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:Statistics vary a great deal across the world. Pancreatic cancer undoubtedly has the worst prognosis of all cancers, with the highest death rate. However, lung cancer causes the highest number of deaths of all cancers. Stomach cancer causes the second highest number of deaths in the world, colorectal cancer causes the third highest number. [[User:Qzm|Qzm]] ([[User talk:Qzm|talk]]) 10:26, 15 September 2009 (UTC)
:Statistics vary a great deal across the world. Pancreatic cancer undoubtedly has the worst prognosis of all cancers, with the highest death rate. However, lung cancer causes the highest number of deaths of all cancers. Stomach cancer causes the second highest number of deaths in the world, colorectal cancer causes the third highest number. [[User:Qzm|Qzm]] ([[User talk:Qzm|talk]]) 10:26, 15 September 2009 (UTC)


"The prognosis is relatively poor but has improved; the three-year survival rate is now about thirty percent (according to the Washington University School of Medicine), but less than 5 percent of those diagnosed are still alive five years after diagnosis". The latter fact is correct and sourced. The former fact (30% after three years) is absolutely incorrect and is not properly sourced. Somebody should delete this because it's clearly incorrect -- this article correctly cites that the median survival is only 6 months from diagnosis, which is inconsistent with a 3 year/30% survival rate.


== Awareness ==
== Awareness ==

Revision as of 03:10, 21 December 2009

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Updated statistics

I have updated the statistics. Source: PanCAN - Pancreatic Cancer Facts for 2005 EricNau 04:57, 5 June 2006 (UTC)[reply]

Pancreatic cancer listed as fourth most deadly - but after what other 3?

Statistics vary a great deal across the world. Pancreatic cancer undoubtedly has the worst prognosis of all cancers, with the highest death rate. However, lung cancer causes the highest number of deaths of all cancers. Stomach cancer causes the second highest number of deaths in the world, colorectal cancer causes the third highest number. Qzm (talk) 10:26, 15 September 2009 (UTC)[reply]


"The prognosis is relatively poor but has improved; the three-year survival rate is now about thirty percent (according to the Washington University School of Medicine), but less than 5 percent of those diagnosed are still alive five years after diagnosis". The latter fact is correct and sourced. The former fact (30% after three years) is absolutely incorrect and is not properly sourced. Somebody should delete this because it's clearly incorrect -- this article correctly cites that the median survival is only 6 months from diagnosis, which is inconsistent with a 3 year/30% survival rate.

Awareness

I added the "Awareness" (or lack thereof) section. Feel free to add more! Pancreatic Cancer is definitely a cancer that deserves more attention. EricNau 05:17, 5 June 2006 (UTC)[reply]

The Awareness section currently has three (redundant) entries relating to celebrity deaths:

I will be condensing these three entries into one entry:

EricNau 04:33, 5 December 2006 (UTC)[reply]

List of victims

I have removed the list of victims/patients. None of these are relevant to mention - none of them have famously suffered such as Michael J Fox is doing from Parkinson's or Ronald Reagan from Alzheimer's. I've put the list here in case we need to revisit this at some point.

Victims of pancreatic cancer (living people)
  • Steve Jobs, Co-founder of Apple Computer was diagnosed with a islet cell neuroendocrine tumor in the pancreas, which is a surgically curable, far less aggressive and virulent form of pancreatic cancer.
  • Colin Friels, UK-born/Australian-based actor (husband of Judy Davis); in remission
  • Marilyn Horne, American opera singer who was diagnosed in December 2005; treatment ongoing/good prognosis.
  • Debbie Ryan, Head women's basketball coach, University of Virginia; diagnosed with aggressive pancreatic cancer in 2000, currently in remission
  • Marvin Zindler, News reporter for KTRK-TV in Houston, Texas. Diagnosed 7.6.07
Victims of pancreatic cancer (all deceased)

It is even worse when people are listed because they are the brother or sister of someone. JFW | T@lk 18:59, 11 June 2006 (UTC)[reply]

I feel this list contributes a great deal to the article, and at one point, would like to put it back. However, I agree that the list is "bloated" and needs to be trimmed down, but I am unsure on the best way to do this. It would be hard to define who is "worthy" of being on the list, which is probably why it grew to such an extent. What are your thoughts? EricNau 03:56, 14 June 2006 (UTC)[reply]

