title: Pancreatic cancer: Slow progression in the early stages.
abstract: BACKGROUND
  The rates of pancreatic cancer development in the early stages of growth remain unclear; but it is generally believed that they demonstrate a rapid degree of progression. There is evidence to suggest that pancreatic cancers measuring less than 1cm demonstrate better survival rates, hence it is clear that detecting pancreatic cancers less than 1cm in size is of paramount importance. However, to date, there has been no scientifically adequate research to show the growth rate of small pancreatic cancers less than 1cm in the early stages.
  
  
  METHODS
  We present the case of a 65-year-old woman whose small pancreatic cancer possibly demonstrated a slow progressive rate as it grew to an invasive carcinoma measuring 1cm diameter from over the 29 months.
  
  
  CONCLUSIONS
  It is reasonable to assume that the progression of some pancreatic cancers until 1cm size, can take up to 29 months. During this silent period, it is crucial to detect such a small pancreatic cancer by means of the initial US and subsequent EUS and ERCP. It is clear, therefore, that clinicians have to be aware of the growth rate of small pancreatic cancers and in particular high risk patients should be encouraged to monitor size of the main pancreatic duct by means of US on regular basis.
  
  
  CONCLUSIONS
  This could give better outcomes for pancreatic cancer patients. Hopefully, by detecting these lethal, pancreatic cancers in their early stages, it will give us an extension of time to perform effective therapies.
authors.affiliation: Department of Surgery, Omihachiman Medical Community Center, Tsuchida-cho 1379, Omihachiman, Shiga, Japan. Electronic address: tsukasa@koto.kpu-m.ac.jp.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Nakamura
authors.forename: Koji
authors.initials: K
authors.lastname: Masuda
authors.forename: Shumpei
authors.initials: S
authors.lastname: Harada
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Akioka
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Sako
keywords: Invasive ductal carcinoma; Main pancreatic duct dilatation; Pancreas; Slow progression; Small pancreatic cancer