Pancreatic cancer prognosis, explained by A/Prof Andrew Metz

After a pancreatic cancer diagnosis, you may feel overwhelmed by thoughts of what comes next and what the diagnosis means for you or your loved ones.

Associate Professor Andrew Metz leads the Jreissati Pancreatic Centre at Epworth and is a gastroenterologist and endoscopist with extensive experience in pancreatic cancer.

Andrew answers common questions about pancreatic cancer prognosis to help you understand what it is and how it’s diagnosed.

Is pancreatic cancer curable?

A small minority of pancreatic cancers can be completely cured. This is usually when they are found very early and remain small. Sadly, the majority of cancers are large or have spread by the time diagnosis is confirmed, and are no longer curable. This shows how important it is to think about screening in high risk groups, and surveillance of pre-cancerous lesions. It’s also crucial for GPs to be aware of the possibility of pancreatic cancer when a patient first presents with symptoms.

What does prognosis mean? What factors play a role in pancreatic cancer prognosis and how do specialists determine it?

Prognosis means the likely outcome of the cancer diagnosis.

A number of factors can affect the chance of recovery. This includes the size of the tumour, whether it has spread directly out of the pancreas, into lymph nodes or around the body. The general health of the patient also has an impact, including age, gender and other co-morbidities (conditions).

A cancer prognosis can be quite different for each person. Some cancers are aggressive and some grow slowly. This can affect the outcome much more than other factors. It cannot always be predicted.

What is your advice for understanding prognosis?

No one has a crystal ball when it comes to cancer prognosis. There are many factors that can play a role, and treatment plans usually relate to how advanced the tumours are. However, there are other things that influence outcomes and chance of recovery or recurrence. So, it is important to have a positive outlook, and regularly monitor and adjust management strategies based on how the cancer develops.

How do you believe we will achieve better pancreatic cancer outcomes?

This is our ultimate goal at the Jreissati Family Pancreatic Centre at Epworth. I believe it requires a combination of strategies, with a focus to:

• improve diagnosis and management at every stage.
• find cancers early through screening programs and surveillance of pre-cancerous lesions.
• provide individualised treatment - tailoring drugs and local therapies depending on stage or genetic mutations. The aim is to improve efficacy and reduce side effects.
• ensure nutrition, manage symptoms and psychological wellbeing.
• continue to access and invest in the latest studies, testing new drugs and devices.
• ensure care in centres of excellence. There is very good data of better outcomes in places with standardised care, high volumes of patients, and 24 hour services to deal with any issues. This allows skills to be maximised, and complications minimised.

For information about your individual situation, please speak to your treating doctor or specialist. They can also help you cope and process challenging emotions about pancreatic cancer.

Our Pancreatic Nurse Coordinator is here to help you understand your next steps, and triage you to see an Epworth specialist within 72 hours. Call 0428 658 039 or email [email protected] to become a patient at the Jreissati Family Pancreatic Centre at Epworth.