We've had this discussion on many pages. I am strongly of the view that unless the patient's disease is notable (e.g. Kylie Minogue and breast cancer, Michael J Fox and Parkinson's) there is more grounds for inclusion than when someone develops a condition after the fame has gone. Relatives of famous people should not be included unless these famous people then make this their cause and go on record for fundraising etc. In all events we should have reliable sources for each mention. Still, these lists add very little to the article in absolute terms. JFW | T@lk 07:31, 14 June 2006 (UTC)[reply]

List restored on 18 June 2006. The people involved may not be ""famous suffers"" of the disease, but it is informative to know who has what medical condition and helps raise the profile of the disease in question. Franz-kafka 18:24, 19 June 2006 (UTC)[reply]

An anonymous user deleted the entire list of victims for no reason, without discussion and without authorization.

List restored. 216.194.60.137 01:35, 25 May 2006 (UTC)[reply]

JFW is incredibly ignorant of pancreatic cancer. Because people die relatively quickly after diagnosis, they don't "suffer famously" in ways that are as overt as Michael J. Fox. Pancreatic patients simply don't live that long to get on TV and tug your heart strings. They're usually trying to find a chemo regimen that will give them some mroe time, or they're undergoing whipple surgery - and after THAT surgery, the last thing you're thinking of is ways to publicize your disease when you can't eat!
Because pancreatic cancer has THE highest mortality rate of any cancer, and because it gets almost no funding relative to other cancers, the list of famous people should be included in the article. There's apparently no way to get publicity for this disease, and certainly no way to get more money for it (PanCan being a "ladies who lunch" club which does approximately nothing to help anyone with pancreatic cancer.)
People who are ignorant of this disease should just STFU. —Preceding unsigned comment added by 68.36.127.193 (talk) 14:05, 10 October 2007 (UTC)[reply]

Predisposing factors: African-American ethnicity

Under predisposing factors, they list "African-American ethnicity" why "African-American" and not just "African"? I read the source which says "African Americans are 40% to 50% more likely to develop cancer of the pancreas than whites. This may be explained by smoking and diabetes in men and overweight in women.", and so it's not mulattos (specifically). They said African-Americans probably because the website is (US)American. There is no point in saying African-American just as it would be pointless to say African-European. --A Sunshade Lust 01:41, 1 July 2006 (UTC)[reply]

it says 'african-americans' because that's who was studied! pretty simple, huh? it is not appropriate to say 'africans' because no africans were studied. if the study had been conducted in africa, it would be incorrect to say african americans, but it wasn't.saying 'africans' in this instance would introduce other factors, which were not studied. i.e. various african diets, climate and who knows what else. what can be said is that one's chance of pancreatic ca is increased by being AFRICAN-AMERICAN.Toyokuni3 (talk) 03:25, 5 May 2008 (UTC)[reply]

doi:10.1111/j.1572-0241.2007.01202.x confirms this again. The same study gives other indicators as to which subgroups do better after surgery. JFW | T@lk 12:04, 24 June 2007 (UTC)[reply]

Incidence rates in Africa will be a lot lower, due to the fact that lives are much shorter, and incidence of the disease increases with age. Do people of African descent have a higher rate of pancreatic cancer when compared with whites in the same countries? We know it is true of the United States, but what about in the UK, France, Australia etc? Is the difference in incidence between races due to genetics or lifestyle? Qzm (talk) 10:26, 15 September 2009 (UTC)[reply]

Neuroendocrine prognosis

TH 03:47, 27 July 2006 (UTC)[reply]

I took out the several paragraphs that I put here by mistake.

