Pancreatic cancer, which will be diagnosed in about 56,770 people in the United States this year, is the only cancer with a rising mortality rate through 2014, although five-year survival has begun to inch up, from 8 percent to 9 percent by 2016. It remains the nation’s third leading cause of cancer deaths, after cancers of the lung and colon, and it is on track to overtake colon cancer within a decade. Three-fourths of people who develop pancreatic cancer die within a year of diagnosis, and only about one in 10 live five years or longer.

Perhaps like me you’ve wondered why modern medicine has thus far failed to gain the upper hand against pancreatic cancer despite having achieved major survival advances for more common cancers like breast and colon. What follows is a large part of the answer.

Although pancreatic cancer is a relatively uncommon malignancy, accounting for only 3 percent of life-threatening cancers over all, it is one of medicine’s most challenging. Aside from avoiding smoking, obesity and Type 2 diabetes, there is little a person can do to prevent it, and there is nothing comparable to mammography or colonoscopy to screen for it in seemingly healthy individuals when it is most amenable to cure.

Among the small minority of patients who are cured of this disease, it is nearly always discovered accidentally at a very early symptom-free stage during an unrelated medical procedure. By the time this cancer produces symptoms, it has nearly always spread beyond the pancreas. In fact, surgery is a treatment option in relatively few patients because the cancer is usually already too advanced at diagnosis for surgery to have survival value.