We were saddened to learn about the death of Patrick Swayze at age 57 from pancreatic cancer. I keep saying that there's no good cancers, but recent high-profile celebrity cases have featured some of the worst. Pancreatic cancer, unless caught very early, is pretty much a death sentence. Up against a four percent survival rate over five years, Swayze's prognosis never looked great. Still, he and his people always assured the public he was fighting the disease and feeling positive about his future. Those with pancreatic cancer who are able to have the tumor reduced often have, at best, 18 to 20 months of survival; Swayze, who was diagnosed in early 2008, became another sad statistic. (Still, he fought bravely: reports constantly surfaced that Swayze was struggling; in May he was supposed to be near death, but lived on through the summer).
According to the Hirshberg Center for Pancreatic Cancer Research, the survival rate is so low due to the advanced state in which most pancreatic cancer is diagnosed. Since there's no standard diagnostic screening (like a pap smear or colonoscopy) or early physical symptoms, pancreatic cancer is usually only detected after things start going horribly wrong, and by that point it's often too late. The tumors have usually spread beyond the pancreas, making their removal impossible.
Still, for those currently suffering with pancreatic cancer, there's always those in the five percent. Cancer prognosis are not the whole picture, as Russ Juskalian noted in his recent piece, "A Death Sentance Re-Examined"
A prognosis is only as good as the data that go into it. Andrew Vickers, an associate attending research methodologist at Memorial Sloan-Kettering Cancer Center, cautions that "huge numbers of decisions in cancer medicine"—often including prognoses—"are based upon a single variable, your stage, which is a crude risk categorization." Staging, which is primarily determined by the size and spread of tumors, is one of the most useful predictors of how a disease will progress, but doesn't cover all the factors that determine cancer survival. Those factors include, but are not limited to: histology, or grade, of the tumors (the characteristics of the cancer at the cellular level); how the tumors respond to hormones; whether the cancer is detected early or late; what treatments have already been attempted; and the age, general health, and lifestyle of the patient. It's important, says Vickers, for a patient to ask his oncologist what factors are being used to determine his prognosis.
Supreme Court Justice Ruth Bader Ginsberg may be one of the lucky few who survive pancreatic cancer because of her early diagnosis: the tumor was detected via a CT scan at a routine checkup, and doctors were able to remove the entire tumor soon after.
Steve Jobs was also diagnosed with pancreatic cancer in 2004, and after a recent undisclosed illness, is now back to work at Apple. Swayze, Bader Ginseber, and Jobs are part of the37,680 Americans diagnosed with pancreatic cancer each year. According to an article about Swayze on NEWSWEEK.com last year:
most them will be over 65 years of age. About a quarter of all cases are related to smoking, and diabetes and obesity are considered to be risk factors for the disease. (Swayze smoked.) Excessive drinking may also be a risk factor.
To speculate on the cause of Swayze's condition seems besides the point tonight. Instead, we reflect on Swayze's work, and offer condolences to his family: Swayze is survived by his wife, Lisa Nemi. We send best wishes to all of our readers who are dealing with this difficult disease or who have had loved ones taken away too soon because of it.