Silent Killer With Growing Impact

By: Dr. Neeraj Chaudhary

Pancreatic cancer is one of the deadliest and most challenging cancers, often called a “silent killer” due to its subtle symptoms and aggressive nature. Unlike many other cancers that present early warning signs, pancreatic cancer remains asymptomatic in its early stages, making early detection extremely difficult. As a result, it is often diagnosed late, leading to poor survival outcomes.
Late Detection
One of the most unique aspects of pancreatic cancer is the absence of early symptoms. The pancreas is located deep within the abdomen, making it difficult to detect tumours in their early stages. Symptoms such as jaundice, weight loss, and abdominal pain often only appear when the cancer has spread to other organs, usually by Stage IV. This contributes to the low 5-year survival rate, which globally is less than 10%.
Aggressive Progression
Pancreatic cancer spreads rapidly and tends to invade nearby organs like the liver, lungs, and peritoneum early in its development. It also tends to metastasize to distant organs, making it more difficult to treat and contributing to its aggressive nature.
Treatment Resistance
Pancreatic cancer is notoriously resistant to traditional treatments like chemotherapy and radiation. Surgery is the most effective option, but only about 20% of patients are candidates for surgical resection due to the advanced stage at which the disease is typically diagnosed. Furthermore, the pancreas’ proximity to major blood vessels complicates surgical removal, limiting the options for curative treatment.
Links to Diabetes and Obesity
Interestingly, pancreatic cancer has a strong association with metabolic disorders like diabetes, particularly Type 2 diabetes. Many patients are diagnosed with diabetes shortly before the onset of pancreatic cancer, suggesting a potential causal relationship. Additionally, obesity and chronic pancreatitis are significant risk factors for developing this cancer.
A Growing Concern
Pancreatic cancer is a significant but under-recognized health issue in India. Though relatively rare compared to other cancers, the incidence of pancreatic cancer is on the rise in India, with lifestyle changes, increasing rates of diabetes, and obesity contributing to this upward trend.
The lack of awareness about the disease also plays a role in the delayed presentation, with many patients only seeking medical attention when the cancer has progressed to an advanced stage.
Early Detection and Future
Directions
Currently, there are no routine screening tests for pancreatic cancer, which makes early detection nearly impossible. The key to improving outcomes lies in better diagnostic tools, increased awareness, and early intervention. Research is ongoing into improving imaging techniques and developing blood tests that can detect pancreatic cancer markers at an earlier stage.
Raising awareness about the symptoms, risk factors, and importance of early medical consultation is essential in improving survival rates. Regular health check-ups for those at high risk, such as individuals with a family history of pancreatic cancer, long-standing diabetes, or chronic pancreatitis, could lead to earlier detection and better treatment outcomes.
Pancreatic cancer remains one of the most challenging forms of cancer. Its late detection, rapid progression, and resistance to treatment make it a formidable adversary. However, with continued advancements in research and a focus on early diagnosis, there is hope that outcomes for pancreatic cancer patients will improve in the years to come.

The writer is Director Robotic and Laparoscopic GI-HPB Surgery and GI-HPB Oncology, Yatharth Hospital, Greater Noida

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