A tough admission to the VIP floor came in a few days back. Patrick Swayze, the '80s heart throb most famous for dirty dancing with Jennifer Grey and potterizing Demi Moore was diagnosed with pancreatic cancer.
George Fisher, MD, Swayze's oncologist told People magazine that "Patrick has a very limited amount of disease and he appears to be responding well to treatment thus far. All of the reports stating the time frame of his prognosis and his physical side effects are absolutely untrue. We are considerably more optimistic."
Fisher is an Associate Professor of Medicine and has published extensively on GI malignancies.
Swayze is in for a tough fight but his relatively young age of 55 will serve him well as will the early diagnosis.
More than 37,000 people develop pancreatic CA every year in the United States, and nearly all die form the disease, the outstanding majority within five years of diagnosis. If you're keeping track, it's the fourth leading cause of cancer-related death in the United States.
Surgery is the only chance of cure, but only 15-20% of cases are even candidates at presentation. Reported five-year survival rates following the typical surgery (removal of pancreas, part of the small intestine and the gallbladder) range from 10 - 30% depending whether there has been spread of the disease to the surrounding tissue (particularly the lymph nodes).
Patients survival may be improving over time, possibly related to an increased percentage of patients having surgery at a major center and the addition of new chemo agents before and/or after the surgery.
Major risk factors for pancreatic CA include chronic pancreatitis, smoking, diabetes mellitus, and hereditary predisposition to pancreatic cancer itself or to multiple cancers.
Most likely, Swayze complained of pain, weight loss, and/or jaundice (yellowing of skin and mucosa) as most patients will present with one or a combo of these symptoms.
Typically a patient presenting with these symptoms will be sent for a CT scan or ultrasound (US) as both are not too invasive and have similar rates of picking up the disease. If there is a mass in or close to the pancreas the next stage is a more invasive look -- either endoscopic US, ERCP (Endoscopic Retrograde Cholangiopancreatography), or staging laparoscopy. They do these more invasive studies primarily to determine whether the patient is a candidate for surgical resection and to determine the extent to which the malignancy has penetrated (i.e. adjacent organs, lymph nodes, etc). Obviously, the less it has spread, the better the chances are of a meaningful treatment course and prognosis.
Assuming the tumor is resectable, there is no one best treatment method for patients after surgery of a pancreatic cancer, and the approach is different in Europe and in the United States. Most large centers, like Stanford, will enroll these patients in an ongoing clinical trial where different treatment regimens are evaluated. Usually these methods compare the standard of care verses something additional, e.g. chemo before surgery, chemo after surgery, or chemo before and after surgery.
We wish Mr. Swayze the best of luck in his battle with pancreatic cancer and if nothing else, the media coverage he brings to his fight will certainly make the general public more aware of the disease and its risk factors.