The 5-year survival rate of pancreatic cancer patients is 13.9% … one-fifth of all cancers
No symptoms, difficult to diagnose early… Major risk factors such as smoking and drinking
The typical prognostic symptom is jaundice… Thirty-nine scenes from the JTBC drama, which show a trend of improving treatment results due to the development of anticancer drugs. screen capture
[Seoul Economy]
“I don’t want chemotherapy. didnt you hear Thats 0.8%. Who can tell if Im 0.8 or not”
This is a line that appears in the recently popular drama Thirty, Nine. Chanyoung, who was sentenced to six months with stage 4 pancreatic cancer at the age of 39, ultimately died while refusing chemotherapy, making viewers sad.
Pancreatic cancer is considered to be a representative cancer with a poor prognosis to the extent that ‘diagnosis is a death sentence’. According to recent national cancer registry statistics, the 5-year relative survival rate of pancreatic cancer patients was 13.9%, which was only one-fifth of the overall cancer survival rate. This means that more than 8 out of 10 people with pancreatic cancer will die within 5 years.
What is the cause of the still low survival rate of pancreatic cancer despite advances in medical technology? Is there no way to beat pancreatic cancer? I looked through the help of Professor Ji-gon Ryu, a professor of gastroenterology at Seoul National University Hospital.
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◇ Pancreatic cancer, what causes it?
Pancreatic cancer is a malignant tumor of the pancreas. As with other cancers, it is difficult to pinpoint a specific cause. Aging, smoking history, and chronic pancreatitis are known to be major risk factors.
Pancreatic cancer schematic diagram. Photo courtesy of Seoul National University Hospital
The incidence of pancreatic cancer greatly increases depending on the gene or family history. Even if there are only two patients with pancreatic cancer in the household, the probability of getting pancreatic cancer is 10 times higher than that of the general public. Medically, this case is called familial pancreatic cancer. If you have a family member with pancreatic cancer, its good to keep in mind that the risk is high.
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◇ Pancreatic cancer 5-year survival rate ‘13.9%’… Why is it so much lower than other cancers?
First, the main cause of the low survival rate of pancreatic cancer is that it is difficult to detect early. Pancreatic cancer has few symptoms in its early stages. When symptoms such as abdominal pain appear enough to be noticed by the patient, they have already progressed considerably.
Second, the operation is difficult. Surgery is the best way to treat pancreatic cancer, but the probability of surgery at the time of diagnosis is low, less than 20%. Stage 3 cancer cells have invaded the arteries around the pancreas, and stage 4 cancer cells have metastasized to other organs such as the liver, making surgery difficult.
Third, the likelihood of recurrence is high. When other cancers are detected in the first stage and operated, the survival rate rises to 95-100%. No chemotherapy is required. On the other hand, pancreatic cancer has a high recurrence rate, so the 5-year survival rate after surgery is only 30%. Chemotherapy is usually performed after surgery to prevent recurrence.
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◇ What are the symptoms of pancreatic cancer?
The most common symptoms of pancreatic cancer include abdominal pain, loss of appetite, weight loss, and jaundice. Depending on the patient, general pancreatic disease symptoms may appear. The pancreas has an endocrine function that regulates blood sugar by secreting insulin and an exocrine function that helps break down fat by secreting digestive enzymes. Therefore, if the pancreas is damaged, there is a problem with blood sugar control, resulting in diabetes, or fat digestion may be difficult, leading to oily stools.
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◇ Is there any way to detect pancreatic cancer early?
The typical prognostic symptoms of pancreatic cancer are loss of appetite, weight loss, and jaundice. Jaundice is a symptom in which the whites of the eyes or the skin are colored yellow, and the bile secreted from the duodenum cannot come down due to the hardened pancreas and accumulates in the blood. Since jaundice appears relatively early, there is a high possibility of surgery for pancreatic cancer detected when jaundice occurs.
If pancreatic cancer is suspected and you visit the hospital, a CT scan is recommended. If it is judged that the likelihood of pancreatic cancer is very low considering risk factors such as age, family history, smoking, and diabetes, an abdominal ultrasound may be performed. If the presence of pancreatic cancer is uncertain based on CT results alone, an additional MRI scan can be used to conduct a detailed examination of the suspected area.
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◇ How is chemotherapy for pancreatic cancer that is difficult to operate?
Pancreatic cancer treatment is divided into △5-fluorouracil and two other drugs according to the type of drug used; The three-drug therapy is a treatment that involves hospitalization for 2 nights and 3 days twice a month and administering anticancer drugs. On the other hand, in the two-drug regimen, the administration time is as short as 30 minutes, so administration is performed once a week. If the drug becomes resistant and becomes less effective, you can move on to other treatments.
The problem is that the anticancer drug used at this time is a cytotoxic drug, and sometimes side effects that attack normal cells occur. In the case of pancreatic cancer, long-term administration of chemotherapy can cause kidney and nervous system abnormalities. The typical symptoms are numbness and pain in the hands and toes, or discomfort in performing normally natural movements such as walking and using a spoon.
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◇ How has the results of pancreatic cancer chemotherapy changed recently?
With the development of anticancer drugs over the past five years, the treatment results of pancreatic cancer have also improved. The average survival time of stage IV pancreatic cancer patients increased from 6 months to 12 to 14 months. In some cases, patients who were difficult to operate were improved enough to be able to undergo surgery through chemotherapy.
Studies have also found that people with certain genetic mutations have a good therapeutic effect on the ‘three-drug therapy’. As a result of analyzing the genes of about 100 patients, it was found that the treatment effect of the three-agent therapy was more than three times different depending on the presence or absence of the ERCC6 gene. The basis for selecting a more effective anticancer treatment has been laid.
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◇ What would you recommend to the general public, including pancreatic cancer patients?
Pancreatic cancer causes anorexia, and if chemotherapy is added to this, appetite may decrease even more. However, if you skip a meal, your stamina will decrease and side effects of anticancer drugs are likely to occur, so you should pay attention to managing a balanced diet. Diet is so important that hospitals prescribe appetite stimulants for pancreatic cancer patients undergoing chemotherapy. Avoid carbohydrates and fats and eat protein mainly, but it may also be helpful to get an amino acid nutritional supplement that makes protein at a local clinic.
Those who want to manage their pancreas in a healthy way should refrain from drinking and smoking. Alcohol and smoking increase the risk of developing chronic pancreatitis, which can lead to pancreatic cancer. Obesity is also bad for the pancreas, so you should avoid excessive fat intake and maintain a standard weight with appropriate exercise.
Professor Ji-gon Ryu, Department of Gastroenterology. Photo courtesy of Seoul National University Hospital
