Cancer survivors are people who are living with a diagnosis of cancer, including those who have recovered. Awareness of cancer survival has increased greatly since the 1990s. So has the number of people living with a diagnosis of cancer. The total number of recovered cancer survivors in the world in 2002 was estimated to be just under 25 million, and by 2050 may approach 70 million.

The term ‘cancer survivor’ covers a very wide variety of circumstances. Thus, the needs of people currently undergoing therapy are likely to be different from those of people whose metabolic functions have been altered as a result of therapy and from those of people who are evidently fully recovered and whose functions are intact.

Conventional medicine is also known as modern or Western medicine. It is allopathic, meaning that it relies on diagnosis of disease, by examinations and tests, and treatment. With cancer, treatment includes surgery, chemotherapy, and radiotherapy. Conventional medicine is based on investigation of the biology (including anatomy, physiology and biochemistry) of body organs, tissues and cells. It includes an understanding of the pathological processes that lead to disease, and testing of interventions for efficacy and safety. Conventional practitioners undergo externally validated and structured education and training programs, and continuing professional development, and they are subject to statutory regulation.

Complementary and alternative medicine includes many diverse medical and healthcare systems, practices, and products- some traditional, some modern. Training and regulation of providers exist, but often vary between therapies and nations. Some orthodox scientific evidence is available regarding some of these therapies, although the efficacy of many remains unclear and often controversial.

These therapies include mind-body interventions, such as meditation; biologically based treatments, such as radical nutritional regimens, micronutrient supplements, and herbal products; manipulative and body-based techniques, such as massage and osteopathy; ‘energy therapies’, such as the use of magnets or therapeutic touch; and alternative medical systems, such as traditional Chinese and Ayurvedic medicine.

‘Integrative medicine’ is a recent approach that uses some complementary and alternative therapies within conventional medicine. Physical activity programs and dietary interventions are commonly used in integrative medicine, together with counseling.

Cancer survivors should consult their physician or qualified health professional before initiating any therapies that are alternative or complementary to conventional therapies. Cancer survivors should keep all of the health professionals involved in providing any treatment fully informed of their choices in these areas.

What is Pancreatic Cancer?

The pancreas is a long, flat gland that lies in the abdomen behind the stomach. It produces enzymes that aid digestion and certain hormones that help maintain the proper level of blood sugar. The American Cancer Society estimates that in the U.S. in 2009, there will be 42,470 people diagnosed with pancreatic cancer and 35,420 deaths from pancreatic cancer, making it the nation's fourth leading cause of cancer death overall. Unlike other cancers, there is no screening test for pancreatic cancer. There are also no symptoms until the cancer has begun to spread, which accounts for the cancer's dismal survival rate.

Pancreas cancer remains one of the most lethal forms of human cancer, with a 5 year survival rate of only 3-5%. More than 80% of patients present with advanced disease at diagnosis and therefore are not candidates for potentially curative surgical resection. Gemcitabine, remains the standard approach for the treatment of locally advanced and metastatic pancreatic cancer since 1997 with a median survival of approximately 6 months.

Pancreatic cancer has been brought to the forefront by the diagnoses of several prominent figures, including the late actor Patrick Swayze, who died of pancreatic cancer in September 2009, Apple cofounder and CEO Steve Jobs, and U.S. Supreme Court Justice Ruth Bader Ginsburg. The lifetime risks of pancreatic cancer is about 1 in 76. Pancreatic cancer ranks as the fourth deadliest cancer.

Stages of Pancreatic Cancer

Stage is a term used in cancer treatment to describe the extent of spread. The stages of pancreatic cancer exist partly to guide treatment, but also to classify patients for clinical trials. The stages of pancreatic cancer are:

• Stage 0: No spread. Pancreatic cancer is limited to a single layer of cells in the pancreas. The pancreatic cancer is not visible on imaging tests or even to the naked eye.
• Stage I: Local growth. Pancreatic cancer is limited to the pancreas, but has grown to be less than 2 centimeters across (stage IA) or greater than 2 centimeters (stage IB).
• Stage II: Local spread. Pancreatic cancer has grown outside the pancreas, and/or has spread to nearby lymph nodes.
• Stage III: Wider spread. The tumor has expanded into nearby major blood vessels or nerves. As yet, pancreatic cancer can't be seen in other organs.
• Stage IV: Confirmed spread. Pancreatic cancer is found in distant organs.

Recent advances into the molecular pathogenesis of pancreatic cancer have allowed researchers to better understand the involvement of multiple pathways and defined mutations associated with this tumor. This molecular heterogenicity is a major reason for failure of many targeted therapy. However, research over the last few decades have has led us to belief that pancreatic cancers show a progression model similar to that of colon cancer. 

Figure 1. Histological images of benign pancreatic ductal epithelial cells, progressive PanIN lesions and invasive carcinoma, with associated genetic alterations (Figure adapted from: Ghaneh et al GUT 2007, 56, 1134)