A decade ago, the five-year survival rate for people diagnosed with pancreatic cancer was a dismal 7%. Today that rate is nearly double, at 13%, but statistics temper that good news.

The five-year survival rate for pancreatic cancer still places last among 16 different cancers. And while pancreatic cancer was not among the leaders in new cancer cases in 2024, it was the third-leading cause of cancer deaths.

Despite those somber numbers, there are glimmers of hope, said Dr. Richard Schulick, chair of the Department of Surgery at the University of Colorado School of Medicine and director of the University of Colorado Cancer Center. Schulick noted that the 13% five-year survival rate represents “all comers” with the disease, including the very large number whose cancer has spread to other parts of the body, making it inoperable.

Among those whose cancer has not spread, the five-year survival rate is 44%, according to the American Cancer Society. That’s an improvement of about 10 percentage points from a decade ago, based on statistics from the National Cancer Institute.

Pancreatic cancer: A formidable foe

Still, pancreatic cancer remains notoriously difficult to treat, as it often progresses without people noticing symptoms. Its location deep in the body, surrounded by other organs, makes it a challenging surgical target.

“It’s an organ that is in there deep, and you don’t really have symptoms until it’s more advanced, or if it blocks the bile duct,” Schulick said.

At that point, a person might have jaundice or digestive problems and see a physician for a fortunate early catch. A small percentage of people have a hereditary risk of pancreatic cancer; individuals who know and report that to their providers can benefit from surveillance, he added. Similarly, providers might pick up a pancreatic cyst with imaging before it becomes cancerous.

In general, though, most pancreatic cancer patients are not diagnosed until their disease is at stage IV. Even so, modern medicine is slowly gaining ground on this tough opponent, Schulick said.

Chemotherapy makes progress against pancreatic cancer

One key advance is improved chemotherapy, delivered before surgery. This type of chemotherapy improves the chances of arresting tumor growth and halting the spread of cancer cells beyond the pancreas. When that treatment succeeds, surgeons can attempt to remove the tumor.

“Chemotherapy is getting so much better, and I think that contributes hugely to these increased survival rates,” Schulick said.

For example, Schulick and Dr. Marco Del Chiaro, chief of Surgical Oncology and director of the Hepatopancreatobiliary Program at the University of Colorado School of Medicine, were among the co-authors of a recent study that investigated using chemotherapy before surgery for pancreatic adenocarcinoma – the most common type of pancreatic cancer.

Patients had their tumors removed following chemotherapy. Nearly 5% of the patients had a “pathological complete response” (pCR), meaning tissue removed after the surgery had no detectable cancer cells. The authors cautioned that a pCR finding does not mean a cure, but added that those patients had an “overall survival” rate at five years that doubled those of others in the trial (63% to 30%).

Biology offers guidance in treating pancreatic cancer

Del Chiaro added that many providers today judge the success of chemotherapy treatments for pancreatic cancer less by anatomy – whether a tumor has grown or not – and more by biology. For example, chemotherapy may not shrink a tumor, but if it doesn’t grow, that is a good sign for surgery.

In addition, providers may see signs of cancer only in the pancreas when, in fact, cancer cells may have spread undetected throughout the body, thus thwarting surgical success. But biology may provide a more reliable indicator, Del Chiaro said. A majority of pancreas cancer patients express a tumor biomarker called CA19-9, which is one key to detecting the disease. A patient with a declining CA19-9 level could be a good candidate for surgery, even if the tumor in the pancreas has complicated involvement with surrounding blood vessels, he explained.

“Much more powerful chemotherapy weapons have allowed us to do more extensive surgery,” Del Chiaro said.

Advances in surgery for pancreatic cancer

Indeed, as chemotherapy treatments have advanced, so, too, have surgical techniques, particularly at institutions that specialize in treating pancreatic cancer. Tumors that might be deemed inoperable can, in fact, be removed in some cases, Schulick said.

“We are much better able to take pieces of blood vessels – veins and arteries – and reconstruct them,” he said. “So we’ve gotten much more aggressive in taking patients to the operating room and resecting tumors that previously were deemed unresectable.”

Many minds improve success in treating pancreatic cancer

Both Schulick and Del Chiaro also emphasized the importance of the UCHealth Pancreas and Biliary Center – Anschutz Medical Campus, which provides multidisciplinary care to all patients. The model includes not only a full range of diagnostic procedures and treatments – surgery, chemotherapy, radiation and combinations of the three – but also support from other medical specialists, nurses, dietitians, social workers and support staff.

A patient referred to the center gets a one-day complete assessment of their case, including reviews of their medical history, imaging scans, and blood tests. A team of medical specialists convenes to discuss the case and devise a recommended treatment plan. The patient then meets with the appropriate providers for an explanation of what the treatment will entail.

“In one day, you get all the assessments you need and go home with a plan,” Del Chiaro said.

Schulick noted that “top cancer centers” have visited the Anschutz Medical Campus to observe the multidisciplinary approach developed at the Pancreas and Biliary Center. He credits its success to a significant commitment of resources, attention to detail and an emphasis on serving the individual needs of each patient.

