Written By Tony Subia
March 2, 2017
Updated October 6, 2018
Pancreatic Cancer is the Most Brutal of Cancers
For decades the average 5-year average survival rate for cancer of the pancreas was barely 5% or less. Today (2018) the rate hovers around 8.5%. Yes it is an improvement, but still the overwhelming worst of all tumor-type cancers. To put that dismal statistic in perspective to other more well-known cancers, the average 5-year survival rate for female breast cancer is 89.7% which is over 10 times better than pancreatic cancer. Pancreatic cancer is now the third leading cause of cancer deaths trailing only Lung and Bronchus Cancer and Colorectal Cancer.
Survival rate is generally determined by the specific Cancer Stage at diagnosis. The stage at discovery determines treatment options and has strong influence on length of survival. In the case of pancreatic cancer, about 75% of patients will die within a year after diagnosis.
How Crucial is Early Detection?
Although the average 5-year survival rate is about 8.5% across all pancreatic cancer stages, the earlier the diagnosis is made, the greater the influence on length of survival becomes and it can be quite significant. Following are approximate averages of 5-year survival when diagnosed at various stages per the National Cancer Institute as of 2014 data.
1. 34.3% WHEN TUMOR IS LOCALIZED. CONFINED TO THE PANCREAS
2. 11.1% WHEN TUMOR HAS SPREAD TO REGIONAL LYMPH NODES
3. 2.7% AFTER SPREADING TO DISTANT ORGANS SUCH AS THE LIVER, LUNGS, STOMACH, OR BRAIN
Notice that when diagnosis is made when the tumor is localized within the pancreas, the average rate of surviving 5-years is 0ver 11 time greater versus diagnosis when the cancer has metastasized (spread to distant organs). Unfortunately only about 9% of cases are detected at stage 1 (tumor is confined to the pancreas).
Why are pancreatic cancer survival rates so low? There are several reasons:
1. There are no easy early detection methods.
2. Signs and symptoms are vague and usually don’t become obvious until the cancer has already spread.
3. Misdiagnosis by general practitioners that may not even consider the possibility of pancreatic cancer.
4. Doctors don’t spend enough time with the patient asking the right questions or querying family history of cancer.
5. People ignore symptoms until it’s too late.
6. People are not vigilant or not assertive with their doctors when they suspect cancer of the pancreas
A Few Facts About Pancreatic Cancer
In the latest 2018 government statistics, although pancreatic cancer ranks 11th in the number of 2018 projected new cases at 55,440, it is 3rd in projected annual deaths of 44,330 which trails only Lung and Bronchus Cancers at 154,050 and Colorectal Cancers at 50,630. Pancreatic Cancer has surpassed Female Breast Cancer in projected annual deaths 44,330 versus 40,920.
Summary Highlight Cancer Statistics (SEER 2014)
TUMOR-TYPE COMPARATIVE AVERAGE 5-YEAR SURVIVAL RATES
Lung : 18.6%
Esophageal : 19.2%
Brain and Nervous System Related Cancer: 33.2%
Colon and Rectum : 64.5%
Kidney and Renal Pelvis: 74.5%
Bladder : 76.8%
Breast (female) : 89.7%
Prostate : 98.2%
Although pancreatic cancer only represents 3.1% of cancer cases, it ranks 3rd in cancer deaths.
Notice that the average 5-year survival rate of Female Breast Cancer is over 10 times that of Pancreatic Cancer. 89.7% versus 8.5%. Read: “Should Purple Become The New Pink?”
NON-TUMOR CANCER 5 -YEAR SURVIVAL RATES
Acute Myeloid Leukemia: 27%
Acute Lympohocytic Leukemia: 68%
Chronic Myeloid Leukemia: 68%
Non-Hodgkin Lymphoma: 71%
Chronic Lymphocytic Leukemia: 84%
Hodgkin Lymphoma: 87%
How Can We Triple The 5-Year Average Survival Rate of Pancreatic Cancer?
Pancreatic cancer is often called the “silent cancer”. Although is the most brutal of cancers, its early symptoms are relatively “light” and common to many non-serious illnesses. Often mistaken for acid reflux, or a minor stomach ache. Frequently there are no noticeable symptoms at all until the cancer has already spread to other parts of the body and subsequent treatments are only palliative rather that curative. Surgical removal of pancreatic malignant tumors can generally only be considered while the cancer is still fully contained within the pancreas.
Unfortunately only 10% of cases are diagnosed while confined to the primary site, the pancreas. This is the primary reason why the 5-year “average” survival rate is only 8.5%.
