Pancreatic cancer: Symptoms, treatment, and prevention

Hard to detect and quick to spread, pancreatic cancer is among the deadliest of cancers. Scientists hope that genetic research will make it more like other cancers-a treatable disease. But even if it's caught while confined to the pancreas-and it rarely is-just 16% of patients are alive five years after the initial diagnosis. By comparison, the five-year survival rate for localized breast cancer is 86%. If the cancer has spread beyond the pancreas, the likelihood of living another five years is just 2%. Only the statistics for liver cancer are as grim.

Fortunately, pancreatic cancer is uncommon compared with other major cancers. About 50,000 new cases are diagnosed every year in the United States, in contrast to about 250,000 new cases of breast cancer, and 225,000 new cases of lung cancer. But because it's so untreatable, pancreatic cancer causes about 40,000 deaths each year. It is the 4th leading cause of cancer death.

No one knows exactly what causes pancreatic cancer. Like many cancers, it's an older person's disease - the median age at diagnosis is 71. Because Americans are living longer, there are more cases now than a half-century ago. Pancreatic cancer does run in families. Former President Jimmy Carter's father, brother, and two sisters died of the disease. Familial cases account for 5%-15% of the total.

Symptoms

Symptoms often include abdominal pain that radiates to the back and weight loss. Because the pancreas is near the spine, backaches are common. It sometimes causes people to itch all over their bodies. About 70% of pancreatic cancers start in what doctors refer to as the head of the pancreas, which is the bulbous end of the gland. The tumor can block the common bile duct, which drains the gallbladder and liver. As a result, the waste product bilirubin backs up and gets into the blood. This results in jaundice, yellow discoloration of the skin and the eyes.

Treatment

Surgery provides the best chance of cure. However, the surgeon discovers that even a localized tumor is inoperable. If the tumor can be cut out, the surgeon may remove all or part of the pancreas, as well as parts of nearby organs. Salvaging some of the pancreas is preferred because otherwise the patient must cope with a sudden loss of insulin production as well as a life-threatening cancer.

If the cancer is in the head of the pancreas, the surgeon may perform the Whipple procedure, a major operation that involves removing parts of the small intestine, bile duct, and stomach, in addition to the head of the pancreas. If the tumor is another part, surgeons may remove that part of the pancreas along with the spleen.

Prevention is the best medicine

But preventing the disease is by far the best course of action. Smoking is the clearest risk factor, so not lighting up is the surest prevention tip. After you've kicked the habit, in several years your risk becomes the same as if you never smoked.

Other ways to help prevent pancreatic cancer include maintaining a healthy weight, exercising regularly, limiting alcohol use, and eating a Mediterranean-style diet.