Internal Medicine

Pancreatic cancer prognosis

Forecasts in Oncology

Nowadays, forecasts are only given statistically.
Patients who ask about their life expectancy with a certain type of cancer should actually no longer receive an answer in numbers from the doctors, since it is purely statistical information and not absolute individual numbers.
However, through the nationwide cancer registry and the evaluation of the numbers, it is possible to correct the numbers retrospectively.

In oncology, the so-called 5 year survival rate is used. So the patients are counted who are still alive 5 years after the diagnosis.

The count is based solely on survival and does not provide any information about the patient's quality of life.
A bedridden patient severely impaired by a serious oncological disease would also be in the 5 year survival rate fall into it.

Also known as pancreatic cancer Pancreatic cancer is a very serious and life-threatening disease that requires prompt treatment in order to achieve a corresponding improvement in prognosis.
Together with the Bronchial carcinoma pancreatic cancer is one of the most serious diseases known.

A major problem is that the first symptoms of pancreatic cancer appear relatively late, so that a diagnosis in the early stages is either made by chance or the diagnosis can only be made when the symptoms start.
At this point the cancer mostly well advanced and that End-stage pancreatic cancer reached. Especially when the cancer has large parts of the pancreas has infected and has already spread to other organs, the therapeutic measures that are still available must be weighed.

So-called staging is of crucial importance (so the classification of the tumor). The classification includes how far the tumor has already spread and, above all, whether the tumor has already metastasized.
One also speaks of what is known as remote metastasis. Distant metastasis can also affect organs further away.
It is also particularly important to find out if that Lymphatic system is affected.
The so-called lymph channels span the entire body and serve to ward off invading pathogens. Before a pathogen enters the body's bloodstream, where it is life-threatening Blood poisoning can cause it, it must first cross the barrier in the lymphatic system.
For filtering are at regular intervals in the lymphatic system node switched on, which filter the lymph fluid and can swell and pain in the event of infections.

As great as the advantage in warding off pathogens is, a corresponding infestation with malignant cells is disadvantageous.
Since the lymphatic system pervades the entire body, malignant changed cells that have entered the circulation can also spread very easily.
The Lymphatic system is directly connected to the blood system. Malignant cells that are in the blood can at some point enter the lymphatic system and vice versa. The malignant cells quickly reach the lymph nodes through the lymphatic system, which they can then also attack.
Lymph node involvement means malignant involvement of the lymphatic system and represents a serious problem in terms of prognosis.

The classification of the tumor of the pancreas is called I. means when the tumor is confined to the pancreas.
If the adjacent tissues are also affected, the tumor is classified in the category II assigned.
Are regional Lymph nodes affected the tumor comes into the group III.
If there are distant metastases, the tumor is called IV-gradually.

Prognosis for non-operated pancreatic cancer

If those affected are very old or have many comorbidities, it will be more advanced Pancreatic cancer, which has already affected large parts of the surrounding organs and has also settled distant metastases, as well as that Lymphatic system infested has chosen a palliative approach.

Palliative treatment is not understood to be a curative, i.e. healing, procedure but a symptom-relieving and, if possible, life-prolonging procedure.
If you have decided on such a procedure, no more operations are performed. Usually there is no chemotherapy started more.
The focus of this treatment strategy is pain management and symptom relief. E.g. by inserting a small tube, the pancreatic duct can be kept open and thus a free passage for the jammed Bile acids be created.

The 5 year survival rate of patients treated palliatively is 0%. That means that no patient is only symptomatic and not through chemotherapy or is treated by surgery after 5 years still living. In this case, one speaks of a poor prognosis.
On average, patients who received palliative therapy are still alive 6 months. The quality of life of the patient is also not taken into account in these figures.

In the case of a regionally limited tumor infestation, an appropriate treatment, which is generally regarded as curative, comes into play.
This includes both surgery and chemotherapythat can be done either before or after surgery.
There are also tumor stages in which only chemotherapy is carried out and surgery is dispensed with.
Depending on which approach is chosen, the forecasts and the 5 year survival rates.

Survival rates after surgery

The so-called Whipple operation is available as an operational measure, in which the pancreas as well as the Duodenum is removed and the adjoining and upstream organs are surgically interconnected.

Today the operation is mostly preferred, in which the duodenum as well as the pancreas but the stomach is left to stand completely (during Whipple surgery, parts of the stomach entrance are also removed).

Since the results of both operations are almost identical, one usually opts for the somewhat gentler second operation.
If there is a limited tumor incidence in parts of the pancreas, while the surrounding organs and the lymphatic system are tumor-free and the appropriate surgical method is used, the 5 year survival rate 40 %.
That means that 40% of patients who undergo this treatment after 5 years still live. The statistics say nothing about how many patients after 7-10 years Life.

Survival rate after combined surgery with chemotherapeutic agents

Sometimes it may be necessary to have one before surgery Treatment with a chemotherapy drug to start, which should achieve that the tumor in the pancreas is already a little smaller.
With tumor reduction not only the patient is relieved, since e.g. congested bile ducts are decompressed, but by shrinking the tumor, the subsequent operation is easier to perform, since not quite as much Pancreatic tissue must be removed.
In general, the surgical procedure is gentler, even if treatment with chemotherapeutic agents is described as more stressful for the patient.

The combination of chemotherapy and surgery is mainly carried out when the tumor is already over pancreas has moved out.
Without chemotherapy preceded, there is no way the entire tumor could be removed, even if the pancreas has been removed.

chemotherapy can also be performed after an operation.
The consideration here is that the main tumor in the pancreas may have been removed, but small tumor cells have already reached the surrounding tissue without necessarily affecting other organs.
Here one then makes use of the treatment with chemotherapy after an operation to kill any malignant cells that may have escaped.
After chemotherapy after surgery, the average is 5 year survival rate 30%.

If only an operation is performed without chemotherapy, statistically speaking, 15% of the patients are still after 5 yearsn alive.
However, these are carcinomas that have already spread or have metastasized remotely, but for various reasons a decision was made against prior or subsequent chemotherapy.

In addition to the 5-year survival rates, which relate to certain treatment strategies, there is also an average for some oncological diseases 5 year survival ratei.e. the absolute average survival rate.
Because all types of treatment are included in this average, the result is extremely inaccurate, as there are also individual standards for each person affected (such as time of tumor diagnosis, affected areas, distant metastasis and treatment used) should be taken into account.
The average 5 year survival ratewhich include all types of treatment and all stages of the disease should therefore only be used for comparison with other oncological diseases and should not be applied to the individual affected.

In the case of the Pancreatic cancer is the average 5 year survival rate including all treatment methods and all disease stages in 5%. This means that on average 5% of the patients are still after 5 years Life.
If you take this value and compare it with the values of other oncological diseases, it becomes clear that it is the Pancreatic cancer is one of the most malignant cancers with one of the worst prognoses.