I see a lot of mentions about aggressiveness and lack of symptoms early on but one other interesting factor is that the tumors are not very vascular. A very common thing for tumors to do is something called angiogenesis which means making blood vessels. Tumors use this blood flow to get all the nutrients they need to grow. A lot of pancreatic cancer tumors don’t have as many blood vessels around them. This makes it very hard to get any type of drugs to reach the middle of the tumor. If chemotherapy drugs can’t get to it, they can’t kill it.
Some cancers don’t start to really cause discernible symptoms until they’ve metastasized. I’m considered lucky my stomach cancer was “only” stage three. I only had symptoms a few weeks before the diagnosis was confirmed. Most people are diagnosed at stage four, when there’s only a 4% chance of survival.
The digestive enzymes produced by the pancreas are carefully controlled. They must only digest food; not you. Unfortunately, pancreatic tissue that has gone rogue will do some nasty things to surrounding tissues, such as the liver.
And, as many have mentioned, it’s difficult to detect at early stages.
It is lethal because it is quiet. But…not every dies from it. If it is caught early it can be treated with surgery followed up with chemo. For those with a combination of a good surgical outcome (clear margins), no lymph node involvement, and a full course of chemo…recurrence can be very low.
At best, this is a low percentage of patients. Cancer in an organ like the pancreas doesn’t hurt…and the other symptoms are somewhat innocuous until the the cancer has spread to the liver and other parts of the abdomen.
But, the 5 Year SEER broke 10% a couple years ago. Progress is being made.
Several reasons:
1. While it’s not particularly aggressive, it’s sneaky and usually doesn’t produce symptoms until it’s very advanced or even terminal
2. The pancreas is a viral organ surrounded by other vital organs, so surgery is always risky and complicated
3. The treatment options consist of what I’ve heard doctors describe as the most brutal chemotherapy, and a surgery (The Whipple Procedure) that basically rearranges your digestive system
I lost my grandmother to pancreatic cancer and several people I’m close to have also lost relatives to it. It’s an absolutely ruthless disease.
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