Our Approach To Pancreatic Cancer
Johns Hopkins pancreatic surgeons perform a variety of innovative techniques to treat pancreatic cancer, including operations using both traditional open methods and minimally invasive methods. During one appointment at our multidisciplinary clinic, patients will meet with experienced specialists who will care for them at every stage of the journey.
Pancreatitis And Pancreatic Cancer
Pancreatitis is an inflammation of the pancreas that can be acute or chronic and induces pancreatic damage because the activation of digestive enzymes occurs before they are released in the small intestine and consequently, they attack the pancreas.
Recurrent bouts of acute pancreatitis can cause glandular damage and lead to chronic pancreatitis by inducing a progressive, destructive inflammatory process that ends in the total destruction of the pancreas and results in malabsorption of dietary nutrients, diabetes mellitus and severe, unrelenting pain .
In recent decades, accumulating evidence has defined that longstanding pre-existing chronic pancreatitis as a strong risk factor for pancreatic cancer . However, only 1.8% of these patients will develop pancreatic cancer within 10 years from the diagnosis and 4% after 20 years . A considerable proportion of cases of pancreatitis is thought to be a consequence of pancreatic tumor-related ductal obstruction , indicating that this condition can be either a risk factor or a sign of early disease.
The association between long-standing chronic pancreatitis and cancer has now been established. Pancreatic cancer develops in the setting of chronic pancreatitis from all known etiologies but appears to require 30 – 40 years of inflammation before an appreciable percentage of patients develop pancreatic cancer.
What Are The Pancreatic Cancer Survival Rates
With that in mind, here are some of the most recent statistics regarding the survival rates of pancreatic cancer:
- The overall five-year survival rate for Pancreatic cancer is 7.2%
- Looking only at pancreatic cancers that have not spread beyond the pancreas , the survival rate is 27.1%.
- For cancers that have spread, but only to nearby areas , the survival rate is 10.7%.
- For cancers that have spread beyond that , the survival rate is 2.4%
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Survival For Pancreatic Endocrine Tumours
Pancreatic endocrine tumours are an uncommon type of pancreatic cancer. More recently doctors have been calling them neuroendocrine neoplasms . This is an umbrella term for this group of disorders. Then they are called either neuroendocrine tumours or neuroendocrine carcinomas . This depends on how slow or fast growing the cells are.
They generally have a better outlook than adenocarcinoma of the pancreas.
1 year survival
The information below is for 1 year overall survival for pancreatic neuroendocrine neoplasms in the UK.
Around 80 in 100 people survive for 1 year or more.
5 year survival
There are no UK-wide 5 year survival statistics available for pancreatic NENs. The statistics below are from a European study. Please be aware that these figures may not be a true picture of survival in the UK. This is due to differences in health care systems, data collection and the population,
Around 40 out of 100 people survive their cancer for 5 years or more after diagnosis.
British Journal of Cancer Volume 121, pages 966972
Living As A Pancreatic Cancer Survivor
For some people with pancreatic cancer, treatment can remove or destroy the cancer. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer coming back. This is very common if youve had cancer.
For many people with pancreatic cancer, the cancer might never go away completely, or it might come back in another part of the body. These people may get regular treatments with chemotherapy, radiation therapy, or other therapies to help keep the cancer under control for as long as possible. Learning to live with cancer that does not go away can be difficult and very stressful.
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Who Dies From This Cancer
Because survival is poor, the population distribution of people who die of pancreatic cancer is similar to that of people who are diagnosed with the disease. In part because it is difficult to detect early, the average survival time from pancreatic cancer is low. Pancreatic cancer is the third leading cause of cancer death in the United States. The death rate was 11.1 per 100,000 men and women per year based on 20162020 deaths, age-adjusted.
Death Rate per 100,000 Persons by Race/Ethnicity & Sex: Pancreatic Cancer
What Is Locally Advanced Pancreatic Cancer
Locally advanced pancreatic cancer is considered stage 3 cancer. It is cancer that has spread beyond the pancreas, typically to large blood vessels near the pancreas or to nearby lymph nodes. In most cases, the cancer is too advanced to be fully removed. Treatment for locally advanced pancreatic cancer is highly individualized based on the patients overall health, tumor spread and personal desires, but may include:
- Surgery to remove a portion of the tumor
- Chemotherapy or radiation therapy to slow the spread of cancerous cells and provide symptom relief
- Clinical trials
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What Is The Outlook For Pancreatic Cancer
Over the past decade, the five-year survival rate for pancreatic cancer patients increased from 6% to 11%.2 There is an urgent need to improve survival even more. But this increase shows that progress is being made. Those five percentage points mean that 11 people out of 100, instead of six people out of 100, will be alive five years after their pancreatic cancer diagnosis.
