Pancreatic cancer hard to spot, treatable

PHOTOGRAPHER: Jeff Wilkin

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“Cancer” is always a scary word to hear inside a doctor’s office.

Especially the words “pancreatic cancer.”

“If you had to choose one, you would probably want to stay away from that one,” said Dr. Max Laguerre, a radiation oncologist at Ellis Hospital in Schenectady. “It tends to go places even before you diagnose it.”

The lethal cancer was in the news this week when Apple founder Steve Jobs died Wednesday of the disease. The National Cancer Institute of the National Institute of Health estimates there will be 44,030 new cases of pancreatic cancer in 2011. And 37,660 deaths this year from the disease.

According to the Mayo Clinic, pancreatic cancer begins in the tissues of the pancreas — an organ in the abdomen that lies horizontally behind the lower part of the stomach. The pancreas secretes enzymes that aid digestion and hormones that help regulate the metabolism of sugars. Doctors say the cancer typically spreads quickly and is seldom detected in its early stages.

There are things to watch for.

“There are three major symptoms you can have,” said Laguerre, who also said between 10 and 15 pancreatic cancer cases are treated annually at Ellis. “You can have pain in the upper abdomen area, you can lose a lot of weight, you don’t have any appetite. Weight loss is a very common symptom.”

The third symptom, Laguerre added, is skin that becomes jaundiced. “The pancreatic cancer blocks the flow of bile and then you become yellow,” he said.

Urine can smell different. It can be foamy, and become very dark. Stool samples, Laguerre said, can become much lighter.

Genetics can play a part in the development of pancreatic cancer. But Laguerre said people can take steps to cut their risks — the elimination of smoking, better weight control, more exercise and a diet high in fruits and vegetables among them.

“That’s a good tip to follow for every cancer,” Laguerre said of dietary advice.

If people are diagnosed with pancreatic cancer, he added, it should not be considered a death sentence.

“No,” he said. “It is not. It is treatable. Keep in mind, if you get diagnosed, you have about a 25 percent chance you’ll be able to have surgery.”

For many people, surgery is not an option.

“In some cases, blood vessels you cannot live without are in the neighborhood of the pancreas,” Laguerre said. “Pancreatic cancer is notorious for invading, attaching itself to these major blood vessels. This is one of the main reasons you cannot have surgery.”

For people who have surgery, radiation treatment and chemotherapy, the five-year survival rate can be as high as 25 percent to 35 percent. For people who do not have surgery, Laguerre said — with only radiation and chemotherapy — the survival rate is closer to a year for approximately 30 percent to 50 percent of patients. Much depends on the stage of the cancer.

Some new things are happening in research.

“Recently, there have been improvements in the results we’ve got with the chemotherapy,” Laguerre said. “There have been some new agents of chemotherapy that have actually improved your survival.”

Laguerre stressed that if people notice things like weight loss, pain and changes in bodily wastes, they should see their doctors as soon as possible. “Particularly if you think things are not going away, and things are getting worse.”