Questions To Ask The Doctor
- Do you know the stage of the cancer?
- If not, how and when will you find out the stage of the cancer?
- Would you explain to me what the stage means in my case?
- Based on the stage of the cancer, how long do you think Ill live?
- What is the grade of the cancer and what will that mean for treatment?
- What will happen next?
Pancreatic Cancer Life Expectancy And Survival Rate
A survival rate is a percentage of how many people with the same type and stage of a cancer are still alive after a specific amount of time. This number doesnt indicate how long people may live. Instead, it helps gauge how successful treatment for a cancer might be.
Many survival rates are given as a 5-year percentage, which refers to the percentage of people alive 5 years after being diagnosed or starting treatment.
Its important to keep in mind that survival rates arent definitive and can vary greatly from person to person depending on age, overall health, and how the cancer progresses. As a result, they also cant determine an individuals life expectancy.
Survival rates for pancreatic cancer are typically provided for localized, regional, and distant stages:
- Localized. Cancer hasnt spread from the pancreas, which corresponds with stages 0, 1, or 2A.
- Regional. Cancer has spread to nearby tissues or lymph nodes, which corresponds with stages 2B and 3.
- Distant. Cancer has spread to distant sites, like the lungs or bones, which corresponds with stage 4.
Heres a look at the 1-, 5-, and 10-year relative survival rates from diagnosis for each stage.
If you or a loved one was recently diagnosed with pancreatic cancer, its understandable to immediately wonder about life expectancy, but this depends on a range of factors that vary greatly from person to person. Your healthcare team can provide the most accurate estimate based on these factors.
A Number Of Physical Changes Are Common When The Patient Is Near Death
Certain physical changes may occur in the patient at the end of life:
- The patient may feel tired or weak.
- The patient may pass less urine and it may be dark in color.
- The patients hands and feet may become blotchy, cold, or blue. Caregivers can use blankets to keep the patient warm. Electric blankets or heating pads should not be used.
- The heart rate may go up or down and become irregular.
- Blood pressure usually goes down.
- Breathing may become irregular, with very shallow breathing, short periods of not breathing, or deep, rapid breathing.
However, these signs and changes don’t always occur in everyone. For this reason, it may be hard to know when a patient is near death.
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Choices About Care And Treatment At The End Of Life Should Be Made While The Patient Is Able To Make Them
A patient may wish to receive all possible treatments, only some treatments, or no treatment at all in the last days of life. These decisions may be written down ahead of time in an advance directive, such as a living will. Advance directive is the general term for different types of legal documents that describe the treatment or care a patient wishes to receive or not receive when he or she is no longer able to speak their wishes.
Studies have shown that cancer patients who have end-of-life discussions with their doctors choose to have fewer procedures, such as resuscitation or the use of a ventilator. They are also less likely to be in intensive care, and the cost of their healthcare is lower during their final week of life. Reports from their caregivers show that these patients live as long as patients who choose to have more procedures and that they have a better quality of life in their last days.
See the PDQ summary on Planning the Transition to End-of-Life Care in Advanced Cancer for more information.
What Do We Mean By Pancreatic Cancer Prognosis
When we look at pancreatic cancer prognosis and life expectancy, we usually focus on the five-year survival ratethe percentage of people still alive five years after their pancreatic cancer has been diagnosed.
Why five years? We use five years as a benchmark because thats a good indicator that the cancer has responded to treatment.
Keep in mind, these rates do not refer to people who survive ONLY five years. Some go on to live much longer than that.
Also, since these numbers take five years to collect, they dont always reflect survival improvements due to advances in treatment.
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Physical Status After Treatment
Getting the right nutrition and keeping physically active as much as possible under the circumstances can really impact how a patient tolerates the side effects of treatment and the symptoms of pancreatic cancer.
Younger patients tend to do better because they have fewer other conditions that may limit recovery, but even older patients can positively impact their prognosis by focusing on nutrition and exercise.
Talk to your doctor about what to expect after treatment and what you can do to get the best possible prognosis.
Confusion Restlessness Or Agitation
Sometimes a person may become confused, restless or agitated. Your loved one may not know where they are or who is with them. Or they may fidget, or want to move about even if theyre not able to. You may want to reassure them by reminding them of who you are and what is going on around them.
They may describe speaking to someone who has died or they may see things that arent there. If theyre not upset, its fine to talk to them about what they can see or hear. Some people may be frightened staying near them, gently touching them and reassuring them may help. A calm room with quiet music and familiar items like photos nearby can also help.
