Chemo After Surgery Prolongs Life in Pancreatic Cancer Patients, Study Finds

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Expert notes question now is which drug, drug combination is best after removal of tumorTUESDAY, Oct. 8 (HealthDay News) -- Treating pancreatic cancer patients with the chemotherapy drug gemcitabine (Gemzar) after surgery improved survival rates when compared to doing nothing, German researchers report.

However, one expert noted that the finding may not be clinically relevant anymore.

The trial showed the benefit of treatment over no treatment, said Dr. Nilofer Azad, director of the Phase 1 Clinical Trials Group at Johns Hopkins Kimmel Cancer Center in Baltimore. "But more recently, the question has turned to what should that treatment be, not whether there should be a treatment," Azad noted.

Today, no patients would be randomized to no therapy, she added. "There are other drug combinations that we are looking at now. There are other novel treatments and experimental therapies we are looking at. Those are the open questions," Azad said.

For example, the findings of a Japanese study published in the April 1 issue of the Journal of Clinical Oncology showed that an experimental drug plus gemcitabine improved survival longer than either drug alone, she noted.

Despite these advances, the overall picture for pancreatic cancer remains bleak, Azad added.

"It's still depressing. Pancreatic cancer still has the worst cure rate of any solid tumor. It's the fifth-leading killer even though it's rarer than common cancers, and we haven't made a substantial impact on it," she said.

What is really needed is a way to diagnose pancreatic cancer early, when it is still curable. "The best way we can lower the death rate from pancreatic cancer is to diagnose it when it is very early on," Azad stressed.

The latest report was published in the Oct. 9 issue of the Journal of the American Medical Association.

For the study, a team led by Dr. Helmut Oettle, of the Charite-Universitatsmedizin in Berlin, gathered data on 354 patients with pancreatic cancer who had their tumor removed. These patients were randomly assigned to six months of treatment with gemcitabine or observation alone.

The patients began the study between July 1998 and December 2004, and were followed until September 2012.

By September 2012, 308 patients (87 percent) had relapsed. The average disease-free survival was 13.4 months among patients who received gemcitabine, compared with 6.7 months among those who received no treatment, the researchers found.

At the end of the study, 316 patients (nearly 90 percent) had died and 38 patients were still alive. Of those still living, 23 had been treated with gemcitabine while 15 hadn't, the study authors noted.

Oettle's group found a statistically significant difference in overall survival between the groups, with an average of 22.8 months for those taking gemcitabine, compared with 20.2 months for those in the observation-only group.

Among patients who received gemcitabine there was also a statistically significant absolute 10.3 percent improvement in five-year survival, compared with those who received no treatment (20.7 percent versus 10.4 percent) and a 4.5 percent improvement in the 10-year survival (12.2 percent versus 7.7 percent), the researchers found.

More information

For more on pancreatic cancer, visit the U.S. National Cancer Institute.

SOURCES: Nilofer Azad, M.D., assistant professor, director, Phase I Clinical Trials Group, Johns Hopkins Kimmel Cancer Center, Baltimore; Oct. 9, 2013, Journal of the American Medical Association

Copyright © 2013 HealthDay. All rights reserved.



Thu Oct 10, 2013 09:41 PM

Pancreatic Cancer can be defeated not by drugs but by diet. There are no symptoms but by using the AMAS blood test it can be detected up to 19 months in advance. Long before a pet-scan, mri or ct can even see it. The immune system should be rebuilt immediately. Patient should consider a strict diet such as Budwig. The patient Should research how a balanced alkalinity and oxygen supply may work in their favor. There are several things doctors of western medicine aren’t allowed to do. Find yourself an outstanding nutritionists who consentrates on treating the cause not the sympton.


Sat Oct 12, 2013 06:52 PM

Please, if you have pancreatic cancer- do not listen to the diet quacks.  One of the things that makes the life of Steve Jobs meaningful is that he stands as an example.  If you forego the opportunity for life saving surgery, you may die from a cancer that could have been cured.  If you like to combine diet or anything else for that matter with western medicine, fine.  But if you are lucky enough to be a candidate for surgery get it cut out and cut out now.  I did, and I'm alive.

Sat Oct 19, 2013 01:31 AM

Wipple surgery sometimes works. Most of the diet quacks were nominated for Nobel prize. Many people who refuse surgery, radiation and chemo therapy have done very well. The medical industry says if you live 5 yrs your a survivor even if you die at 5yrs 1day. Many people who chose alternative medicine have been cured period. Ask your doctor if the chemo therapy will save your life. Ask him for a list of cancer cures and see what he tells you. Do not be rushed look before you leap. Its difficult to make good decisions under such stress.

Sun Apr 13, 2014 11:54 PM

Coke4 PLEASE tell me where I can find the data that substantiates your claim? Don't get me wrong, I believe diet is EXTREMELY important, but alone? To fight adenocarcinoma? I'm sorry, but I am very skeptical of that. I have adenocarcinoma, had the Whipple and was "cancer free" for 2 months. Yes, I had a recurrence, but between chemo and my diet, along with exercise, I'm again beating pancreatic cancer.

Mon Jun 09, 2014 12:13 AM


Well, all I can say is I chose the leap-of-faith, one year ago on June 7th my B-Day a very experienced surgeon recommended I let him do the Whipple for me... ASAP. So on June 24th after 6 hours of surgery, I had a very complete visual inspection and reconfiguration of my GI system..the Whipple was complete. The Dr. told me I was one of the lucky ones, in that no other cancerous tissue was found.

I was one of the lucky ones because my ampula valve closed up displaying evidence of cancerous tissue / activity early enough so that the Whipple procedure was my best chance for many more years of life. I asked Dr. Eric Kortz how long has your longest lasting Whipple subject lived? He said that fellow is still going strong 21 years later! 

It truly did take a leap of faith to agree to "let even a very experienced surgeon" open me up remove & reconfigure many pieces & parts.  When in fact.. since my first ERCP opened up my ampula valve draining all backed up fluids thereby relieving me of all negative symptoms almost 1 year prior.  The reason I take the time to respond to your comments is that I believe you should not give advise unless, and until you have walked the walk.

As I said my surgeon believed he removed all cancerous tissue...but he then recommended I then get further insurance by beginning any "advised treatments" from an oncologist he recommended. The oncologist did his thing...referred my findings to his group of Oncologists. The finding of that team was that in "my case" they need not recommend any chemotherapies "at this time."

I happen to have health insurance that would cover any and all needed costs & money had nothing to do with my or that surgeon's decision. I am now advised to return every 6 months for Pet scan / blood test inspection.

When you walk the walk as I did researching the Doctors the way I did..I believe you would have made the same decisions I did. There is no Doctor that will tell you what they recommend will cure you. What all of my doctors did say was.."if it was me I would do it." Oh, my surgeon Dr. Eric Kortz did say, when I questioned him after successful Whipple surgery about the need for me to see an oncologist, he actually gave the same recommendation to his mother!

Between my GI, Surgeon, and Oncologist they have over 94 years of experance. What is your experience with these true life decisions?

I would advise every person who is faced with these kinds of decisions go with the more experienced opinions of professionals, not me nor Coke4.   


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