Pancreatic Cancer (Ca. Pancreas) and Survival

I got the following question as a comment

Hello Doctor,

I am a S/W Engineer and I have a question.

One of my friend's dad got diagnised with Pancreatic cancer and undergone a surgery called Whipple's surgery in one of the hospitals at Coimbatore. I beleive the doctors said its a critical one and he is still in danger. They also said that the survival of the person affected by Pancreatic tumor is very less. When I checked in Internet it says for the same disease the survival is 75% - 95% in US. I am not sure whether its not the case in India. If you are a doctor or If you know anyone who survived after the surgery(in India), please let me know.

Please shoot out a mail to ___@gmail.com or ___@gmail.com.

Also you can call me @ (US: 201-233-xxxx) and if you are in India, please call my other friend Deepan @ 99400xxxxx. (Since my friend is in hospital with his dad and he cannot attend calls)

(Personal Information removed)

I don't know where you saw the 75% survival rate. Any way, this further adds support to my policy of NOT CHECKING FOR HEALTH ADVICE FROM INTERNET.

As per Harrison's text book of Medicine (the widely acclaimed textbook of medicine world wide and published in US)

The incidence of pancreatic carcinoma in the United States has increased significantly as the median life expectancy of the American population has lengthened. The tumor results in the death of >98% of afflicted patients. 28,200 individuals died of pancreatic cancer in 2000, making it the fifth most common cause of cancer-related mortality. The disease is more common in males than in females and in blacks than in whites. It rarely develops before the age of 50

Complete surgical resection of pancreatic tumors offers the only effective treatment for this disease. Unfortunately, such "curative" operations are only possible in 10 to 15% of patients with pancreatic cancer, usually those individuals with a tumor in the pancreatic head in whom jaundice was the initial symptom. Patients considered for such a procedure should have no evidence of metastatic spread on a chest radiograph and abdominal-pelvic CT scan and should be operated on by an experienced surgeon, as mortality rates of >15% have been associated with this procedure. Curative resection is usually preceded by laparoscopic inspection of the abdomen to confirm absence of occult disease spread to the omentum, peritoneum, or liver, which would preclude curative resection. Although the potential for cure in patients with pancreatic cancer is restricted to the few who are able to undergo a complete surgical resection, the 5-year survival rate following such operations is only 10%. Nonetheless, the procedure is worth attempting, particularly for lesions in the pancreatic head, since ductal carcinomas often cannot be distinguished preoperatively from ampullary, duodenal, and distal bile duct tumors or pancreatic cyst adenocarcinomas, all of which have far higher rates of resectability and cure. Furthermore, patients who undergo resection and eventually experience disease recurrence survive three to four times longer than those whose tumor is not excised, indicating that such operations have a palliative effect. The risk for tumor recurrence is not affected by the type of operative procedure i.e., total pancreatectomy versus pancreaticoduodenectomy ("Whipple resection") but it is increased by the presence of lymph node metastases or tumor invasion into adjacent viscera. As a rule, pancreaticoduodenectomy or distal pancreatectomy seems preferable to total pancreatectomy because of the retention of exocrine function and avoidance of brittle diabetes.

The median survival for patients whose pancreatic cancers are surgically unresectable is 6 months.

Sabiston's textbook of Surgery (The standard text book of Surgery in US) says

In the United States there are approximately 28,000 cases of cancer of the exocrine pancreas diagnosed each year. Cancer of the pancreas is the fifth most common cause of cancer death, exceeded only by lung, colorectal, breast, and prostate cancers. Ninety percent of patients die within the first year after diagnosis. In both men and women, pancreatic cancer represents 3% of all cancers and 5% of all cancer deaths. Since 1960, the relative 5-year survival rate for all cases of pancreatic cancer has increased from 1% to 3%. Considering only cancers of the digestive tract, cancer of the pancreas ranks second, behind colorectal cancer, in incidence and cancer death rates. Cancer of the pancreas is more common in blacks than in whites, more common in smokers than in nonsmokers, more common in males than in females, and appears to be linked to the presence of diabetes mellitus. Cancer of the pancreas is possibly linked to both a history of previous chronic pancreatitis and the ingestion of a high-fat diet.

Please don't follow health advice from Internet. As Sujatha once said "Internet என்பது கங்கை மாதிரி, பூவும் வரும், பிணமும் வரும்"