"I Thought It Was Indigestion, But Could It Be Pancreatic Cancer?" ... What Signals Does the Pancreas Send? [Health Talk]

[Financial News] The five-year survival rate for all cancer patients is 73.7%, but for pancreatic cancer patients it stands at just 17.0%. As a result, pancreatic cancer is regarded as the cancer with the worst prognosis among major cancers in South Korea.
According to the National Cancer Registration Statistics for 2023, 9,748 people were diagnosed with pancreatic cancer in South Korea last year, making it the eighth most common cancer overall. However, the Ministry of Data and Statistics' cause-of-death figures show that it is one of the deadliest cancers, ranking fourth after lung, liver, and colorectal cancer. Although the five-year survival rate has improved by 6.3 percentage points compared with the 1993-1995 period, it still has the poorest prognosis among major cancers in the country.

Known major risk factors for pancreatic cancer include smoking, diabetes, chronic pancreatitis, family history, and a diet high in meat and fat. Among them, smoking is considered one of the strongest risk factors identified so far. Smokers are two to three times more likely than nonsmokers to develop pancreatic cancer, and smoking is believed to account for about 20% of all cases.
Diabetes is also closely linked to pancreatic cancer. Diabetes itself can be a risk factor for pancreatic cancer, and pancreatic cancer can also lead to secondary diabetes. In particular, if a diabetes patient develops sudden abdominal pain, jaundice, loss of appetite, or weight loss, or if adult-onset diabetes appears without any clear cause, it is important to check for pancreatic disease.
Chronic pancreatitis is another major risk factor for pancreatic cancer. Excessive drinking is known to be a leading cause of chronic pancreatitis, so heavy alcohol consumption can also raise the risk of pancreatic cancer.
Kim Wan-bae, professor of Hepato-Biliary-Pancreatic Surgery at Korea University Guro Hospital, said, "Family history is known to account for about 10% of pancreatic cancer cases. Reports show that the risk rises 6.4 times when two immediate family members have pancreatic cancer, and up to 32 times when three do." He added, "If two or more immediate family members have had pancreatic cancer, it is advisable to consult a specialist and undergo regular screenings."
The prognosis for pancreatic cancer varies greatly depending on when it is detected. According to the National Cancer Registration Statistics, the five-year relative survival rate is 47.8% when the cancer is confined to the pancreas. It falls to 23.5% in the locally advanced stage, when nearby organs, adjacent tissues, or lymph nodes are involved. In the distant metastatic stage, when it has spread to other organs, the rate is only 2.4%.
The problem is that pancreatic cancer often causes no clear symptoms in its early stages, and even when symptoms do appear, they are often similar to those of other digestive disorders, delaying diagnosis. As a result, only about 20% to 30% of patients are eligible for surgery at the time of their initial diagnosis, making early detection crucial. One of the earlier symptoms that may appear in pancreatic cancer is loss of appetite. In some cases, appetite declines months before obvious symptoms such as abdominal pain or jaundice appear, so prolonged loss of appetite should be checked. However, temporary loss of appetite alone is not a reason to suspect pancreatic cancer.
Abdominal pain occurs in about 70% of pancreatic cancer patients, usually in the center and upper abdomen, including the area around the pit of the stomach. The pain may persist and spread to the back. In some cases, mild abdominal pain begins one to three months before a hospital visit and gradually worsens, so persistent abdominal pain with no clear cause should be evaluated by a doctor.
Jaundice appears in about 50% of pancreatic cancer patients and is characterized by yellowing of the whites of the eyes or the skin. In particular, when cancer develops in the head of the pancreas, it can block the bile duct and cause jaundice relatively early, making it a clue to pancreatic cancer compared with abdominal pain.

Treatment for pancreatic cancer is determined by comprehensively considering surgery, chemotherapy, and radiation therapy, depending on the stage and location of the cancer as well as the patient's overall condition. Among these, surgery is currently known as the most effective way to extend survival in pancreatic cancer. If the tumor is confined to the pancreas and can be removed immediately, surgery is performed followed by adjuvant chemotherapy.

If cancer develops in the head of the pancreas, a pancreaticoduodenectomy is performed to remove the pancreatic head along with the duodenum, bile duct, and gallbladder. If the tumor develops in the body or tail of the pancreas, the affected area may be removed together with the spleen or the left adrenal gland.
In recent years, treatment strategies for locally advanced pancreatic cancer that is difficult to operate on have become more diverse. By first giving chemotherapy to shrink the tumor or suppress its progression and then performing surgery, neoadjuvant treatment has made surgery possible even for patients who previously had no surgical options.
Professor Kim explained, "In the past, surgery was often difficult not only for distant metastatic pancreatic cancer but also for locally advanced cases, and even when surgery was performed, residual cancer was not uncommon." He added, "Recently, treatment strategies that begin with chemotherapy and then proceed to surgery after shrinking the tumor or suppressing its progression have made it possible to pursue more aggressive treatment even for patients who were previously considered inoperable."

He continued, "In particular, even stage 3 or more advanced pancreatic cancer, which is difficult to treat, can benefit from multidisciplinary care involving Hepato-Biliary-Pancreatic Surgery, Gastroenterology, Medical Oncology, and the Department of Radiation Oncology. This allows doctors to establish the most appropriate treatment plan for each patient and closely monitor for recurrence after treatment, raising hopes for improved survival rates."
For pancreatic cancer prevention, quitting smoking is the most important step. Since smoking is a major risk factor, giving up cigarettes can help lower the risk of developing the disease. It is also important to avoid excessive drinking, reduce intake of red and processed meats, and maintain a balanced diet. In addition, diabetes and chronic pancreatitis, which can increase the risk of pancreatic cancer, should be properly managed. People with a family history of pancreatic cancer or multiple risk factors should consult a specialist and undergo regular screenings as needed.
Professor Kim said, "If you have pancreatic cancer risk factors such as smoking and family history, I recommend taking a more proactive approach to health management and receiving regular screenings." He added, "Pancreatic cancer has a poor prognosis, but advances in medical technology have significantly reduced post-surgery mortality, and the chances of extending survival through active treatment are also improving. So even if you are diagnosed with pancreatic cancer, do not give up on treatment. Consult your medical team thoroughly and pursue the treatment that is right for you."


[email protected] Reporter Jeong Myeong-jin Reporter