Pancreatic cancer

Cancer of the pancreas remains a disease for which there is no satisfactory treatment. A specific population at risk and etiologic factors have not been clearly defined. The increased incidence in industralized countries over the past 30 to 40 years is not understood. Technological advances have permitted more frequent diagnosis at an early stage, but this has not influenced survival statistics. Clearly, there is a need for a reliable tumor marker that will allow diagnosis to be made even earlier. Radical surgery appears to have reached a plateau in terms of improving survival. Morbidity and mortality have decreased since pancreatoduodenectomy began to be widely used. This decrease is probably due to better pre- and postoperative surgical management than to major improvements in technique. More radical procedures have failed to demonstrate clearcut improvements in survival. Radiotherapy and chemotherapy are in the early stages of systematic exploration in treating pancreatic cancer. Most reports deal only with palliating advanced, nonresectable disease. The utility of radiotherapy and chemotherapy as adjuncts to surgery have not been defined.