TH 20:27, 10 October 2006 (UTC)[reply]

I really think we should put neuroendocrine pancreatic tumours on another page. They are different diseases, often benign and requiring different assessment and treatment altogether. JFW | T@lk 12:06, 24 June 2007 (UTC)[reply]

Genetic risk

doi:10.1111/j.1572-0241.2007.01475.x reviews genetic predisposition. JFW | T@lk 09:24, 12 August 2007 (UTC)[reply]

SNPedia shows these Single nucleotide polymorphisms as relevant

References section formatting problem

To whoever is watching this page, let me draw your attention to a problem in the reference list: there are numerous 'naked' URLs unintentionally visible (probably due to syntax problems in the source text). I apologize for not correcting this, but I cannot see how to edit the source text. The normal editing procedure that I am familiar with does not seem to work for this section. —Preceding unsigned comment added by Dwhutton (talk • contribs) 14:31, 1 November 2007 (UTC)[reply]

Improvements

Over the next week I'm planning to improve this article with the help of doi:10.1136/gut.2006.103333. This is an 18-page review with 236 references that surveys every aspect of pancreatic cancer, from molecular biology to diagnosis and therapeutics. I expect to be replacing a lot of news/website sources, although I will preserve the studies presently linked.

With regards to the risk factors, the Ghaneh review does not mention "gingivitis or periodontal disease", "diets high in meat", "occupational exposure" and "Helicobacter". Does anyone have references for these? Perhaps we ought to separate between causal links and mere associations (e.g. depression). JFW | T@lk 09:47, 23 August 2007 (UTC)[reply]

Not sure what "occupational exposure" means... H. pylori is an "association", though perhaps not quite a "risk factor" yet - see PMID 11416115, PMID 9428370, and PMID 12837831 (which covers N-nitroso compounds as a possible risk factor, which may be where the "diets high in meats" and "occupational exposure" comes from - though the authors are very clear that this is a hypothesis). And don't forget the well-recognized pathogenic role of Mycoplasma... :) MastCell Talk 16:54, 23 August 2007 (UTC)[reply]
Heh Mycoplasma.
Ghaneh does actuall mention diet, so that's sorted. Perhaps we should leave H. pylori out for the time being.
doi:10.1111/j.1365-2036.2007.03495.x seems to suggest that aspirin/NSAIDs probably do not confer protection, but that there was so much NSAID use in the American studies that it may have obscured an association. JFW | T@lk 21:01, 23 August 2007 (UTC)[reply]
Up to you. I'd be inclined to note the papers that have reported an association with H. pylori, but indicate that a causal relationship is unproven. Mostly to forestall another round of cancer-bacteria arguments. MastCell Talk 21:12, 23 August 2007 (UTC)[reply]

More risk factors

More on risk profile - smoking, family history etc doi:10.1111/j.1572-0241.2007.01510.x JFW | T@lk 21:40, 2 September 2007 (UTC)[reply]

a recent edit changed the risk increase form +75% to 'nearly double'. is going from a specific # to a term less specific an improvement?Toyokuni3 (talk) 15:25, 4 June 2008 (UTC)[reply]
doi:10.1111/j.1572-0241.2007.01475.x another review on genetic risk. JFW | T@lk 22:54, 5 November 2007 (UTC)[reply]

Fair use rationale for Image:PanCAN Ribbon.gif

Image:PanCAN Ribbon.gif is being used on this article. I notice the image page specifies that the image is being used under fair use but there is no explanation or rationale as to why its use in this Wikipedia article constitutes fair use. In addition to the boilerplate fair use template, you must also write out on the image description page a specific explanation or rationale for why using this image in each article is consistent with fair use.

Please go to the image description page and edit it to include a fair use rationale. Using one of the templates at Wikipedia:Fair use rationale guideline is an easy way to insure that your image is in compliance with Wikipedia policy, but remember that you must complete the template. Do not simply insert a blank template on an image page.

If there is other fair use media, consider checking that you have specified the fair use rationale on the other images used on this page. Note that any fair use images lacking such an explanation can be deleted one week after being tagged, as described on criteria for speedy deletion. If you have any questions please ask them at the Media copyright questions page. Thank you. BetacommandBot (talk) 16:37, 2 January 2008 (UTC)[reply]

Fine, let's leave it as it is. JFW | T@lk 07:21, 3 February 2008 (UTC)[reply]

Diabetes

About 40% of cases have diabetes, and much of those is recent-onset when temporarily related with diagnosis of pancreatic cancer. While most new diabetics do not have pancreatic cancer, it may prompt a noninvasive approach. Ca19-9 anyone? doi:10.1053/j.gastro.2007.10.040 JFW | T@lk 07:21, 3 February 2008 (UTC)[reply]

Alternative treatments

I got these comments from JFW as a motivation why he remved the studies on Ukrain:

