Pancreatic cancer is the 5th and 6th most common cancer to take lives in men and women in Singapore, respectively. More than 80% of cases cannot be fully treated by the time of diagnosis. About 5% of pancreatic cancer patients live beyond five years, but only 1% survive beyond ten years. What is pancreatic cancer, and why is it so lethal?

What is pancreatic cancer?

The pancreas is an organ located in the upper abdomen, in between the stomach and the spine. The organ has two functions, which is to secrete enzymes to digest fats, proteins, and carbohydrates (exocrine function); and to produce insulin and glucagon to regulate blood sugar levels (endocrine function).

Pancreatic cancer occurs when a tumour grows in part of the pancreas, hindering the normal function of the pancreas. In advanced stages of the illness, the growth of the tumour can also metastasise (spread) to other parts of the body, which makes total removal of cancer cells close to impossible.

There are two main types of pancreatic cancer, depending on which part of the pancreas the tumour begins to grow in. The more common and also more aggressive type is the exocrine pancreatic cancer, wherein the tumour affects the exocrine function of the pancreas. The less common variant is the endocrine pancreatic cancer, in which the tumour affects the endocrine function of the pancreas.

Why is pancreatic cancer so lethal?

Pancreatic cancer is said to be an aggressive and deadly illness because most of the patients who are diagnosed have little chance of survival. Here are some of the reasons why pancreatic cancer offers little hope for patients:

• There is no known cause: There is no known cause for pancreatic cancer, making it difficult to identify people who are at-risk. While there are some factors found to have correlations to pancreatic cancer, such as a family history of pancreatic illness, smoking, and obesity, these are still much too general to effectively predict or narrow down people at risk of developing pancreatic cancer, such that early diagnosis can be made.
• Symptoms are non-specific: Doctors list the symptoms of pancreatic cancer to be upper abdomen pain, jaundice, poor appetite, nausea, vomiting, weight loss, malnutrition, and pale greasy stools, amongst others. However, these symptoms vary from case to case and are not specific to pancreatic cancer. This makes it difficult to immediately pinpoint the cause of symptoms to pancreatic cancer.
• Symptoms arise when its already too late: Most cases of pancreatic cancer are diagnosed when it is already too late to be cured. This is because symptoms of pancreatic cancer often only arise at the later stages of cancer when the tumour has already grown quite large. At this point, the growth would have infiltrated nearby organs such as biliary ducts, liver, surrounding lymph nodes, blood vessels and bones, making it impossible to remove at the time of diagnosis.
• There is no reliable screening method: Unlike breast cancer or colon cancer where diagnosis tests are relatively reliable and accessible, pancreatic cancer lacks a reliable and widely available test for the masses to conduct regular checks. This makes it difficult to detect pancreatic cancer at the early stages when it is still curable.

Unfortunately, pancreatic cancer continues to take lives with warnings that are too little and too late. What you can do is to maintain a healthy lifestyle to reduce the risk factors of pancreatic cancer, and keep a lookout for warning signs. If you would like to know more about pancreatic cancer, you can consult a gastroenterologist specialist to tell you more about its symptoms, diagnosis methods, and treatment options.