Pancreatic cancer

It is anticipated that by 2030 pancreatic cancer will be the second leading cause of death from cancer. Surgery remains the only potentially curative therapy. However, less than a quarter of patients are suitable for surgical resection. The lack of early symptoms, the propensity for pancreatic cancer cells to metastasize early in disease development together with the marked resistance to chemotherapy and radiotherapy, are partly responsible for the poor survival rates. Recent improvements in diagnostic imaging, such as pancreas protocol computed tomography and the role of endoscopic ultrasound, allow for earlier detection and facilitate earlier management of pancreatic cancer. In recent years, the approved use of FOLFIRINOX and gemcitabine nab-paclitaxel regimens in patients with metastatic disease has seen an improvement in survival rates and there has been increasing interest in its use in neoadjuvant chemotherapy. Future perspectives include studying the carcinogenesis of pancreatic malignancy and tumour-related genetic mutations, which it is hoped will lead to new developments in the management of pancreatic cancer, and indeed in survival rates.