Why is pancreatic cancer so deadly

I read a bit on what the pancreas do, like regulate insulin and digestive juices but I don’t really understand it. I read Patrick Swayze has pancreatic cancer, but why is it so deadly when compared to other cancers. What exactly does a pancreas do that makes it so vital?

Thanks

Just guessing here, but some cancers aren’t typically found until pretty late in the game, when survival rates are low. If pancreatic cancer is one of those, that’s the problem.

Previous thread: Medical Question: Why is pancreatic cancer so virulent?

Thanks for the point to the thread, if I’m reading it right the lateness of discovery makes it hard to treat. Hopefully they can work on early diagnosis. I wonder how much that improves the life expenctancy rate

And, conversely, Steve Jobs supposedly had some rare form of pancreatic cancer that was (so far, four years later) successfully treated. And that was after his herbal remedies and meditation failed to arrest its growth.

This wasn’t mentioned in that other thread. Is getting pancreatic cancer just a case of cosmic Russian Roulette or is there some sort of hereditary link or lifestyle cause?

Anecdote to throw into the mix - my dentist told his staff one day to cancel his appointments for the rest of the week, and disappeared. The next Monday morning, somebody called his office to tell the staff that he had been diagnosed with pancreatic cancer and had made a desperate trip to Sweden to receive some treatment that was not available here in the US, but had died over the weekend. None of the staff knew anything was wrong.

Some forms run in families, but most cases have no such family history.

Other identified risk factors include tobacco use, obesity, age over 50, and diabetes.

But lots of folks get it who don’t have those risks either.

There are no good screening tools for pancreatic cancer. It tends to cause no symptoms at all until the disease is far too advanced to treat.

Massive screenings of people over 50, to try to identify the cancer while still treatable, would only identify a bunch of folks with something suspicious on their scan, which turns out to be nothing at biopsy. A certain percent of those getting the biopsy will get sick from the biopsy and some will die from it, more than will be saved from pancreatic cancer by the screenings.

In most cases there are very few early symptoms and the early symptoms are vague and appear to be psychological in nature…heartburn,weight loss, digestive difficulties, fatigue and depression. My SO had these and went to the doctor in March 2004. He told the doctor he thought he had pancreatic cancer, got an ultrasound and bloodwork and was told there was no sign of cancer. On June 1 (the same year) he became jaundiced and was diagnosed with inoperable stage 4 pancreatic cancer and told he had 3 to 6 months to live ( he made it 10 months ).

Even when it is caught very early (usually in people “lucky” enough to get the cancer close to the bile duct, this cause more symptoms sooner) and the patient has successful surgery, the chances of recurrence are very high.

Pancreatic adenocarcinoma is a very aggressive cancer and it is not deadly because the pancreas is that important, in fact if they catch the cancer early enpough they remove the pancreas along with adjoining parts of the digestive system.

It spreads rapidly, usually to the liver. Death is usually due to massive chemical imbalances, stroke ( cancer causes abnormal blood clotting), liver failure or starvation) pancreatic cancer takes the lions share of the calories consumed to feed itself). There is some controversy about tube feeding and IV nutrition in late stage patients. Families often demand it because it is hard to watch your loved one starve but it is usually not a good idea, it just fuels the cancer and makes it spread faster.

Steve Jobs had a different type of pancreatic cancer, a rare neuroendocrine type that is unrelated to pancreatic adenocarcinoma.The neuroendrocine cancers are slow growing and have a fairly good prognosis.

There is some hereditary susceptibility and there may be some correlations to smoking, alcohol abuse and weight problems. of the hundred or so pancreatic cancer patients I have “met” through on-line support groups there are lot of people that were mildly overweight and a fair amount of smokers…I can only think of 1 person with a drinking problem, though. I have also met people with this cancer that never smoked, never drank, worked out daily and ate only organic foods.

The prognosis is very grim if the patient isn’t eligible for surgery. Most doctors give 3 to 6 months…in my experience most of the patients that opt for chemo live 9-12 months. About 10% of patients have a good response to chemo and go into some sort of remission but recurrence usually happens in 1-2 years. I know of one guy that lived 8 years ( he was the “poster boy” for one of the chemo treatments) but I think the number of 5 year survivors among patients ineligible for surgery is statistically insignificant.

Barbara

You can live without a pancreas? And what other parts of the digestive system can be removed, along with it?

Would a late stage patient feel the effects of starvation, if tube feeding or IV nutrition weren’t used?

Yeah, it’s also mentionable that him being a quadridllionaire had nothing to do with it either. Weird, huh?

Two big mistakes here:

  1. The aim of surgery is generally to remove the part of the pancreas that is cancerous, but leave as much healthy tissue as possible. Total removal of the pancreas is a last-ditch option since it requires extremely aggressive support to prevent raging diabetes, among other things.
  2. Pancreas malfunction results in wasting and starvation from two causes: a) the exocrine pancreas produces digestive enzymes; without them, food is inefficiently absorbed, and b) the endocrine pancreas produces insulin which promotes glucose uptake by muscle, liver, and other tissues; without it, your body cannot make effective use of the calories ingested. The cancer itself does NOT consume “the lions share” of the patient’s calorie intake.

Yes, but you don’t want to unless you have to.

You can lose most of your stomach and intestine, about 90% of your liver, and various other bits and still live (not necessarily all at once, though).

One of the reasons why pancreatic cancer is such a disaster is that the organ is a) quite fragile, and b) full of nasty enzymes designed to chew up food but quite capable of chewing up your body too. Any manipulation (as in, for example, surgery) carries the risk of causing a leak of said enzymes, which can then start chewing up nearby pancreas, which can lead to widespread autolysis, which dumps all that stuff into your abdomen and causes massive inflammation.

JRB

The standard surgery, called the Whipple procedure, removes the head of the pancreas, the gallbladder and the duodendum. Depending on the location of the cancer it is sometimes combined with a distal pancreatectomy, which takes body and tail of the pancreas and the spleen.

In general, late stage pancreatic cancer patients have no appetite. The weight loss and lack of appetite are by far the biggest issue that comes up in the support groups. My sweetie was down to about 110 pounds at the end and he was 6’2" and had a healthy weight of 175. I spent lots of time and effort trying to tempt him and cajole him into eating. So, I guess they feel the effects of starvation in terms of feeling sick and weak, but they aren’t hungry. It is very difficult to watch, but as the end gets closer the body becomes incapable of processing nutrition and forcing it ( via tube ot IV) usually causes discomfort.

Meaning what, exactly?

To add to that, I recall reading an article about (non-cancer related) pancreas transplants, and it stated that commonly, the recipient’s diseased pancreas is left alone, since it’s more risky to try to remove it that to leave it.