The pancreas is a gland, situated behind the stomach, that makes hormones, such as insulin, and digestive juices. When cancerous growths develop from pancreatic cells, in most cases the cancer will be what is called a ductal adenocarcinoma. The outlook, or pancreatic adenocarcinoma prognosis, is often poor, with only around 5 percent of people surviving for five years after diagnosis. Factors which affect the prognosis include how advanced the cancer is when it is discovered, the overall health of the patient and the grade of the tumor. A cancer which is caught early or is of lower grade generally has a better prognosis, and healthier patients can stand up to more intensive treatments, improving the outlook.
Ductal adenocarcinomas of the pancreas develop from cells inside a tube known as the pancreatic duct. Fluid and digestive enzymes, produced by glandular tissue in the pancreas, pass through the pancreatic duct to reach the gut. As the cancer develops, the duct may become obstructed or the tumor may destroy parts of the pancreas or nearby organs.
More advanced cancer may travel in the lymphatic system or blood stream to reach other regions of the body. What is known as staging of pancreatic cancers is carried out in order to assess how far the adenocarcinoma has progressed. Stage I describes a tumor which is confined to the pancreas and stage IV represents distant spread, which has the poorest pancreatic adenocarcinoma prognosis.
A sample of cells, called a biopsy, may be taken from the tumor and examined using a microscope to determine the grade of the adenocarcinoma. Grading is carried out according to how far the tumor cells differ from normal cells in their appearance. The cells of grade 1 cancers are more normal, while grade 4 appear very abnormal and are associated with the least favorable pancreatic adenocarcinoma prognosis.
In the early stages, when an adenocarcinoma has not spread beyond the pancreas, it may be possible to remove the tumor surgically. Even then, the outlook is relatively poor, with only around 15 percent of patients expected to be alive after five years, although occasionally a cure is possible. Many people do not survive because a few, undetectable cancer cells escape treatment and travel throughout the body, developing into new tumors. For people in whom it is not possible to remove the cancer surgically, or where it has already spread widely, pancreatic adenocarcinoma prognosis is much worse, and survival of only a few months is common.