Pancreatic carcinoma

Abstract

The management of patients with pancreatic carcinoma poses many problems. The diagnosis is usually made late, generally because the patients present late, but it is not unusual to find patients who have had many negative investigations for vague upper abdominal symptoms only to be diagnosed as having pancreatic carcinoma many months later. Staging the disease is equally difficult and often inaccurate. The results of treatment are to date discouraging even in those patients diagnosed early. But the outlook is not totally dismal; in recent years the results for surgical resection of pancreatic lesions have improved; adjuvant treatment may finally be having an effect, although small, on this relentless disease. The most notable inroad made in the management of pancreatic cancer in the last 10 years is the improvement in palliation due to the use of the endoprosthesis. In spite of the poor results we must continue to search actively for more accurate methods of diagnosis and better methods of treatment.

Growth-inhibitory effects of vitamin D analogues and retinoids on human pancreatic cancer cells

“…In the United States incidence of pancreatic carcinoma has trebled in the last 50 years (Kelly and Benjamin, 1995). Pancreatic carcinoma is associated with an especially poor prognosis (Jeekel, 1994).…”

Concomitant chemoradiotherapy with low-dose weekly gemcitabine for nonmetastatic unresectable pancreatic cancer

“…Most patients are diagnosed in the locally advanced or metastatic stage and the mortality rate is high, in that about 83% of newly diagnosed pancreatic cancer cases in 2009 will die (2). Although surgery is the only possibility of cure, only about 20% of them are resectable at diagnosis (3). A surgically unresectable tumor comprises the locally advanced pancreatic cancers with involvement of the celiac axis or superior mesenteric artery (4).…”

A phase I study of erlotinib in combination with gemcitabine and radiation in locally advanced, non-operable pancreatic adenocarcinoma

“…This disease has an extremely poor prognosis, with an overall 5 year survival of <5% [1]. For patients who present with locally advanced, unresectable disease (40% [2]), combined chemoradiotherapy is an accepted standard approach, although increasingly the timing of radiotherapy remains controversial. Earlier studies have focused on the role of 5-flourouracil (5-FU) as a radiation sensitizer [3] as proposed by Heidelberger et al [4] in 1958.…”