Primary cancer of the pancreas: a surgical enigma.

Pancreatic cancer is a frequent gastrointestinal malignancy with demonstrable increases in blacks. Predisposing factors are nonspecific but statistically relevant. Early signs and symptoms are vague and the duration prior to medical or surgical evaluation is typically more than four months. The overt clinical picture represents advanced stages of pancreatic cancer that are nonresectable. Positive results or prolonged survivals in excess of five years for curative surgical procedures are meager. The best approaches toward cancer of the pancreas are improvements in education, prevention, early diagnosis, palliative surgical procedures with adjuvant medical measures, and radical surgery in selective cases and under specific circumstances.