ALBANY, NY—Pancreatic cancer remains one of the deadliest malignancies in the United States, but new therapies can extend life and improve quality of life for many patients.
That is especially the case at the VA, where rising treatment rates with more effective therapies extended the survival rate for metastatic pancreatic cancer more than sixfold from 2000 to 2014, according to a recent study in the Journal of Gastrointestinal Oncology.1
Nationally, the incidence rate for pancreatic cancer has risen about 0.5% annually for more than a decade. The number of cases diagnosed in the U.S. rose from about 46,000 in 2014 to nearly 57,000 projected in 2019. At the same time, the malignancy has steadily risen in the ranks of the cancers responsible for the most deaths in the U.S., from fourth place in 2014 to third this year. It is expected to overtake colorectal cancer as the second-leading cause of cancer deaths in the next few years, behind only lung cancer.
The reasons behind the increasing incidence do not augur well for veterans.
“Risk factors for pancreatic cancer have been linked to older age, male gender, smoking, obesity and diabetes, which are more prevalent in veterans than in the general population. About 10-20% of pancreatic cancer is familial,” said lead author Syed A. Mehdi, MD, oncologist with the Stratton VAMC and associate professor of medicine at Albany Medical College in Albany, NY.
Mehdi and his colleagues noted that incidence rates also might have increased as a result of improved imaging and greater use of endoscopic ultrasound, which can detect the cancer at earlier stages. Their study showed a sharp increase in the incidence of localized and small tumors at the VA. On the national level, earlier detection of the cancer could explain some of the increase in the five-year survival rate from 6% in 2014 to a still dismal 9.3% in 2017.
One reason pancreatic cancer has such low survival rates is that most patients are not diagnosed before the disease has spread. Only 10% of patients present with Stage 1 disease at diagnosis, according to the National Cancer Institute Surveillance, Epidemiology and End Results Program data. For those patients, the five-year survival rate is 34%.
More than half of all patients with pancreatic cancer in the U.S. (53%) are first diagnosed with metastatic disease. For them, the five-year survival rate is 3%.
Continue: Metastases at Diagnosis