"We have a good tradition on Wikipedia to avoid discussing phase II trials unless the results are headline-grabbing NEJM-publishingly shocking. Unless I missed this coverage, Ukrain is not quite of that calibre (otherwise Patrick Swayze would be receiving it?) Looking at your contributions to pancreatic cancer, you seem to devote a large amount of space to two very small trials with possibly interesting results that need replicating on larger studies before any guideline-producing or licensing body would dare considering a substance like Ukrain. Hope you understand. Let me know if you have any questions"

I definetely think the result of the studies on Ukrain and Pancreas Cancer are headline-grabbing and that Patrick Swayze should have Ukrain. 25% 5 year survival of Pancreatic Cancer is a lot more than a few percent. You do not need big trials to demonstrate effects when the effect is big. The research on Ukrain have been sabotaged for decennias by the establishment. I agree that less space can be devoted so i took away some sentences. I believe this information is vital in the sense that it literally can save libes out there. BTW Ukrain is already a licensed drug in many countries. —Preceding unsigned comment added by Jmstenborg (talk • contribs) 08:46, 10 April 2008 (UTC)[reply]

Well, Ukrain hasn't grabbed the headlines and Patrick Swayze is not reportedly receiving it. You can claim suppression and sabotage all you like, but at the moment your contribution is completely disproportionate to all other content on the page. In which countries is it licensed?
I feel Ukrain shouldn't be mentioned at all. Please provide evidence why it is so notable that it should be mentioned even though it is only in phase II trials and we presently don't mention any other drugs undergoing phase II trials on this page, for reasons I've given before. JFW | T@lk 13:55, 10 April 2008 (UTC)[reply]

There are really many things that has not grabbed the headlines, who in my opinion really deserves it, and many things who grabs headlines without deserving it. According to the manufacturer "NSC 631570=Ukrain was approved in Belarus (White Russia, 8.1.1995, reg. #1330/95), Ukraine (15.10.1998 and 3.9.2003, reg. #3641), Georgia (5.8.1999, reg. #002861), Turkmenistan (13.4.2000, reg. #0001707), Azerbaijan Republic (5.9.2000, reg. #00267), and Tadshikistan (7.9.2000, reg. #000568) (Information for physicians in Ukrainian and English). Recently, Ukrain has got the orphan drug status for the treatment of pancreatic cancer in Australia and in the United States of America.

I am myself a medical doctor, and gave it to my father, who suffered from a myelodysplastic syndrome. My father previously needed at least one blood transfusion each month and was getting worse. After one year of Ukrain administration he now got his most recent transfusion more thaan six months ago. If you consider a suspected ten fold increase in five year survival not to be interesting, I really wonder what you find more interesting? —Preceding unsigned comment added by Jmstenborg (talk • contribs) 18:27, 10 April 2008 (UTC)[reply]

Is wikipedidia only for big pharma? There is basically only one entity on ths planet that can finance phase III trials, and that is big pharma. In order to pay for investigations with thousands of participants, you need a patentable compound, leaving al natural medicines out. Big pharma aspo have the marketing resources to deliver their messages to medical personnel and patients. By having a principle of only including phase III trials, wikipedia will simply be severely diluted and act as yet another advertizing channel for big pharma. I think this is totally against the founder of Wikipedias intentions. —Preceding unsigned comment added by Jmstenborg (talk • contribs) 04:07, 11 April 2008 (UTC)[reply]

You are completely missing my points, but then you seem to be a strong believer in Ukrain and you are resorting to the usual arguments presented by editors who want to emphasise a particular treatment against content guidelines ("big pharma gets all the airtime, it's not fair"). Wikipedia does not operate according to the perceived viewpoints of its founder; Wikipedia operates according to clear policy. WP:WEIGHT (which you need to read) is one of these policies. JFW | T@lk 06:23, 11 April 2008 (UTC)[reply]

Satanism

I have eliminated the following: "People who get pancreatic cancer worship satan." I have a feeling it's not true. —Preceding unsigned comment added by 216.15.125.46 (talk) 16:12, 24 April 2008 (UTC)[reply]

I tend to agree here. It is actually a pretty awful thing to say. JFW | T@lk 00:28, 26 August 2008 (UTC)[reply]

Raw soy flour as a cause

"is known to cause pancreatic cancer in rats.[60] http://en.wikipedia.org/wiki/Soybean#Carcinogen —Preceding unsigned comment added by 63.193.144.79 (talk) 05:30, 5 May 2008 (UTC)[reply]

Well, good that we're not rats then. JFW | T@lk 00:28, 26 August 2008 (UTC)[reply]

Ditch the NCI source?

