CA: A Cancer Journal for Clinicians, Vol 22, 274-283, Copyright
© 1972 by American Cancer Society
Cancer of the Pancreas
Lemuel Bowden M.D.1
1 Surgical Consultant, Memorial Hospital for Cancer and Allied Diseases, New York, New York; Attending Surgeon, Doctors Hospital, New York; and Associate Attending Surgeon, Beek-man-Downtown Hospital, New York.
1. Cancer of the pancreas is steadily increasing in frequency, yet the etiology remains unknown.
2. The clinical aspects of cancer of the head of the pancreas are quite different from those of cancer of the body or tail. Cancers arising in the head of the pancreas generally cause obstructive jaundice, while cancers of the body or tail are characterized by insidious onset of abdominal or back pain, associated with progressive weight loss, anorexia and gastrointestinal symptoms, none of which are severe until the cancer has existed and progressed for an unknown period of time.
3. Successful treatment of pancreatic cancer has been accomplished only by adequate surgery, which is tedious and fraught with significant morbidity and mortality.
4. Even with successful surgical resection, the five-year salvage is notoriously low. It varies from 2.3 percent to 5.2 percent for cancer of the head of the pancreas and 2.6 percent for cancer of the body or tail.
5. Salvage in pancreatic cancer is so poor that some experienced physicians prefer not to attempt surgical resection because of the associated morbidity and mortality.
Nevertheless, the palliation afforded those who survive surgical resection of the pancreas is so superior and so much more enduring than that accomplished by simple biliary tract decompression that many other experienced practitioners believe that resection should be offered to all patients with localized pancreatic cancer, particularly if operative mortality can be kept in the range of 10 percent or less. By this aggressive approach, an occasional patient may be cured of an otherwise fatal disease.
