Pancreatic adenocarcinoma in the elderly – recurrence and survival: A physician's challenge

Pancreatic Ductal Adenocarcinomas (PDAC) is one of the most lethal cancer, shifting it from the fourth highest to the third-highest cause of cancer-related deaths in the United States recently. The majority of the cases are diagnosed when the disease has metastasized and is associated with poor 5-year survival. A long-term survival data of PDAC has not been well reported in the literature. Pancreatic Cancer requires the imminent need of a multidisciplinary approach. The key to an improved long-term outcome involves early diagnosis and curative resection along with chemotherapeutic agents. Gemcitabine has played a positive role as an adjuvant after surgical resection. Regular follow-ups post-resection are mandatory for the detection of neoplastic recurrence. To add to what is already a challenging task, isolated recurrence of PDAC poses greater challenges for the physicians treating the patients because there is no general consensus on how to manage these specific groups of patients. To effectively handle this challenging task, a definite strategy must be adopted. Long-term survival if accomplished must therefore be accompanied by regular follow-up visits including Spiral CT scans and keeping an eye on the serum tumor marker CA19-9, a prognostic survival predictor.