“Done to the degree that we do, multidisciplinary care is a rarity,” he said. “Other centers want to learn from us.”

A rugged path to recovery

Keith Stechmesser received care through the Pancreas and Biliary Center as part of a long struggle with pancreatic cancer. His experience illustrates many of the challenges of the disease that Schulick and Del Chiaro describe – and why battling it so often ends in defeat. At the same time, Stechmesser offers a beacon of hope for others engaged in the fight.

Stechmesser, now 70, moved to Colorado from the Milwaukee area in 1979. He taught music for 11 years, earned an MBA from the University of Denver in the late 1980s, married and raised two daughters with his wife, Cindy, in Lakewood. After leaving teaching, he built a successful career in financial services that he continues to this day.

Other than a benign cyst on his kidney, Stechmesser enjoyed good health for the first 61 years of his life. That changed with what he calls “a seminal event” on Friday of Labor Day weekend in 2016. By Sunday, severe back pain around his kidneys sent him to the emergency department at a hospital near his home. Along with some medication for his back pain came some troubling news: providers had seen a spot on his pancreas that needed immediate attention.

That was an unpleasant surprise for Stechmesser, who said until then he “had no awareness” of pancreatic cancer.

“I had symptoms consistent with being 61 years old,” he said. “I needed to watch my diet, work out and take off weight.”

In retrospect, however, he recalled a ski trip on Veterans Day 2015 that saddled him with pain in the same area. The discomfort resolved quickly, but he now suspects that it could have been an early sign of the cancer.

Biopsy delivers bad news

A biopsy confirmed that bad news in October 2016. He went in for surgery in December but awoke to the news from his surgeon that a look into his belly cavity with endoscopy had shown that the cancer had spread outside the pancreas. That discovery scrapped the surgery and Stechmesser instead began chemotherapy treatments every two weeks for six months.

After completing his chemotherapy in the summer of 2017, Stechmesser got new scans and tests that gave him hope that a second surgery could remove the cancer from his pancreas. He was disappointed again. This time the operation proceeded, but his surgeon found cancer in the first part of the small intestine. Unsure he could get it all, his surgeon halted the procedure.

Stechmesser responded to the setback with a simple question: “What’s next?” The answer was a four-week daily regimen of radiation in July 2017, not to cure the cancer but “to prolong my life,” he said.

After finishing the radiation, Stechmesser sat down with his oncologist, who laid out three choices: do nothing, undergo chemotherapy once a month for “maintenance” of his disease or go to UCHealth for a multidisciplinary review of his case.

A review and renewed hope

Stechmesser opted for choice number three and completed the review of his case in October 2017. The specialists at the Pancreas and Biliary Center concluded that Stechmesser had received appropriate care for his cancer, but presented a possible new path: a then-experimental procedure to deliver chemotherapy drugs through a catheter directly to the tumor in his pancreas. Deciding to “turn the page,” Stechmesser agreed to the treatments at UCHealth University of Colorado Hospital in December 2017 and completed a series at two-week intervals.

In June 2018, Stechmesser met with Schulick and finally got some good news. The new chemotherapy procedure, in combination with the chemotherapy he had previously received, had made him a candidate for another attempt at surgery.

This time there was no disappointment. In July, Schulick removed a tumor from the tail of Stechmesser’s pancreas and also removed his spleen. After the lengthy procedure, he delivered to Stechmesser and Cindy a profound message, packaged in a mere three words.

“We got it,” Schulick said.

Return to health and a commitment to service

By the beginning of 2019, Stechmesser returned to work, “probably too soon,” he admits. But he steadily recovered, got back on the slopes for eight days that year, continues to ski and describes his appetite as “too good.” As of his last return visit for tests in October 2024, his pancreatic cancer has been banished.

The experience launched him into another career of sorts – as a volunteer and advocate for pancreatic cancer research and care. In 2019, he was looking for support groups for pancreatic cancer survivors and found the nonprofit, national advocacy organization the Pancreatic Cancer Action Network (PanCAN). He took part in a visit that year by the organization to Capitol Hill to meet with lawmakers and raise their awareness of the need for more resources to fight pancreatic cancer.

Today, Stechmesser is the chair of the Colorado affiliate of PanCAN. He takes calls on a regular basis from patients and caregivers to answer questions and share his experiences and is a dedicated participant in PanCan’s annual PurpleStride fundraising walk.

“We acquire soapboxes in life that we didn’t necessarily plan to acquire,” Stechmesser said of his advocacy work. With increased awareness of pancreatic cancer and investment in discovering new treatments – several clinical trials of new approaches are underway – he believes more lives can be saved.

“If I’d been diagnosed two or three years earlier, I probably wouldn’t be alive,” Stechmesser said. He calls UCHealth “the difference maker” in what often seemed like an unlikely path to recovery.

For his part, Schulick credits Stechmesser for taking an active role in his own care.

“He was the perfect patient who understood the pros and cons of what I was proposing,” Schulick said. “He made excellent decisions and was also informed by his own research on his condition. He had the greatest attitude and I think that really helped him through this process.”