The overall five-year survival rate for pancreatic cancer is 9 percent

PANCREATIC CANCER IS one of the deadliest cancers for patients in the U.S. There is no denying the unsettling statistics. According to figures compiled by the Pancreatic Cancer Action Network, or PanCAN:

  • Pancreatic cancer is the third-leading cause of cancer-related death in the U.S., behind only lung cancer and colorectal cancer, and is expected to become the second-leading cause after lung cancer around 2020.
  • The overall five-year survival rate is just 9 percent.
  • In 2019, an estimated 56,770 people will be diagnosed with pancreatic cancer in the U.S.
  • Approximately 45,750 of those newly diagnosed will die from the disease.
  • Pancreatic cancer is the ninth-most commonly diagnosed cancer in women and the 10th-most commonly diagnosed in men.

There are a number of reasons why pancreatic cancer is so deadly. No early screening tests are available, as there are for colorectal, breast and many other cancers. Often there are no symptoms or signs of pancreatic cancer until the disease has progressed. The few symptoms that are common with pancreatic cancer are vague – fatigue, digestive distress and back pain – and they’re all easily attributed to other causes. And this particular cancer is resistant to current chemotherapy agents.

However, there are some silver linings within these clouds. According to PanCAN, the five-year survival rate for pancreatic cancer patients increased from 6 to 9 percent between 2014 and 2017. That seems scant progress to be sure, but a rise of 3 percentage points means that more than 1,700 people across the country survived five years when they would not have three years earlier.

Organizations working toward further progress, such as PanCAN, the Lustgarten Foundation and medical centers around the world, believe that as science discovers ways to find the disease earlier and develop new treatment options these numbers will continue to improve. “As treatments improve, so do survival rates,” says Cassadie Moravek, associate director of clinical initiatives for PanCAN.

Survival Odds and Staging

These survival rates are averages, of course. Each patient’s case is different, and the outcome can be affected by many factors, including:

  • Age.
  • The stage of the disease.
  • Overall health.
  • Access to treatment, pancreatic cancer specialists, clinical trials and supportive care.

Arguably, the most important factor is the disease stage.

  • Stage I: The tumor is confined to the pancreas and is considered localized. Stage IA tumors are 2 centimeters or less, and stage IB tumors are larger than 2 centimeters. Stage I tumors are usually resectable, the medical term for surgical removal. According to the American Cancer Society, the five-year survival rate for stage I pancreatic cancer is 34 percent.
  • Stage II and stage III: The tumor has spread outside the pancreas to nearby blood vessels, lymph nodes or both, but it has not metastasized, or spread, to another organ. It is considered regionalized. Stage IIA tumors have moved outside the pancreas but have not spread to major nearby arteries or lymph nodes. Stage IIB tumors may extend outside the pancreas and spread to nearby lymph nodes without reaching major nearby arteries. These tumors are usually considered resectable or borderline resectable, which means they may be candidates for surgery, especially if radiation and/or chemotherapy treatments are able to shrink the cancer first. Stage III tumors have spread to major nearby arteries and may have spread to nearby lymph nodes, but they have not spread to another organ. Stage III tumors are usually not resectable. The five-year survival rate for regionalized tumors, which the ACS says includes mainly stage IIB and stage III tumors, is 12 percent.
  • Stage IV: Known as metastatic or distant cancer, stage IV tumors have spread to other organs outside the pancreas, usually the liver or lung but also to the bone, brain and other organs. The five-year survival rate for stage IV pancreatic cancer is 3 percent.

How to Increase Your Odds of Survival

Clearly, the earlier the disease is diagnosed, the better the odds for survival. When possible, surgery is the best option by far. PanCAN says that patients who are diagnosed with pancreatic cancer in time to be candidates for surgery are about 10 times more likely to survive five years. A study published in 2017 in the Annals of Surgical Oncology found that the five-year survival rate for patients whose tumors were less than 2 centimeters and removed by surgery is more than 40 percent.

All pancreatic cancer patients can increase their chances for survival by taking the following actions:

  • Get treatment at a medical center that specializes in pancreatic cancer. According to the Lustgarten Foundation’s Navigating Pancreatic Cancer guide, “there are many advantages to receiving treatment at a large cancer center. A center that treats a high number of patients with pancreatic cancer will have more experience in every aspect of your care, which includes diagnosing, staging, performing surgery, and managing side effects and potential complications.” The Lustgarten Foundation guide also states that “several studies have shown that operative complication (morbidity) and death (mortality) rates are lower at hospitals that do a high volume of pancreatic surgeries.” For patients who do not live near a major cancer center, a single visit to one may be enough to make an impact on their care moving forward. “Doctors from top cancer centers often plan patients’ chemotherapy treatment regimens then refer them to doctors closer to home who will carry out the treatment plan,” the guide says.
  • Participate in a clinical trial. Pancreatic cancer patients who participate in clinical research have better outcomes. Moravek says that there has been about a 100 percent increase in median overall survival from phase III clinical trials since 1999.
  • Discuss molecular profiling of your tumor. “We have seen strides with molecular profiling,” Moravek says. This process involves analyzing the specific genetic makeup of the tumor in order to choose the course of treatment that best matches that genetic profile. PanCAN’s Know Your Tumor program assists patients in profiling their specific tumor to help them figure out their best treatment options, she says. A 2018 study in the journal Clinical Cancer Research found that about half of 640 patients who participated in Know Your Tumor between June 2014 and June 2017 had “actionable” alterations in their tumor. “This means that there is a mutation or other molecular alteration present that could influence a tumor’s response to a particular treatment,” said Lynn Matrisian, chief science officer at PanCAN, in a release. Matrisian oversees the program and co-authored the study.

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