The Pancreatic Cancer Action Network is working toward better treatment options for pancreatic cancer patients and ways to find the disease earlier. We are determined to improve patient outcomes today and into the future. Contact PanCAN Patient Services for resources, support and information.
For More Information See Pancreatic Cancer On The Ncci Website
The National Cancer Control Indicators are a set of indicators across the continuum of cancer care, from Prevention and Screening through to Diagnosis, Treatment, Psychosocial care, Research and Outcomes. The NCCI website allows users to see visual representations of data on each indicator through interactive charts.
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Where Do These Numbers Come From
The American Cancer Society relies on information from the SEER* database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for pancreatic cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead, it groups cancers into localized, regional, and distant stages:
- Localized: There is no sign that the cancer has spread outside of the pancreas.
- Regional: The cancer has spread from the pancreas to nearby structures or lymph nodes.
- Distant: The cancer has spread to distant parts of the body such as the lungs, liver or bones.
Pancreatic Cancer Survival Rate
The pancreatic cancer survival rate continues to improve as research leads to new and better ways to diagnose and treat the condition. However, when discussing the survival rate, its important to remember that it is nothing more than a statistic. Every patient is unique and every cancer is different. A statistic can only describe what happened retrospectively in a very large groupit does not take into account the advances in cancer care that are being made every single day, nor can it predict the outcome in any individual situation. In fact, some patients live much longer than the amount of time that would be anticipated based on the survival rate alone.
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What Causes Pancreatic Cancer
Pancreatic cancer is believed to be caused by genetic changes , however, the exact cause for these mutations is unknown. Risk factors for developing pancreatic cancer include:
- This is one of the most common causes of pancreatic cancer
- About 25% of pancreatic cancers are thought to be caused by cigarettesmoking
- The risk of developing pancreatic cancer is about twice as high among smokers compared to those who have never smoked
How Long Do You Have To Live With Stage 4 Pancreatic Cancer
Life expectancy for pancreatic cancer is often expressed in 5-year survival rates, that is, how many people will be alive 5 years after diagnosis.
Pancreatic cancer 5-year survival rates chart
|Pancreatic cancer stage
The life expectancy for stage 4 pancreatic cancer is very low, estimated to be about three to five months. By stage 4, pancreatic cancer has spread to and damaged surrounding organs, which makes it difficult to treat.
Pancreatic Cancer Survival At Roswell Park
At Roswell Park, we compare our survival data with data collected nationally by the Surveillance, Epidemiology and End Results program. The graphs below compare survival rates of pancreas cancer patients treated at Roswell Park with the survival rates for pancreas cancer patients across the nation.
AJCC Stage Group, Pancreatic Cancer
Stage at diagnosis for CY 2014-2015
This pie chart illustrates how many patients with pancreatic cancer have advanced disease at the time of diagnosis.1
Five-Year Relative Survival, Pancreatic Cancer, Stages I-IV
Cases Diagnosed 2006-2013
The following graph illustrates the survival rates of patients with pancreatic cancer at Roswell Park, compared to the survival rates nationwide. Roswell Park patients, at every stage of disease, have better survival rates.2
Relative Survival compares the actual observed survival with the expected survival of persons unaffected by cancer.
How Common Is Pancreatic Cancer
The American Cancer Societys estimates for pancreatic cancer in the United States for 2022 are:
- About 62,210 people will be diagnosed with pancreatic cancer.
- About 49,830 people will die of pancreatic cancer.
Pancreatic cancer accounts for about 3% of all cancers in the US and about 7% of all cancer deaths.
It is slightly more common in men than in women.
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Doctor Visits And Tests
Your schedule of doctor visits, exams, and tests will depend on the original extent of your cancer, how it was treated, and other factors. Most often, for people with no signs of cancer remaining, many doctors recommend follow-up visits about every 3 months for the first couple of years after treatment and then about every 6 months for the next several years. Be sure to follow your doctors advice about follow-up tests.
Survival Rates For Pancreatic Cancer
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. They cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.
Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Your doctor is familiar with your situation ask how these numbers may apply to you.
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Changing How I Thought
Had that doctor said Lets try chemotherapy I would have done it and looked no further. But I was told nothing could be done. Being told nothing can be done was life-changing for me.
I took a leave from my job and started researching. But the negativity increased when I went to a bookstore and looked up pancreatic cancer. Remember, the statistics were worse 20 years ago than they are today. I slammed the book shut and decided I was never going to read anything negative about pancreatic cancer or stage IV cancers of any type.
