Carcinoma of the pancreas: progress or stalemate?

Has treatment for cancer of the pancreas progressed or has a stalemate been reached? This is a difficult question to answer. Cancer of the pancreas has several unique features. First, it has been an extremely difficult tumor to study because of its anatomic location and our present invasive and non-invasive studies have failed to provide for truly early detection of this disease when cure may be possible. Second, assuming that we are able to diagnose early, radical surgical resection (our best treatment to date) still carries a substantial morbidity and mortality. The direction certainly has to be in early detection and screening in the asymptomatic patient. To date all of our therapy is directed to the patient who already has symptoms. Diagnosis prior to this stage of the disease is imperative. This would entail the use of biological and serum antibody-type screening procedures with specific tumor markers and better epidemiologic studies to identify risk factors which would aid in screening procedures. It is apparent that present day techniques in the diagnosis and directions are needed before any significant improvement in survival rates are realized.