancreatic cancer, and the form called ?adenocarcinoma? is the most
common, accounting for 75% of pancreatic cancer cases. Adenocarcinoma
is a type of non-endocrine malignancy and is the form most people
refer to when talking about pancreatic cancer. You did not mention
what kind of cancer you relative was diagnosed with, nor in which part
of the pancreas it is located, so this may not be the same kind.
Pancreatic cancer survival rates, as in most cancer survival rates,
depend on where in the pancreas the tumor started and whether the
disease has spread. When planning treatment and/or surgery, other
factors are considered, such as the patient's age and general health.
Before you read this, remember your relative has a very small cancer,
and one that has not yet spread. This increases patient survivability,
but overall, the statistics are not, I?m afraid very favorable. Also,
the statistics you mentioned from 1992 have not been greatly improved,
even in 2004. According to this Journal Of the Pancreas, September,
2003 ?The latest data on pancreatic cancer epidemiology were published
in 2002 by the American National Cancer Institute. It was confirmed
as the fifth leading cause of death from cancer, causing more than
24,000 deaths each year. The fact that nearly all patients die from
the disease within one year from the diagnosis was also confirmed,
similarly to 15 years ago A number of studies also confirmed the
association of chronic pancreatitis with pancreatic cancer
?http://www.joplink.net/prev/200309/200309_01.pdf
If your relative?s cancer is contained in the head of the pancreas, it
may be respectable (operable). Sadly, if the cancer is in the body or
tail of the pancreas, surgery would not increase survivability.
According to eMedicine : ?The vast majority of patients with
resectable disease have pancreatic cancer of the head of the pancreas.
Unfortunately, patients presenting with cancer of the body or tail of
the pancreas have almost uniformly unresectable disease at the time of
presentation and rarely survive over the long term, even if they
undergo resection? and ?The mean survival for patients with
unresectable disease remains 4-6 months, with a 5-year survival rate
of less than 3%.
The median survival for patients who undergo successful resection
(only 20% of patients) is approximately 12-19 months, with a 5-year
survival rate of 15-20%. Although discouraging, these results are
still markedly better than those for patients with unresectable
pancreatic carcinoma.?
http://www.emedicine.com/med/topic1712.htm
PubMed Central:
?Pancreatic cancer incidence and mortality virtually coincide having a
five-year survival of less than 5%. Surgical intervention is possible
in only about 10% of cases and adjuvant therapies are virtually
ineffective.?
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=149421
The Merck Manual
?Overall 5-yr survival is < 2%. If the tumor is localized to the head
of the pancreas (<= 2 cm), as occurs in only 10% of patients, a total
pancreatectomy or Whipple's operation (pancreaticoduodenectomy)
results in 5-yr survival of 15 to 20%. Adjuvant therapy with
fluorouracil (5-FU) and external beam radiotherapy after resection of
head cancers increases survival. Two-year survival is approximately
40% for patients who are treated with an attempted curative resection
and who receive adjuvant 5-FU plus radiotherapy?
http://www.merck.com/mrkshared/mmanual/section3/chapter34/34e.jsp
Pancreatic Cancer Action Network
Pancreatic Cancer Facts for 2003
? Approximately 30,700 people will be diagnosed with pancreatic cancer
this year in the United States and 30,000 people will die from the
disease.
? Pancreatic cancer has the #1 fatality rate of all cancers.
? Pancreatic cancer is the #4 cancer killer in the United States
amongst both men and women.
? The 99% mortality rate for pancreatic cancer is the highest of any cancer.
? Pancreatic cancer does not discriminate by age, gender or race and
only 4% of patients will survive beyond 5 years.
? The average life expectancy after diagnosis with metastatic (Cancer
that has the tendency to spread) disease is just 3-6 months.
? An estimated 33.1 million dollars was spent on pancreatic cancer
research in 2002 of the National Cancer Institute?s (NCI) cancer
research budget. This is just a mere 0.8 of 1% of the NCI?s 4.176
billion dollar cancer research budget for 2002.
? Despite the especially lethal nature of pancreatic cancer, the
research spending per pancreatic cancer patient is only $1092, the
lowest of any leading cancer.
? No effective early detection methods have been developed, there are
minimal treatment options available and very little research is under
way due to limited research funding.
http://www.pancan.org/Press/PR%20Dec%2010%2003.html
Cancer.gov
Scroll down to about the middle of the page:
?At this time, pancreatic cancer can be cured only when it is found at
an early stage, before it has spread. However, other treatments may be
able to control the disease and help patients live longer and feel
better. When a cure or control of the disease is not possible, some
patients and their doctors choose palliative therapy.?
http://www.cancer.gov/cancer_information/doc_wyntk.aspx?viewid=e70b3e33-2d56-4084-8ded-8336fe72d157#7
Cancer.org
?Even for those people diagnosed with local disease (has not spread to
other organs), the 5-year relative survival rate is only 17%.