I had spent most of my lifetime asking the question Why do some people manage or navigate more successfully through the worst circumstanceswhat do they bring to those situations? I decided to put into practice those characteristics, to do what I could to live happier and if possible longer. In the first shock of the prognosis, I asked How can I have the best death? Soon after, I turned my attention to those people who live longer than the odds or even survive. The hundreds of articles and research studies became the basis of my healing program.
What Can Patients Do To Improve Their Chances
Pancreatic cancer patients who participate in clinical research have better outcomes. Seeing pancreatic cancer specialists, including healthcare professionals who focus on symptom management and supportive care also improves outcomes. And, patients who receive treatment based on their biology can live longer.
For all stages, the Pancreatic Cancer Action Network strongly recommends:
- Clinical trials at diagnosis and during every treatment decision
- Genetic testing for inherited mutations as soon as possible after diagnosis and biomarker testing of tumor tissue to help determine the best treatment options
- Getting an opinion from a specialist, a physician who diagnoses and treats a high volume of pancreatic cancer patients
- Symptom management and supportive care, provided early in your diagnosis as well as during and after treatment
Contact PanCAN Patient Services to learn more about these options.
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Better Prognosis For Resectable Tumors
Patients whose tumors are found before they have metastasized or become locally advanced tend to have longer survival rates, on average, because their tumors can usually be resected .
About 15 to 20 percent of all pancreatic tumors are resectable. These include stage I and stage II tumors. Rarely, locally advanced stage III tumors, which are typically considered unresectable , are characterized as borderline and may be removed if the patient has access to an experienced, highly trained surgeon.
Tumors can still grow back in many patients. So, on average, patients whose tumors were resected live for 2.5 years after their diagnosis and have a five-year survival rate of 20 to 30 percent.
Pancreatic Cancer Survival By Age
Five-year survival for pancreatic cancer is highest in the youngest men and women and decreases with increasing age. Five-year net survival in men ranges from 17% in 15-49 year-olds to 2% in 80-99 year-olds for patients diagnosed with pancreatic cancer in England during 2009-2013. In women, five-year survival ranges from 26% to 2% in the same age groups. Five-year survival is significantly higher in women compared with men in the 15-49 age group.
Pancreatic Cancer , Five-Year Net Survival by Age, England, 2009-2013
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What Goes Into A Prognosis
When figuring out your prognosis, your healthcare provider will consider all the things that could affect the cancer and its treatment. He or she will look at risk estimates for the type and stage of the cancer you have. These estimates are based on what results researchers have seen over many years in other people with the same type and stage of cancer.
If your cancer is likely to respond well to treatment, your healthcare provider will say you have a favorable prognosis. This means youre expected to live many years and may even be cured. If your cancer is likely to be hard to control, your prognosis may be less favorable. The cancer may shorten your life. Its important to keep in mind that a prognosis states whats likely or probable. It is not a prediction of what will definitely happen. No healthcare provider can be fully certain about an outcome.
Your prognosis depends mainly on:
The type and location of the cancer
The stage of the cancer
Your overall health
How well your cancer responds to treatment
The Limitations Of Survival Rates
Survival rates are estimates and are based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. They also dont take into account multiple factors that could play a role in survival such as age, overall health, and how well a person’s cancer responds to treatment.
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Pancreatic Cancer Survival Rate Still Low But Slowly Getting Better
Josh Worley of Simpsonville was an active 33-year-old UPS driver when severe backpain sent him to the doctor.
Prescriptions worked for a while, but the pain just got worse.Finally, a CT scan revealed the source was a tumor on his pancreas.
Tragically, by the time he was diagnosed, the cancer had spreadto his liver, and just 19 months later the father of two was gone.
Unfortunately, as it was in Josh Worleys case, pancreatic cancer often isnt founduntil itsadvanced, making it difficult to treat.
Thatsone of the reasons the survival rate is so low only 11 percent of patientslive five years after diagnosis, according to the American Cancer Society.
But 11 percent is nearly double the 5 percent survival rate of adecade ago, the society reports.
And experts say there is reason to hope it will continue toimprove.
Nationwide, more than 62,000 people will be diagnosed withpancreatic cancer in 2022, according to the cancer society, and nearly 50,000are expected to die of the disease.
Risk factors include smoking, Type 2 diabetes, a family historyof pancreatic cancer, chronic pancreatitis, obesity, and genetic mutationsknown as BRCA1 and BRCA2, which are associated with breast cancer, the societyreports.
Symptoms can include weight loss, abdominal pain that may radiateto the back, jaundice, nausea, and vomiting, according to the ACS.
To begin with, the symptoms which include abdominal pain thatcan mimic indigestion arent obvious, he said.
And its aggressive, Oza adds.