Pancreatic Cancer

“Doc, few days ago, my neighbor’s wife, Yazmin, died of pancreatic cancer at the age of 59. Her husband, Yusuf, is devastated. He feels guilty. He thinks he could have done more to save her.”

Dave looks upset. I know when something is bothering him because normally he would say: What’s up doc? Busy today?

“Dave, here is some information which may help.”

Pancreatic cancer is the fifth leading cause of cancer death in North America. In 1992, 214 Albertans died of the disease (males 114, females 100). In 1993, 216 new cases were diagnosed in this province (males 98, females 118).

The prognosis is dismal. The overall 5 year survival rate is less than 2 percent, the worst of any cancer. Only 20 percent of the patients will be diagnosed at stage where surgery may offer hope.

The surgery is extensive with significant complications. Even those who survive the ordeal, the 5 year prognosis may not be better than 25 percent.

“Doc, why is it difficult to make an early diagnoses?”

Two main reasons: first, the pancreas is a long, narrow, transverse, deep seated organ behind the stomach in the upper abdomen; second, the initial symptoms are none or very vague. By the time ultrasound or CAT scan picks it up, it is too late.

Dave is surprised to hear that. He tells me about the difficulties Yusuf and Yazmin have overcome over the past 25 years. They had arrived penniless as refugees from Uganda with six children: the youngest, triplets, were about a year old.

Yusuf is a good watch repairer. After moving from few unsatisfactory jobs, he opened his own business: a jewelry shop. Yazmin did the “salesmanship” and Yusuf repaired watches. They were happy.

As parents, they had their share of problems raising children. Their oldest daughter has multiple sclerosis. Now, Yusuf has to deal with the tragedy of losing his wife.

Dave was almost in tears. “Doc, what causes pancreatic cancer?”

The precise cause is unknown. Smoking and chronic inflammation are suspected in the causation of the disease. An estimated 5-10 percent of pancreatic cancers are inherited and additional 10-20 percent may have other significant genetic influence (Current Oncology-July 1998).

“Doc, thanks for listening. I will go and see Yusuf. See if I can help him with the information I have.”

Good luck, Dave.

(This series of articles explore the health problems of Dave and his family. They are composite characters of a typical family with health problems)

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