By Jennifer Welsh 

Updated on September 28, 2023

 Medically reviewed by Benjamin Leach, MD

The pancreatic cancer survival rate is one of the lowest of common cancers. As a result, pancreatic cancer is one of the most feared diagnoses. Most people diagnosed with pancreatic cancer are no longer alive five years after diagnosis. For all stages of pancreatic cancer, the one-year relative survival is 28.8% and the five-year rate is 7.9%.¹

Pancreatic cancer is so deadly because it’s difficult to screen the pancreas for cancers. Symptoms of pancreatic cancer are also mild, so tumors there often get diagnosed late. About half of all pancreatic cancers have advanced to stage 4 when diagnosed—meaning they are very difficult to treat because they’ve already metastasized (spread) to other organs and can't be treated with curative surgery.²

The American Cancer Society predicted 57,600 pancreatic cancer diagnoses in 2020, and 47,050 deaths.³ It’s slightly more common in men than women, and it gets more common as we get older.

Rates of pancreatic cancer are higher for Black Americans than White Americans, and lower in Asian Americans and Pacific Islanders.⁴ Pancreatic cancer prognosis is not good, though it varies by stage diagnosed and other factors.

Let’s walk through the survival rates for pancreatic cancer and get a better idea of what influences them. 

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Pancreatic Cancer Stages

Doctors use cancer stages to describe how cancer has grown or spread. Cancer stages help researchers compare patients with similar diagnoses, track cancer progression, study the effectiveness of treatments, and estimate survival rates. Cancer’s classification system, called the TNM system (for tumor, lymph nodes, and metastasis), was developed by the American Joint Committee on Cancer.⁵

The system has three components.

• T for tumor: This is based on the tumor’s size and invasion into nearby structures.

• N for lymph nodes: Lymph node involvement makes it more likely for cancer to spread to other parts of the body. 

• M for metastasis: Metastasis is the spread of cancer to distant organs and lymph nodes. 

While some doctors use the TNM staging system, others prefer to categorize pancreatic cancer into four buckets.⁶

• Resectable: Surgery can remove the tumor.

• Borderline resectable: The tumor is difficult or impossible to remove, but surgery might work after other treatments shrink the tumor. 

• Locally advanced: Doctors can’t remove the tumor surgically because it has spread to areas around the pancreas. 

• Metastatic: Cancer has spread beyond the area of the pancreas to other organs.

Another term that factors into cancer’s diagnosis, treatment, and staging is the tumor’s grade. Doctors will examine the cancerous cells and tissues taken from surgery or a biopsy in the lab and compare how they look to how normal cells look and give them a grade.⁷

Cancer has four grades: grade 1 (low grade), grade 2 (intermediate grade), grade 3 (high grade), and grade 4 (undifferentiated), based on how it looks. If a tumor is low-grade, its cells usually look pretty normal or well-differentiated, and they are typically slower-growing.

A high-grade tumor is likely to be more aggressive, look less like a normal cell, and spread quickly. Doctors call these undifferentiated or poorly differentiated tumor cells because they lack the features and structures of normal cells and tissues.⁷

Survival Rates

Survival rates help doctors estimate how long a person will survive based on the diagnosis given. The cancer-specific survival rate is the percentage of people with a particular diagnosis who survived until a specific time. Doctors frequently talk about survival within a five-year time frame, but you’ll also hear one-year, two-year, and 10-year survival rates.

Some people live much longer than the survival statistics would suggest. Survival rates can only tell you how other patients fared, not how you will fare. They also may not reflect the latest treatments.

You can find cancer survival rates in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program database. Registries like SEER typically use a three-stage approach:

• Localized pancreatic cancers are only in and around the pancreas. This is equivalent to stage 1.

• Regional pancreatic cancers have spread close to lymph nodes, tissues, or organs. Usually stage 2 and 3 would fall here.

• Distant pancreatic cancers have metastasized to remote parts of the body—this is where stage 4 cancers fall.

Data from NCI’s SEER database.

Factors That Influence Survival

Cancer registries base five-year survival rates on everyone with the diagnosis—regardless of age, health, or cancer type. Any one patient’s actual risk of getting pancreatic cancer, as well as their survival after treatment, will be dictated by other factors. Some of those factors can be changed, while others can’t.

• Age: Older patients fare worse than younger patients.⁴

• Race: The pancreatic cancer rate is considerably higher for Black people than for any other race.⁴

• Cancer types: Different cells in the pancreas give rise to tumors that react differently to treatments. These include neuroendocrine tumors, small cell carcinoma, squamous cell carcinoma, adenocarcinoma, and primary pancreatic lymphoma.⁸

• Smoking: Tobacco use is a risk factor for developing pancreatic cancer. If no one smoked, there would be 30% fewer pancreatic cancers.⁹

• Alcohol: Heavy drinkers have a worse prognosis than those who don’t drink or drink less.¹⁰

• Obesity: Excess weight before the age of 50 is correlated with increased pancreatic cancer risk.¹¹

• Diabetes: People with diabetes have worse survival when diagnosed with pancreatic cancer.¹²

• Performance status: This measure of a patient’s ability to perform daily tasks is one of the best indicators of prognosis. The more trouble everyday tasks are, the worse off the patient is.¹³

• Surgery: If the doctor can cut the whole tumor out, the patient has a much better outlook.¹⁴

What You Can Do

If you’ve been diagnosed with pancreatic cancer, there may not be much you can do to alter outcome based solely on lifestyle changes. However, eat a healthy diet and keep active if you can. It is possible that these types of changes can improve general health and performance status, which can lead to better outcomes, not to mention a better quality of life. 

If you’re looking to prevent pancreatic cancer (or any other negative health outcomes), it’s always a good time to quit smoking (and drinking, too!). After 10 years, your pancreatic cancer risk will be the same as a non-smoker.⁴ Sadly, if you’ve already got a diagnosis, there’s no evidence that quitting smoking actually increases survival times, though it would likely make you feel better.⁹ 

Losing weight might also sound like a good idea, and it would be if you’re trying to prevent pancreatic cancer, diabetes, and other health problems. But if you’re already diagnosed, it’s not wise to embark on a weight-loss program while undergoing chemotherapy.

What you can do is make sure you’re eating the right foods and you have the right medications to help you digest food. Pancreatic cancer patients often need to be prescribed digestive enzymes to help with digestion.¹⁵

Before embarking on any lifestyle intervention, speak with your oncologist.