Pancreatic cancer is often called a “silent disease” for a reason. It is usually not diagnosed until the later stages when the cancer is too advanced to cure. It’s often said that pancreatic cancer causes no symptoms in its early stages, but some experts believe lack of symptoms isn’t the problem…… it’s lack of recognition of the symptoms. The failure to consider pancreatic cancer as a possible diagnosis by general practitioners also contributes to the poor survival rate.
Advice for Health Care Practitioners
Every health practitioner should keep cancer of the pancreas in mind when evaluating patients with non-specific symptoms, especially those involving the digestive tract, which have no other explanation. With early diagnosis of pancreatic cancer, the dismal average 5-year survival rate could be tripled when patients lead more healthy lifestyles, are acutely aware of the symptoms, know the risk factors, are aware of their family history of cancer, and being more assertive with physicians to prescribe C-Scans when pancreatic cancer is a suspect. BECOME YOUR OWN BEST ADVOCATE.
Signs and Symptoms All Health Care Providers Should Be Aware Of
If you question patients diagnosed with pancreatic cancer after the fact, you’ll discover a number experienced non-specific symptoms, such as loss of appetite, vague abdominal discomfort or fatigue for weeks to months before their diagnosis. Some pancreatic cancer sufferers describe changes in food preferences and suddenly find foods they previously enjoyed are unpalatable. Some health care practitioners brush these symptoms aside and attribute them to stress or a digestive condition like acid reflux or irritable bowel.
Unfortunately, some practitioners fail to consider the possibility of pancreatic cancer until patients report obvious “red flag” symptoms like jaundice, acute abdominal pain, floating stools or substantial weight loss appear. At this stage, the cancer is usually advanced. Are practitioners missing out on an opportunity to diagnosis pancreatic cancer early, when it’s potentially curable?
It’s important to carefully consider a patient’s personal medical history and family history when patients present with vague digestive symptoms. Some people are at high risk for pancreatic cancer based on genetics. According to the American Cancer Society, as many as 10% of pancreatic cancers are related to genetic factors. If a patient has one or more past or present family members with pancreatic cancer or a strong family history of cancer, it’s vital to keep the diagnosis in mind, especially if a patient has non-specific symptoms with no other known cause. The persistent “heartburn” that a patient is experiencing may actually be an undiagnosed pancreatic cancer.
Recent onset diabetes should raise suspicions in some patients. According to a study published by Mayo Clinic, 4 out of 10 patients with pancreatic cancer were diagnosed with diabetes a year or two before their cancer diagnosis. Experts believe the onset of diabetes in some patients may be related to an undiagnosed pancreatic malignancy. New onset diabetes in combination with other non-specific symptoms like digestive issues or weight loss should raise a red flag.
No health practitioner wants to order unnecessary tests, but any of the symptoms listed above that have no other explanation, especially in people at high risk factors for pancreatic cancer, deserves an imaging study. Many pancreatic cancers can be detected with CT scanning or MRI. ERCP is a more invasive option for visualizing a pancreatic tumor.
Preventing Future Pancreatic Cancers
What about people at high risk genetically? Patients who have a strong family history of cancer may benefit from genetic testing. A relatively recent test called an endoscopic ultrasound may be a useful screening tool for patients at very high risk for pancreatic cancer. Unfortunately, blood tests, including CEA and CA 19-9, that measure levels of proteins that rise in people with pancreatic cancer, aren’t sensitive enough to detect pancreatic cancer in its early stages.
Remember, not all patients who have pancreatic cancer have known risk factors for the disease. These are the folks most likely to “slip through the cracks” and be diagnosed at a late stage.
What about patients who don’t have pancreatic cancer but are at high risk for it based on family history? Some evidence suggests that eating a diet rich in fruits and vegetables, limiting red meat, not smoking, avoiding excessive alcohol, staying physically active and maintaining a healthy weight can lower the risk for pancreatic malignancy. At the very least, doing these things has other potential health benefits and should be recommended to patients at risk for pancreatic cancer.
The Bottom Line
Together we can triple the 5-year survival rate. Be more aware of pancreatic cancer symptoms. Know the risk factors. Be assertive with your general practitioners. If you have multiple symptoms, fit the risk factors profile, and particularly if cancer runs in your family, demand an imaging procedure. Please share this article with others. It may save a life. The Seena Magowitz Foundation will continue to raise crucial funds that will arm medical researchers with the tools they need to find methods of early detection, to extend quality life, and ultimately one day a cure and prevention of this dreadful disease.