Pancreatic cancer: medical aspects

Although pancreatic cancer (PC) continues to be a formidable disease, numerous treatment strategies are evolving that we hope will result in improved patient survival. To prolong the survival of patients with PC, it is essential to detect PC at the earliest stage possible and to develop effective nonsurgical treatments for this disease. The current strategies for the early diagnosis of PC include the development of diagnostic modalities and screening programs for the early detection of PC and the determination of high-risk groups for PC. K-ras mutations in pancreatic juice obtained endoscopically have been studied recently in association with the early diagnosis of PC, although the interpretation of the presence of a mutated K-ras gene requires caution. The role of the current nonsurgical treatments for PC has been limited. Identification of an effective new chemotherapeutic agent is a high priority, and the enrollment of patients with PC with metastatic disease into well-designed clinical trials is essential. New targets for therapy based on the understanding of the molecular biology of PC may provide avenues for future trials. We must continue to search actively for more accurate methods of diagnosis and more effective methods of treatment for PC.