Cancer of pancreas a virulent disease

Ask The Expert Armando Sardi Mercy Medical Center

March 02, 2009|By Liz Atwood | Liz Atwood,

Pancreatic cancer has been in the news recently. Last month, Supreme Court Justice Ruth Bader Ginsburg underwent surgery to remove a malignant tumor from her pancreas. That same week, actor Patrick Swayze, who was diagnosed with the disease about a year ago, wrote a letter to Congress urging increased funding for research.

The pancreas is a large organ that secretes enzymes that aid digestion and hormones that help regulate the metabolism of sugars. While cancer of the pancreas is not as common as other cancers, it is particularly virulent, says Dr. Armando Sardi, director of the Institute for Cancer Care and head of surgical oncology at Mercy Medical Center.

How prevalent is pancreatic cancer?

It's not the most common cancer, but in the United States there are approximately 34,700 new cases each year. Of these, 32,500 [patients] die each year.

What are its symptoms?

It depends on the location of the tumor. Most frequently it is in the head of the pancreas, and usually the patient will develop painless jaundice. If the tumor is in the neck or body of the pancreas, the symptoms can present themselves late with pain.

Who is most at risk?

We don't really know who is at risk. It is mainly a sporadic disease.

What are the possible causes?

Smoking has been linked, but there is not really a known cause. It is not hereditary. There are no known genetic markers. There are rare hereditary syndromes that are associated with pancreatic cancer. But for most patients, we do not know the cause.

How is it diagnosed?

Usually by a CAT scan followed by endoscopic ultrasound and biopsy. In many instances, the clinical presentation leads to surgery and the final diagnosis is not made until the surgery has been done.

How is it treated?

The only curative treatment is surgery if the tumor can be removed. Following complete removal of the tumor, the addition of chemotherapy and sometimes radiation therapy can improve the survival.

What is the survival rate?

Eighty percent of the people who present with the disease have advanced disease at presentation and are not candidates for surgery. Of the 20 percent that are eligible for possible curative surgery, only 20 percent are cured. So that's 4 percent of all those who are diagnosed. Even small tumors are very aggressive. Once the cancer goes beyond the pancreas, the majority of people die within six months. It's a very aggressive disease.

Is there promising research for a cure?

Unfortunately not. There is a lot of work being done with vaccines and chemotherapy, but we really have not been able to find something that will make a difference. It's one of the diseases we haven't made much progress [on] in the last 20 years. However, the mortality from the surgery is less than 1 percent; it used to be as high as 20 percent.

Baltimore Sun Articles
Please note the green-lined linked article text has been applied commercially without any involvement from our newsroom editors, reporters or any other editorial staff.