PETALING JAYA - When one is diagnosed with pancreatic cancer, the outlook is often grim.
The cancer destroys quietly, presenting no symptoms until signs such as backache, abdominal pain, yellowing of the skin (jaundice), itching and lethargy appear.
"Pancreatic cancer is seldom in the news because it's usually detected in the advanced stage and has already spread to other parts of the body.
"When people discover the symptoms, 85 per cent to 90 per cent of the time, it's already too late," said consultant oncologist Dr Harry Yeo Kar Kiat.
The pancreas is an organ in the abdomen that lies horizontally behind the lower part of the stomach. Its role is to secrete enzymes that aid digestion and hormones that help regulate the metabolism of sugars.
"Because many other illnesses present similar symptoms, pancreatic cancer is hard to detect. We can only tell via Computed Tomography scans but we cannot subject healthy individuals to go through this because of the radiation level involved," he said.
Pancreatic cancer has the highest mortality rate of all major cancers, with some 94 per cent of patients dying within five years of diagnosis. About 74 per cent of patients die within the first year of diagnosis.
The cancer is one of the few for which survival has not improved substantially over nearly 40 years.
When the cancer is inoperable, one of the treatment options is the Folfirinox chemotherapy, which uses a combination of four drugs.
"The treatment process can be torturous because the side effects are terrible. Usually, the patients go through 12 cycles of treatment, each lasting two weeks.
"From my experience, the prognosis is generally poor for locally advanced and metastatic pancreatic cancer, with survival rates ranging from three to six months and 10 to 12 months," said Dr Yeo.
The risk factors for pancreatic cancer, he said, included tobacco smoking (about 30 per cent of cases), obesity, old age (more than 50 per cent of the cases involve people above 70), late onset diabetes mellitus, chronic and hereditary pancreatitis and certain cancer syndromes.
In Malaysia, pancreatic cancer, he said, was at the bottom of the cancer statistics, with breast and colorectal cancer topping the list.
"When all treatments have failed, we send the patients to palliative care where we keep them as comfortable and pain-free as possible till the end," said Dr Yeo.