It can be upsetting for you if your family member is confused or agitated. There could be different reasons for why it is happening, so speak to the doctor or nurse. They will look for anything that is causing it, like pain, problems with their bladder or bowels, or issues with their medicines. They may recommend giving medicine to relax and calm them. Or they may suggest putting in a catheter . This will stop the bladder getting full and causing discomfort. If you are worried that your family member may be in pain, the doctor or nurse can help with this.
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Pancreatic Cancer Stage 1
Stage 1 pancreatic cancer involves a tumor thats only in the pancreas. This stage is divided into two subcategories, depending on the size of the tumor:
- Stage 1A. The tumor measures 2 cm or less.
- Stage 1B. The tumor measures more than 2 cm but less than 4 cm.
Stage 1 pancreatic cancer typically doesnt cause any noticeable symptoms.
If detected at this stage, pancreatic cancer may be curable with surgery.
Hospice Eligibility And Pancreatic Cancer
Interested in learning more about the signs of end-of-life pancreatic cancer? Or simply have questions related to how hospice care can help? Crossroads is available 24 hours a day, 7 days a week to answer any question you may have. Choose one of the options in the blue Help Center bar above to speak with someone now.
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Surgery For Pancreatic Cancer
Surgery is used to try to take out all of the cancer if its small and has not spread. Sometimes, surgery can be done to take out only the cancer, and leave the rest of the pancreas alone. But often, depending on how large the cancer is, parts, or even all, of your pancreas and other organs might need to be removed, also. If your cancer is too large or has spread too far, surgery may not be possible and other treatments might be done instead. Ask your doctor what kind of surgery you will have.
Side effects of surgery
Surgery for pancreatic cancer can be a very big operation and can have risks and side effects. Be sure to ask the doctor what to expect and let your doctors know if you have any problems after surgery. Possible problems from surgery are:
- Leaking inside the body
Overall Survival For Pancreatic Cancer
The overall one-year survival rate for pancreatic cancer is 24.4%, in the UK. This means that around 24 in 100 will have survived to one year and beyond.
The five-year survival rate for pancreatic cancer is 7.3%. This means that around 8 in 100 people will have survived for five years and beyond.
10-year survival of the disease is 1%, meaning only around 1 in 100 people survive 10 years and beyond.
Pancreatic cancer has the lowest five-year survival rate of any of the 22 common cancers. However, it is encouraging that survival has more than doubled since Pancreatic Cancer Action began, 10 years ago. Though increases in survival may seem small, we are beginning to see a slow but positive trend upwards after decades without improvement.
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Patients May Not Want To Eat Or Drink In The Final Days Or Hours
In the final days to hours of life, patients often lose the desire to eat or drink, and may not want food and fluids that are offered to them. The family may give ice chips or swab the mouth and lips to keep them moist. Food and fluids should not be forced on the patient. This can make the patient uncomfortable or cause choking.
Pancreatic Cancer In The Older Patient
Michael J. OConnell, MDOncology
Pancreatic cancer is a disease seen predominantly in elderly patients. Compared to younger patients, older patients are more likely to present with early-stage disease and, therefore, may be candidates for aggressive local
ABSTRACT: Pancreatic cancer is a disease seen predominantly in elderly patients. Compared to younger patients, older patients are more likely to present with early-stage disease and, therefore, may be candidates for aggressive local treatment. Little published information exists on treatment outcomes for elderly patients with potentially resectable disease or those with locally advanced or metastatic pancreatic cancer. The limited information available suggests that elderly patients are as likely to benefit from surgery, radiation, and chemotherapy as younger patients. Despite this apparent benefit, elderly patients appear to have a worse long-term outcome. This may be due to the failure to offer them aggressive treatment or to comorbid conditions. Nevertheless, further studies need to be conducted in this area, and greater emphasis needs to be placed on including elderly patients in clinical trials. For elderly patients with terminal disease, there should be better use of palliative measures that may be of benefit. Each of these issues is discussed in detail.
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Survival Statistics For Pancreatic Cancer
Survival statistics for pancreatic cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular persons chances of survival.
There are many different ways to measure and report cancer survival statistics. Your doctor can explain the statistics for pancreatic cancer and what they mean to you.
Survival Rates By Stage
If youve been diagnosed and your stage has been determined, you may be curious about your outlook. An outlook is based on information compiled from people who have a similar cancer.
Although theyre useful, survival statistics arent definitive. Make sure you discuss your individual outlook with your doctor so you can better understand what it means for you.
