Aretha Franklin, the Queen of Soul, with such signature hits as "(You Make Me Feel) Like A Natural Woman," "Respect," and "Chain of Fools," has been recovering in the Detroit area from surgery for what published reports have identified as pancreatic cancerr, one of the most deadly malignancies.
Without more information, it's hard to judge how the diva might fare, because not all pancreatic tumors are alike. In about 90 percent of cases, the term "pancreatic cancer" means adenocarcinoma of the pancreas, a tumor in the duct of the organ that kills more than half of patients within 5 months; fewer than 4 percent are alive after five years, according to American Cancer Society figures. However, when these cancers can be identified and surgically removed before they spread to other organs, doctors do use the word "cure." The five-year survival rate for pancreatic tumors caught early is about 40 percent. A small number of pancreatic cancers are neuroendocrine tumors, which are generally slower-growing and less likely to metastasize; survival can be years.
That Franklin underwent surgery would appear to be a good sign, as surgeons don't operate on pancreatic tumors unless they're confident they can remove them completely. Just 10 percent to 20 percent of the 40,000 pancreatic cancers diagnosed each year are operable, because the pancreas is located near several major blood vessels that feed other organs, said Dr. J. Marc Pipas, director of GI oncology at the Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center in Lebanon, N.H. Although the national standard of care has been to operate first on pancreatic tumors, then follow up with chemotherapy and radiation, Dartmouth and M.D. Anderson Cancer Center in Houston have been leaders in pre-treating pancreatic tumors with radiation and chemotherapy to shrink them as much as possible to increase the odds of successful surgery. "An incomplete resection doesn't help you live longer," Pipas said.
Part of the theory of pre-treating the tumor is that when surgery is performed first, "about 1 in 4 patients can never get chemoradiation because they're so beat-up after surgery," he said. The weight loss, poor healing and extreme fatigue often leave them too weak to withstand an extensive operation that removes parts of the pancreas, intestine, bile duct, gallbladder and stomach.