Hope for pancreatic cancer survivors

A new study shows that pancreatic cancer patients 65 or older who live at least five years after surgery have nearly as good a chance as anyone else to live another five years.

Researchers at the Kimmel Cancer Center at Thomas Jefferson University and Thomas Jefferson University Hospital in Philadelphia reviewed the records of 890 patients with pancreatic cancer who underwent the standard pancreaticoduodenectomy, or Whipple procedure, which entails the removal of the gallbladder, common bile duct, part of the duodenum, and the head of the pancreas, between 1970 and 1999 at Johns Hopkins University. They identified those who lived for five years, and compared those who lived for at least an additional five years to the "actuarial" - or estimated - survival of the general population beginning at age 70.

Reporting in the journal Surgery, they found that 201 patients (23 percent) lived five years after surgery, at least half of whom were 65 years old or older at the time of surgery. Of those five-year survivors, an estimated 65 percent lived at least an additional five years. In the general population, roughly 87 percent of the same age group live another five years.

The study has an important message, says Charles Yeo, M.D., Samuel Gross Professor and Chair of Surgery at Jefferson Medical College, who led the work. "A decade ago, many clinicians thought that there was little reason to operate on patients with pancreatic ductal cancer, that surgery does little to extend life and improve the quality of life," says Dr. Yeo. "Not too long ago, few lived for five years after diagnosis. Today that's not true. There's been a paradigm shift in the way we treat and think about this disease."

While only approximately 25 percent of those diagnosed with pancreatic cancer who undergo successful surgical "resection" of their disease live at least five years, overall, of those who live for five years after resection, some 55 percent will be alive at least another five years.

"The public hears 'pancreatic cancer' and thinks there's little hope and there isn't much to do. The good news is, with new imaging techniques, better early detection, improved screening of high-risk groups, and new therapies on the horizon, we're actually making great progress when it comes to pancreatic cancer. It's no longer a death sentence."

Pancreatic cancer, the fifth-leading cause of cancer death in this country, takes some 30,000 lives a year. It remains one of the deadliest cancers; only approximately 5 percent of all those with pancreatic cancer live one year after diagnosis, and only 1 percent are alive five years later.