General Discussion: The pancreas is the tenth most common site of new cancers, but pancreatic cancer is the fourth leading cause of cancer deaths among both men and women, comprising 6% of all cancer-related deaths.
At the time of diagnosis, 52% of all patients have distant disease and 26% have regional spread. The relative 1-year survival rate for pancreatic cancer is only 24% and overall 5-year survival is 5%
Typically, pancreatic cancer first metastasizes to regional lymph nodes, then to the liver and, less commonly, to the lungs. It can also directly invade surrounding visceral organs such as the duodenum, stomach, and colon or metastasize to any surface in the abdominal cavity via peritoneal spread. Occasionaly pancreatic cancer metastasises to unusual sites such as muscle, skin, heart, pleura, stomach, umbilicus, kidney, appendix, spermatic cord, and prostate.
PET scanning appears to be especially useful in detecting occult metastatic disease. Its role in pancreatic cancer evaluation management is still under investigation. False-positive PET scans have been reported in pancreatitis.
By itself, PET does not seem to offer additional benefits to high-quality CT scan. However, recent studies of PET scanning combined with simultaneous CT (PET-CT) suggest that PET-CT is more sensitive than conventional imaging for detection of pancreatic cancer, and that PET-CT findings sometimes change clinical management