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trebek beat the pancreatic cancer odds for months

the two-year survival rate for stage 4 pancreatic cancer is just seven per cent.

here's why most pancreatic cancer patients don't beat the odds
alex trebek attends the 150th anniversary of canada's confederation at the official residence of canada on june 30, 2017 in los angeles, california. emma mcintyre/getty images

beloved jeopardy! host alex trebek died on sunday after batting pancreatic cancer for more than a year and a half. the 80-year-old announced in early march 2019 that he was diagnosed with stage 4 cancer, but planned to “beat the low survival rate statistics of this disease.”

“normally the prognosis for this is not very encouraging,” trebek said in a jeopardy! video . “but i’m going to fight this, and i’m going to keep working.”

and fight trebek did. the canadian tv presenter survived the advanced stage cancer for longer than most who are diagnosed with the disease. only about 18 per cent of stage 4 pancreatic cancer patients make it to the one-year survival mark — a victory trebek acknowledged this past march

the two-year survival rate for stage 4, which trebek was about four months shy of, is even lower at about seven per cent

 

why pancreatic cancer is so hard to beat 

according to the canadian cancer society , about eight per cent of people diagnosed with pancreatic cancer will survive for at least five years. for people with stage 4 pancreatic cancer, like trebek, the five-year survival rate is between one and two per cent. 

“the average patient diagnosed with late-stage pancreatic cancer will live for about one year after diagnosis,” john hopkins medicine says

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the reason why pancreatic cancer has such a low survival rate is because the disease often goes undetected in its early stages. patients usually don’t have symptoms until the cancer has advanced or spread, according to john hopkins medicine , which makes it difficult to treat. 

like with other cancers, earlier detection means doctors are more likely able to treat the disease and remove tumours. john hopkins medicine estimates that about 15 to 20 per cent of all pancreatic tumours are removable, which include stage 1 and stage 2 tumours.

treatment becomes more difficult with stage 4 patients, as the cancer has spread to another part of the body at this point. according to the pancreatic cancer action network , it often “spreads to the liver, abdominal wall, lungs, distant lymph nodes or a combination of these.” 

unfortunately, tumours that have been removed can grow back. “so, on average, patients whose tumours were resected [removed] live for 2.5 years after their diagnosis and have a five-year survival rate of 20 to 30 per cent,” john hopkins medicine reports. 
 

what are the types of pancreatic cancer?

the most common type of pancreatic cancer is the exocrine type, which starts in cells “that produce pancreatic digestive juices,” cancer research uk says . about 80 per cent of exocrine pancreatic cancers are adenocarcinomas, the cancer centre says, and nearly all of these are ductal adenocarcinomas, meaning they “start in the cells lining the ducts of the pancreas.”

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a less common type of pancreatic cancer is endocrine tumours. these tumours “start in the endocrine pancreas, where insulin and other hormones are made and released directly into the bloodstream,” cancer research uk says. there are other less common types as well, including pancreatoblastoma and sarcomas of the pancreas.

older adults are at greater risk of pancreatic cancer as about two-thirds of patients are 65 or older when diagnosed . men are known to be slightly more affected than women. aside from age and gender, risk factors include cigarette smoking, obesity, diabetes and a family history of pancreatic cancer, among others. 

how pancreatic cancer is diagnosed

because the pancreas is deep inside the body, early tumours are often undetected by doctors during routine physical exams, the american cancer society reports . if pancreatic cancer runs in your family or you are believed to be at risk, your doctor will examine you and may order tests

to diagnose pancreatic cancer, tools like a complete blood count (cbc) test, ct scan, blood chemistry test, tumour marker test, ultrasound, mri, pet scan and a biopsy may be used, among others, the canadian cancer society says

trebek’s doctors found his cancer when he went in for a ct scan. 

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symptoms of pancreatic cancer 

like many with pancreatic cancer, trebek said he didn’t have symptoms until the cancer had spread throughout his body. trebek’s wife, jean, wrote an essay about noticing changes in her husband’s health during a trip to israel and thinking his skin colouring looked off.

symptoms of pancreatic cancer include yellowing of the skin (jaundice), pain in the upper abdomen or upper back, changes in stools, unexplained weight loss, loss of appetite, fatigue and nausea or vomiting, according to the canadian cancer society  the full list of symptoms can be found here .)

when the cancer has advanced, symptoms can get worse. trebek was open about the pain he experienced during his final months while also filming jeopardy!  

“yesterday morning my wife came to me and said, ‘how are you feeling?’ and i said, ‘i feel like i want to die.’ it was that bad,” he told the new york times in july

“there comes a time where you have to make a decision as to whether you want to continue with such a low quality of life, or whether you want to just ease yourself into the next level. it doesn’t bother me in the least,” trebek said.
 

how do you treat pancreatic cancer?

how doctors treat pancreatic cancer depends on the patient and the stage of the cancer. in its early stages, cancerous tumours may be removed through surgery. for people with advanced stages, a combination of radiation and chemotherapy may be used. trebek was undergoing chemotherapy in 2019 for his cancer and an immunotherapy program .

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“when pancreatic cancer is advanced and these treatments aren’t likely to offer a benefit, your doctor will focus on symptom relief (palliative care) to keep you as comfortable as possible for as long as possible,” the mayo clinic explains .

laura hensley is a writer with healthing.ca.
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