Many patients with noncurable pancreatic cancer are not being given treatments that can lengthen their lives and reduce symptoms, a study published in 2019 in CMAJ suggests.
To analyze patterns of access to specialized care, researchers examined data on 10,881 patients with a diagnosis of pancreatic adenocarcinoma. About two-thirds had a specialized cancer consultation at some point after their diagnosis, but only 4,144 (38 percent) received cancer-directed therapy, such as chemotherapy.
Patients were more likely to receive cancer-directed care if their first consultation was with a medical or radiation oncologist rather than a surgeon. Factors associated with not receiving cancer-directed therapy included being older than 81 and having a lower income.
It is not clear why so many patients failed to receive cancer-directed care. The extent of disease was not known, and this could have affected referral patterns. But patients should be aware that they have options and may benefit from consulting with a medical oncologist. The American Society of Clinical Oncology’s 2018 guideline update included chemotherapy for the noncurative management of pancreatic adenocarcinoma in most patients. Thoughtful discussions should take place regarding the benefits and side effects of any proposed chemotherapy and radiation.