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Old 01-11-2007, 01:42 PM
Dross Dross is offline
Join Date: Nov 2006
Posts: 883
Default Thomas Jefferson University Hospital - Pancreatic Cancer Surgery Five-Year Survivors

Thomas Jefferson University Hospital - Pancreatic Cancer Surgery Five-Year Survivors 65 and Up Live Nearly as Long As Anyone

A new study shows that pancreatic cancer patients 65 or older who live at least five years after surgery have nearly as good a chance as anyone else to live another five years. Researchers at the Kimmel Cancer Center at Thomas Jefferson University and Thomas Jefferson University Hospital in Philadelphia reviewed the records of 890 patients with pancreatic cancer who underwent the standard pancreaticoduodenectomy, or Whipple procedure, which entails the removal of the gallbladder, common bile duct, part of the duodenum, and the head of the pancreas, between 1970 and 1999 at Johns Hopkins University. They identified those who lived for five years, and compared those who lived for at least an additional five years to the actuarial estimated survival of the general population beginning at age 70. Reporting in the journal Surgery, they found that 201 patients (23 percent) lived five years after surgery, at least half of whom were 65 years old or older at the time of surgery. Of those five-year survivors, an estimated 65 percent lived at least an additional five years.

In the general population, roughly 87 percent of the same age group live another five years. The study has an important message, says Charles Yeo, M.D., Samuel Gross Professor and Chair of Surgery at Jefferson Medical College, who led the work. a decade ago, many clinicians thought that there was little reason to operate on patients with pancreatic ductal cancer, that surgery does little to extend life and improve the quality of life, says Dr. Yeo. Not too long ago, few lived for five years after diagnosis. Today that's not true. There's been a paradigm shift in the way we treat and think about this disease. While only approximately 25 percent of those diagnosed with pancreatic cancer who undergo successful surgical resection of their disease live at least five years, overall, of those who live for five years after resection, some 55 percent will be alive at least another five years. The public hears pancreatic cancer and thinks there's little hope and there isn't much to do. The good news is, with new imaging techniques, better early detection, improved screening of high-risk groups, and new therapies on the horizon, we're actually making great progress when it comes to pancreatic cancer. It's no longer a death sentence. Pancreatic cancer, the fifth-leading cause of cancer death in this country, takes some 30,000 lives a year. It remains one of the deadliest cancers; only approximately 15 to 25 percent of all those with pancreatic cancer live one year after diagnosis, and only 5 percent are alive five years later.

Last edited by gdpawel : 11-05-2013 at 09:38 PM. Reason: posted full article on forum board
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Old 11-04-2013, 05:07 PM
gdpawel gdpawel is offline
Join Date: Feb 2007
Location: Pennsylvania
Posts: 4,360
Default Surgery for pancreatic cancer

Cristina Ferrone, M.D.
Assistant Professor
Department of Surgery
Harvard Medical School

Surgeons are the only ones who can decide whether or not a patient is a candidate for an operation.

The most common pancreatic cancer symptoms that lead to further testing are jaundice (yellowing of the skin) and/or pain.

Resectability determines is a pancreatic cancer is borderline resectable. It is determined by the relationship of the cancer to vital blood vessels such as the superior mesenteric artery, celiac/common hepatic artery, portal vein, superior mesenteric vein, etc. If the tumor is partially involving one or more of these blood vessels that tumor may be considered borderline resectable.

Ductal adenocarcinoma is the most common type of pancreatic cancer. Other types of pancreatic tumors are neuroendocrine tumors, acinar tumors, cystic tumors, etc.

When the surgeon is in the operating room he/she will often be able to see and feel if there is cancer outside of the pancreas. Additionally the specimen which is removed from the body is sent to the pathologist. The pathologist looks at the margins (areas which are cut) to be sure there are no cancer cells left.

It is hard to predict how many lymph nodes will be removed and how many the pathologist is able to find in the cancer which is removed. The surgeon performs the appropriate operation which includes the local lymph nodes.

If the cancer has spread to the lymph nodes patients often receive chemotherapy. Most patients who have pancreatic cancer and undergo an operation have cancer which has spread to the lymph nodes.

Biopsies are typically performed if the patient wants to get chemo or radiation therapy if the patient is not going to go the operating room or if the patient will receive therapy before the operation. Another reason to perform the biopsy includes uncertainty of the diagnosis.
Gregory D. Pawelski
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