Pancreatic cancer is unfortunately, a very grave disease. In all the
US there are only about 5500 people who are alive 5 years after the
diagnosis of pancreatic cancer.?
http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_are_the_key_statistics_for_pancreatic_cancer_34.asp?sitearea=
?Only about 20 to 40% of patients with adenocarcinoma of the pancreas
have a tumor that is confined to the pancreas at the time of
diagnosis. The 5-year survival for patients who undergo surgical
resection of adenocarcinoma of the pancreas is about 20 to 40%.?
http://www.surgery.usc.edu/divisions/tumor/PancreasDiseases/pancreas%20cancer%20overview.html
From eMedicine.com
According to eMedicine, worldwide, the country with the least
incidence of pancreatic cancer is India, with the highest being
African-American males. ?The incidence of pancreatic cancer in males
has been slowly dropping over the past 2 decades, while the incidence
in females has increased slightly. These trends probably represent the
effect of changing smoking rates for men and women.?
Unfortuately, eMedicine concurs with every other site I found about survival rates:
·Pancreatic carcinoma is almost uniformly fatal. Most patients succumb
to the consequences of metastatic cancer, and actual long-term cures
are very rare.
·Fewer than 5% of all patients are still alive 5 years after initial
diagnosis. The collective median survival of all patients is 4-6
months.
·In patients able to undergo a successful curative resection (only 20%
of patients), median survival ranges from 12-19 months, and the 5-year
survival rate is 15-20%.
http://www.emedicine.com/med/byname/pancreatic-cancer.htm
and http://www.emedicine.com/med/topic1712.htm
National Cancer Institute
?Pancreatic cancer is the fifth leading cause of cancer death in the
United States.Because it is usually diagnosed at an advanced stage,the
survival rate is poor compared to other types of
cancer.Unfortunately,there has been little
change in overall pancreatic cancer incidence or mortality rates
throughout the past three decades,with men being more vulnerable than
women.?
http://prg.nci.nih.gov/snapshots/Pancreatic-Snapshot.pdf
From The Age site, in Australia:
??survival rates were less than 10 per cent for people diagnosed with
mesothelioma, pancreatic cancer and liver cancer. Lung cancer has a
survival rate of 11 per cent.
"Unfortunately, cancers like these remain very difficult to treat," Dr
English said. "They are either very aggressive, or by the time they
are detected are advanced or have spread to other parts of the body."
http://www.theage.com.au/articles/2003/12/10/1070732282479.html?from=storyrhs
Treatments for Pancreatic Cancer Site:
?If the tumor is confined to the pancreas when diagnosed, surgical
removal of the diseased tissue is the only possible cure. However,
only ten to fifteen percent of all adenocarcinomas are localized when
detected. If surgery is an option, five-year survival rates are only
fourteen percent.
If surgery is not an option, life expectancy drops to less than six
months. The average five-year survival rate for all pancreatic
carcinomas is four percent.?
http://www.treatments-for-pancreatic-cancer.com/
Siteman Cancer Center
?For example, the major operation for pancreatic cancer patients is
the intricate Whipple procedure, which involves removal of the
pancreas, a portion of the stomach, the duodenum, common bile duct and
gallbladder. Surgeons in the hepatobiliary pancreatic surgery section
at Barnes-Jewish Hospital performed 55 Whipple procedures in 1998 and
75 in 1999. And in the past 125 Whipples, there has not been a single
death. The mortality rate for the 60 liver resections they do each
year is also very low ? just 1 percent.? And ?The five-year survival
rate for resected pancreatic cancer has also risen ? from 5 to 10
percent to 20 or 25 percent.?
http://www.siteman.wustl.edu/patient/specialized_cc/gastro_treatment2.shtml
The Whipple Procedure is the gold standard in pancreatic tumor
surgery, and is performed at these 4 hospitals:
Beth Israel Deaconess Hospital, 330 Brookline Ave., Boston, MA 02215
617-667-7000
http://bidmc.harvard.edu/default.asp?node_id=1391
Johns Hopkins Medical Center, 720 Rutland Ave., Baltimore, MD 21205
http://pathology2.jhu.edu/pancreas/surgery.cfm
USC/Norris Cancer Hospital, University of Southern California, 1450
San Pablo Street,
DEI 2510, Los Angeles, CA 90033
Phone (323) 442-2830
Fax (323) 442-2832
http://www.usc.edu/hsc/info/pr/ccr/ccrspring2002/keyhole.html
University of Southern California, 1510 San Pablo St, Los Angeles CA 90033
Phone:1-323-442-5837
e-mail: PancreasDiseases@surgery.usc.edu
http://www.surgery.usc.edu/divisions/tumor/PancreasDiseases/index.html
The Whipple Procedure, from the USC site:
?In the Whipple operation the head of the pancreas, a portion of the
bile duct, the gallbladder and the duodenum is removed. Occasionally a
portion of the stomach may also be removed. After removal of these
structures the remaining pancreas, bile duct and the intestine is
sutured back into the intestine to direct the gastrointestinal
secretions back into the gut.?
http://www.surgery.usc.edu/divisions/tumor/PancreasDiseases/web%20pages/pancreas%20resection/whipple%20operation.html
From this Cancer-Info site, last updated on 9/4/02,
?STAGE I PANCREATIC CANCER
Your treatment may be one of the following: 1. Surgery to remove the
head of the pancreas, part of the small intestine, and some of the
surrounding tissues (Whipple procedure). 2. Surgery to remove the
entire pancreas and the organs around it (total pancreatectomy). 3.