The NCI source is authoritative and so on, but I think we should try to use peer-reviewed clinical sources in preference. JFW | T@lk 00:28, 26 August 2008 (UTC)[reply]

Neuroendocrine tumours

doi:10.1053/j.gastro.2008.05.047 recent review. JFW | T@lk 14:20, 11 November 2008 (UTC)[reply]

Acid Reflux link?

I can't find a citation for this so I won't add it to the article. However, I've known several people who died of pancreatic cancer and they all developed acid reflux a couple years before being diagnosed. Its possible that someday they may find it to be an early indicator. --66.60.137.134 (talk) 06:33, 12 November 2008 (UTC)[reply]

Tumour and cancer

The article needs some attention of an expert. The lead paragraph discusses pancreatic tumours (e.g. serous cystadenomas)-- which aren't pancreatic cancer.[3] Cancer is a tumour that is malignant, i.e. can metastasize. Tumours that cannot metastasize are not cancer. I think the article confuses the terms tumour and cancer-- they are not the same thing. Nephron  T|C 04:59, 15 December 2008 (UTC)[reply]

I think much of this needs clarification. Neuroendocrine tumours are also being treated as cancer, which is incorrect if they are not invasive. I'm personally in favour of slashing information about tumours in the pancreas and restrict ourselves to pancreatic adenocarcinoma. I'm not sure if {{expert}} has anything to do with that. JFW | T@lk 23:03, 15 December 2008 (UTC)[reply]
I've gone through the article and restricted it to pancreatic cancer. I removed the benign neoplasms that were erroneously placed in the lead. As for JFW's comment, we can't really restrict the article to pancreatic adenocarcinoma since other carcinomas (albeit rare) do occur in the pancreas. However, an article certainly could be created at Pancreatic adenocarcinoma. I'm going to removed the expert needed tag for now, but feel free to replace it if you feel the article needs further attention. Dgf32 (talk) 19:55, 7 April 2009 (UTC)[reply]

Pain

Pancreatic cancer can be extremely painful. doi:10.1053/j.gastro.2008.09.029 shows that not only is there a form of localised neuropathy mediated by Gap-43 protein expression but also that pain is a strongly predictive negative prognostic indicator. JFW | T@lk 13:46, 31 December 2008 (UTC)[reply]

Survival after diagnosis: contradiction

The article begins with

less than 5 percent of those diagnosed still alive 3 months after diagnosis

then in the Prognosis section

Median survival from diagnosis is around 3 to 6 months; 5-year survival is less than 5%.

Is it 3 months or 5 years, can anyone check? Okud (talk) 07:58, 29 January 2009 (UTC)[reply]

I found the edit in the last week or so -- looks like the editor leaped before they looked. Reverted. Srain (talk) 22:03, 5 February 2009 (UTC)[reply]

Obesity

Being fat not only increases the risk but also reduces chance of succesful treatment http://jama.ama-assn.org/cgi/content/abstract/301/24/2553 JFW | T@lk 22:56, 23 June 2009 (UTC)[reply]

LDN

I have removed the single patient stories under chemotherapy as wells as the references to very small studies in phase I. Reason: I belive there should only be referenced to large randomized or good trials, since very sick desperate people read these pages. It is unfair to tell them fantastic stories about novel treatment. I can only imagine the rea$$on why anyone would promote drugs/strategies tested on so few patients. A study can be poor even if it is peer-reviewed. I sincerely hope we find new good drugs to combat this disease, but information on this page should be as objective as possible. —Preceding unsigned comment added by Boulevard100 (talk • contribs) 21:52, 30 September 2009 (UTC)[reply]

Agree. Thanks. JFW | T@lk 20:01, 1 October 2009 (UTC)[reply]
Given repeated attempts to insert the same material I have now semiprotected the article for two months. JFW | T@lk 11:59, 29 November 2009 (UTC)[reply]
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