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Dr. Rajesh Patel, MD.
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Ask the Doctor!
March 2009
Q:
With the recent headlines of pancreatic cancer diagnoses of Patrick Swayze and Supreme Court Justice Ruth Bader Ginsburg and their early detection, I would like to know what are the early symptoms of pancreatic cancer? What are the survival rates for early detection and most successful treatment options available?
-- C. Johnson, Winter Haven, FL
A:
Pancreatic cancer is a disease generally affecting the older population. The average age of diagnosis ranges from 65 to 84. It is rarely seen before age 50. Incidence is typically higher in men and in African-Americans.
Symptoms will depend on the location of the tumor. They include a vague upper- or mid-abdominal pain which may radiate to the back (relieved by leaning forward), inexplicable weight loss and generalized weakness, yellow discoloration of the skin and eyes, and a palpable mass in the upper abdomen. Unfortunately, when these symptoms do arise, the cancer may be well into its progression. This is often why it's difficult to combat this disease. Therefore, seek medical attention for any of the above symptoms as soon as possible.
As a screening measure, a physician will look for important risk factors like alcohol and tobacco abuse, a history of chronic or hereditary pancreatitis, and a family history of pancreatic cancer. Diabetes seems to play a possible role in this condition as well.
Routine screening tests (ultrasound, CT, ERCP) are generally not done due to high false-positives. However, further evaluation should be done in those of high risk. If an individual has a family member who has had pancreatic cancer, he/she should undergo a special CT scan 10 years prior to the year of initial diagnosis in that family member. In addition, people with existing hereditary pancreatitis are advised to undergo routine screening tests from age 35 and up.
The long-term survival rate for this type of cancer is generally low, about 5% for five-year survival. However, the five-year survival rate can reach up to 40% in those having a tumor confined to a therapeutically favorable area and without any spread. Also, certain individuals will respond better to treatment than others. The most beneficial treatment consists of surgery, radiation, and chemotherapy. Hormone and enzyme replacement may also be necessary. The form of therapy will depend on the nature of the disease in each person.
It is a good idea to maintain a high-fiber, low-fat diet, exercise regularly, and avoid smoking. These practices may possibly reduce the risk of this cancer as well as other medical conditions. Pancreatic cancer poses several challenges, but with early intervention we can try to fight this disease as much as possible.
Submit your questions to askthedoctor@nowoodennickels.org
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