Surgery to remove the tail of the pancreas (distal pancreatectomy) for
tumors in the tail of the pancreas. 4. Surgery followed by
chemotherapy and radiation therapy. 5. Clinical trials of radiation
therapy with or without chemotherapy given before, during, or after
surgery. ? and ?Of the 29,000 Americans who this year will learn they
have pancreatic cancer, all but 100 will die within 12 months of
diagnosis. While pancreatic cancer is the fifth leading cause of
cancer death in the United States, it is one of the least well-funded
areas of cancer research. ?
http://www.cancer-info.com/pancreas.htm
Additional Resources:
Cancer.gov has very good explanations and illustrations on this site:
http://www.cancer.gov/cancer_information/doc_wyntk.aspx?viewid=e70b3e33-2d56-4084-8ded-8336fe72d157
Lustgarten Foundation
http://www.lustgartenfoundation.org/
PanCan
http://www.pancan.org/
Pancreatic Surgical Techniques, from USC
http://www.surgery.usc.edu/divisions/tumor/PancreasDiseases/web%20pages/pancreas%20resection/ORGAN%20PRESERVATION.html
From Cancer.gov, these questions to ask the doctor before treatment:
These are some questions a person may want to ask the doctor before
treatment begins:
·What is the diagnosis?
·Where in the pancreas did the cancer start?
·Is there any evidence the cancer has spread? What is the stage of the disease?
·Do I need any more tests to check whether the disease has spread?
·What are my treatment choices? Which do you recommend for me? Why?
·What are the expected benefits of each kind of treatment?
·What are the risks and possible side effects of each treatment?
·What is the treatment likely to cost? Is this treatment covered by my
insurance plan?
·How will treatment affect my normal activities?
·Would a clinical trial (research study) be appropriate for me?
http://www.cancer.gov/cancer_information/doc_wyntk.aspx?viewid=e70b3e33-2d56-4084-8ded-8336fe72d157#7
Pancreatic Cancer Vaccine, from Johns Hopkins
?This cancer vaccine, unlike vaccines for childhood infections, is a
vaccine used to treat existing disease. Pancreatic cancer must already
have been diagnosed for this vaccine to work. The vaccination causes
an immune response that targets the pancreatic cancer. We can think of
this as a battle between the immune system and the pancreatic cancer.
In order to evaluate the effectiveness of the vaccine, a phase 2
clinical trial began in October of 2001 and is still ongoing. As much
as we would like to offer the vaccine to everyone, eligibility
criteria had to be established for this study. Patients with
adenocarcinoma of the pancreas who have surgery at Johns Hopkins
Hospital to remove their pancreatic cancer and who have no clinical
evidence of spread of the cancer outside the pancreas are eligible for
this study. Patients with bile duct cancer or neuroendocrine tumors or
islet cell cancer are not eligible.?
http://pathology2.jhu.edu/pancreas/vaccine.cfm
Where can Pancreatic Cancer Spread? From Johns Hopkins:
http://pathology2.jhu.edu/pancreas/mets.cfm
American Cancer Society: What?s New in Pancreatic Cancer Research and Treatment?
http://www.cancer.org/docroot/CRI/content/CRI_2_4_6X_Whats_new_in_pancreatic_cancer_research_and_treatment_34.asp?rnav=cri
Cancer Treatment Centers of America
http://www.cancercenter.com/pancreatic-cancer/biotherapy-immunotherapy.cfm
University of Texas, Survivor Story
http://www.cancerwise.org/November_2000/
Another personal story
http://www3.mdanderson.org/DEPARTMENTS/pancreatic/Patient%20Profiles/Rusty's%20Story.htm
Survivability Predicting
http://cancerguide.org/median_not_msg.html
Hope for the future
?Additional therapies, such as a combination of chemoradiation and
immunotherapy techniques, are currently being investigated as a way of
increasing survival rates for people with pancreatic cancer.
Similarly, new developments in the field of molecular genetics may one
day help detect the cancer at an earlier stage in its development,
allowing earlier surgical intervention and higher survival rates.?
http://www.mydr.com.au/default.asp?article=3381
To summarize, tmr1948, no one can precisely predict survival rates for
a cancer patient. The data, even in 2004, all suggests that the 5-year
survival rate is still only 17%.The fact that the existing cancer is
small, seems to be a Stage 1, and has not spread may prove positive in
your family member?s survival rate.
I do not like to be the bearer of such news, tmr1948, but I hope you
have found the information I have presented useful. If any part of my
answer is unclear, please request an Answer Clarification, and I will
be happy to assist you further, if possible. I wish you all the best
with your relative.
Sincerely,
crabcakes-ga
Search Terms
Mortality rates pancreatic cancer
Pancreatic cancer survival rates 2003
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