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What Will Happen After Treatment
Youll be glad when treatment is over. For years after treatment ends, you will see your cancer doctor. Be sure to go to all of these follow-up visits. You will have exams, blood tests, and maybe other tests to see if the cancer has come back. At first, your visits may be every 3 to 6 months. Then, the longer youre cancer-free, the less often the visits are needed.
Some treatments may not cure your cancer. You many need to keep getting treatment and care. From time to time tests will be done to see how your treatment is working.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. Call us at 1-800-227-2345 or talk to your cancer care team to find out what you can do to feel better. You cant change the fact that you have cancer. What you can change is how you live the rest of your life.
Factors That Influence Survival
Cancer registries base five-year survival rates on everyone with the diagnosisregardless of age, health, or cancer type. Any one patients actual risk of getting pancreatic cancer, as well as their survival after treatment, will be dictated by other factors. Some of those factors can be changed, while others cant.
- Age: Older patients fare worse than younger patients.
- Race:The pancreatic cancer rate is considerably higher for Black people than for any other race.
- Cancer types: Different cells in the pancreas give rise to tumors that react differently to treatments. These include neuroendocrine tumors, small cell carcinoma, squamous cell carcinoma, adenocarcinoma, and primary pancreatic lymphoma.
- Smoking:Tobacco use is a risk factor for developing pancreatic cancer. If no one smoked, there would be 30% fewer pancreatic cancers.
- Alcohol:Heavy drinkers have a worse prognosis than those who dont drink or drink less.
- Obesity: Excess weight before the age of 50 is correlated with increased pancreatic cancer risk.
- Diabetes: People with diabetes have worse survival when diagnosed with pancreatic cancer.
- Performance status:This measure of a patients ability to perform daily tasks is one of the best indicators of prognosis. The more trouble everyday tasks are, the worse off the patient is.
- Surgery:If the doctor can cut the whole tumor out, the patient has a much better outlook.
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What Can Patients Do To Improve Their Chances
Pancreatic cancer patients who participate in clinical research have better outcomes. Seeing pancreatic cancer specialists, including healthcare professionals who focus on symptom management and supportive care also improves outcomes. And, patients who receive treatment based on their biology can live longer.
For all stages, the Pancreatic Cancer Action Network strongly recommends:
- Clinical trials at diagnosis and during every treatment decision
- Genetic testing for inherited mutations as soon as possible after diagnosis and biomarker testing of tumor tissue to help determine the best treatment options
- Getting an opinion from a specialist, a physician who diagnoses and treats a high volume of pancreatic cancer patients
- Symptom management and supportive care, provided early in your diagnosis as well as during and after treatment
Contact PanCAN Patient Services to learn more about these options.
Finding The Right Oncologist
Finally, I was referred to Dr. Mitchell Gaynor*, who practiced integrative oncology. He believed that medicine alone was not sufficient, and that patients needed to include changes on the physical, mental, emotional, and spiritual realms. When I met with him, Dr. Gaynor said there was so much I could do. He also said whether or not I chose him for my treatment I should come to his support group. I was astounded that he ran his own support group, which included chanting and Tibetan bowls. I was reluctant to go to the first meeting because I was scared to be around people who would be talking about pain and dying. At his group I met people who were exercising, even running, while in stage IV. Meeting Dr. Gaynors patients, who were so filled with life, led me to choose him as my oncologist. The quality of their experience was a very important factor in my decision.
Because of an extensive family history of cancermy mother, father, sisters, uncles, and both grandmothers had died of cancerDr. Gaynor suggested genetic testing. In fact, he was the first doctor to suggest this to me. He sent me for a biopsy, and I found out that I carried the BRCA2 gene.
I didnt start chemotherapy right awaythe other oncologists I had seen were adamant that chemotherapy would at most give me a couple of extra months, and leave me sick as a dog! I told him that I wanted to try his non-medical interventions first. He agreed, realizing that I was not going to be persuaded at this time.
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Survival Rates: What To Know
Because doctors rarely find pancreatic cancer in its early stages when its easiest to treat, its one of the most deadly cancers. About 9% of people with pancreatic cancer live at least 5 years after diagnosis. But the 5-year survival rate is much better — 34% — if it hasnt spread past the pancreas. Know that survival rates cant predict what will happen to any single person and may not reflect newer types of treatment.
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Where Do These Numbers Come From
The American Cancer Society relies on information from the SEER* database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for pancreatic cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead, it groups cancers into localized, regional, and distant stages:
- Localized: There is no sign that the cancer has spread outside of the pancreas.
- Regional: The cancer has spread from the pancreas to nearby structures or lymph nodes.
- Distant: The cancer has spread to distant parts of the body such as the lungs, liver or bones.