Pancreatic cancer is 'always non-resectable'

Pancreatic cancer is characterized by its very aggressive biological behavior which makes it a rapidly disseminating and deadly tumor. Due to their initial 'silent' behavior, pancreatic cancers are generally diagnosed too late and at that point surgical or medical interventions are futile. The outcome of pancreatic cancer has not improved over the last decades. It is evident that only very few pancreatic cancers are potentially resectable and curable, but many times even these small cancers have poor prognostic factors. Furthermore, upon surgery many of the patients considered preoperatively to have resectable tumors are found to have non-resectable disease. The problem of pancreatic cancer is further compounded by the fact that most tumors are diagnosed in elderly, frail or chronically ill patients, which makes them poor surgical candidates, and only half or fewer of these patients can undergo surgery. The stress of surgery is poorly tolerated by many patients who either die, develop complications or are then unable to receive adjuvant chemotherapy. The bottom line is that pancreatic cancer is a very aggressive tumor. Currently, most cancers are treated by non-surgical methods, and the very few patients with tumors which are potentially resectable should be operated on in specialized, high-volume pancreatic centers.