Pancreatic Cancer Is Often a Death Sentence

There are reports swirling that Bernie Madoff is dying of pancreatic cancer — and if those rumors are true — it's not a question of whether the convicted Ponzi schemer will die — it's a question of when.

Most pancreatic cancer diagnoses are fatal because cases often are asymptomatic, making it less likely that the cancer will be caught before it spreads.

The later the cancer is caught the lower the chances of survival, according to Dr. Avram Cooperman, surgical director for the Pancreas and Biliary Center at St. Vincent’s Hospital in New York City, who spoke to in March 2008 just after actor Patrick Swayze announced his pancreatic cancer diagnosis.

“Overall survival isn't good,” Cooperman said. “Many never even make it to the hospital. Some have minor symptoms and, if treated with surgery and chemotherapy, the survival rates get better."

Why is cancer in such a tiny organ so grim? Not only is it typically aggressive, there's no early detection test. Vague indigestion may be the only early sign. By the time such classic symptoms as yellowing skin, itching, weight loss and abdominal pain appear, the cancer has spread.

People ages 50 to 70 are most at risk for developing the disease. Smokers, heavy drinkers of alcohol and, in some cases, people with a genetic predisposition are most at risk for pancreatic cancer, Cooperman said. Some sufferers of chronic pancreatitis may also be at risk. A recent study linked eating a lot of charred red meat to an increased risk for pancreatic cancer.

Besides eating right and abstaining from smoking and heavy drinking, there's very little that can be done to prevent the disease.

"There's no real screening test for it," Cooperman said. "There are markers that are being developed and there are studies that are ongoing, but it's not like lung cancer where you can take an X-ray of a person's lungs. There are screenings, but they present radiation risks and there are MRIs, which are expensive."

Supreme Court Justice Ruth Bader Ginsburg announced in February that she had pancreatic cancer. She has since undergone surgery.

As few as 10 of every 100 patients have their pancreatic tumor cut out. The majority has the most aggressive form of pancreatic cancer, called adenocarcinoma, and usually it's too far gone to operate.

This is one of the most formidable cancers. The American Cancer Society estimates that nearly 38,000 people last year were diagnosed with it, and no more than 5 percent overall survive five years.

Caught in its advanced stages, pancreatic cancer, which affects about 30,000 people a year, has a 5 percent survival rate for five years. Caught early enough and treated with surgery and chemotherapy, the five-year survival rate goes up to 17 to 25 percent, Cooperman said.

More on the signs and symptoms of pancreatic cancer:

What is pancreatic cancer?

Pancreatic cancer is the formation of malignant cancer cells and tumors in the tissues of the pancreas.

What are the symptoms?

Pancreatic cancer has very few early symptoms and, in some cases, may present no symptoms at all or symptoms that may be confused for other ailments. However, some symptoms include yellowing of skin and eyes (jaundice), pain in the upper/middle abdomen and back and unexplained weight loss and fatigue. Sudden onset of diabetes may also be a symptom.

Who’s at risk?

Smoking and family history of the disease increase an individual's chances of getting the disease. Other risk factors include chronic pancreatitis and diabetes.

What are the treatment options?

Surgery to remove the malignant tumor is the best treatment. However, if the cancer has spread to other areas of the body such as the lymph nodes, radiation therapy, chemotherapy or a combination of these treatments may be necessary.

Ways to prevent it?

Don’t smoke/quit smoking. People at high risk for the disease may benefit from periodic screenings such as chest X-rays, annual physicals, CT/PET scans and MRI.

The Associated Press contributed to this story.