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Pancreatic cancer is a very aggressive form of cancer with quite low survival rates, constituting the 4th most common cause of cancer death worldwide.

Many prejudices of the past have been established in the public consciousness, resulting in the majority of patients being hesitant about the application of modern therapeutic methods.

The pancreas is an intra-abdominal, retroperitoneal organ that is in direct contact with large vessels and with the bile duct that transports bile from the liver to the intestine.

This location is what leads to mild, non-specific symptomatology of the cancer, resulting in delayed diagnosis of the disease. In fact, despite the development of medicine and modern diagnostic methods, only 15-20% of patients with pancreatic cancer are in an early stage of the disease when they are diagnosed.

Pancreatic cancer occurs when cells in the pancreas grow and multiply uncontrollably, creating a mass called a tumor.

The risk factors that likely cause and influence the progression of the disease are: age, as 90% of pancreatic cancer occurs in people aged 55 and over, family history, smoking, alcohol, obesity, increased fat intake, the presence of diabetes or chronic pancreatitis.

In the early stages, pancreatic cancer can be difficult to detect, as it usually does not present specific symptoms, which makes early diagnosis difficult. The most common symptoms of pancreatic cancer are: nausea, jaundice, depression, abdominal and lower back pain, onset of diabetes not associated with weight gain, deep vein thrombosis, changes in bowel habits: diarrhea/steatorrhea, unexplained weight loss. Imaging tests (i.e. CT scan and MRI), endoscopic ultrasound (EUS), laparoscopy and biopsy are used for diagnosis.

The only therapeutic option in the treatment of pancreatic cancer is the radical removal of the tumor through surgery. Pancreatectomy is a very technically demanding operation around which many myths have been created regarding the risk of the operation but also its usefulness, which incorrectly lead patients and even many doctors to avoid it.

A big myth that has its roots in the 70s and 80s is that most patients who undergo pancreatectomy die immediately postoperatively. The improvement of surgical techniques and the increase in experience in specialized pancreatic centers have led to postoperative mortality rates of less than 3%. However, morbidity remains relatively high (25 – 30%), with the majority of complications being successfully treated conservatively.

The second big myth about pancreatectomies is that they do not contribute to patient survival. However, recent data from centers with extensive experience show that resection of the tumor to healthy margins can achieve survival rates of 25%, a rate that in patients with early disease can reach 42%.

Chemotherapy and, in addition, radiotherapy, can be used to shrink the tumor and slow its growth, but neither option will cure the cancer. There are some newer targeted therapies that target only certain characteristics of the cancer cells, which only affect 0.8% of all pancreatic cancers (MSI High).

Research in recent years has focused on the combination of chemotherapy and new targeted therapies such as immunotherapies, which are used successfully in other types of cancer. Thus, chemotherapy remains the main treatment option for the majority of patients.

Pancreatic cancer is a very aggressive malignant disease. Valid diagnosis, treatment of patients in specialized centers that exist in Greece, and overcoming past fears can offer a cure in a large percentage.

Raising awareness among all of us towards the early diagnosis of pancreatic cancer also brings the best therapeutic results, so a visit to the doctor can save your life.