Remembering Harry Reid and Understanding Pancreatic Cancer

Four years, one operation, one trial

Harry Reid represented Nevada in the Senate and led its Democratic majority. The Pancreatic Cancer Action Network reports that he was diagnosed in 2018, at 78. He had surgery to remove the cancer. In July 2020 he took part in an experimental immunotherapy treatment.

He died on December 28, 2021, at 82. His wife Landra Reid said: "He died peacefully this afternoon, surrounded by our family, following a courageous, four-year battle with pancreatic cancer." They had been married 62 years.

That is the public record, and it is all of it. What follows is about the disease. It is one of the hardest in oncology, and one of the most misunderstood.

An organ that hides

The pancreas sits deep in the abdomen, behind the stomach. It does two jobs. It makes enzymes that break down food. It also makes hormones, including insulin, that control blood sugar.

Its position is the problem. The National Cancer Institute gives two blunt reasons this cancer is usually found late. First, "There aren't any noticeable signs or symptoms in the early stages of pancreatic cancer." Second, "The pancreas is hidden behind other organs such as the stomach, small intestine, liver, gallbladder, spleen, and bile ducts."

About nine in ten cases are duct cell carcinoma. That means cancer arising from the cells that line the pancreatic ducts. For 2026 the American Cancer Society puts new cases at 67,530 and deaths at 52,740 in the United States. NCI's PDQ summary still reprints the 2025 estimates of 67,440 and 51,980. Set those two numbers beside each other. In most cancers the gap is wide, and here it is not.

When to get checked

NCI lists these symptoms, and they appear later than anyone would like. None is proof of cancer, and several have common harmless explanations. All of them earn a prompt appointment.

• Yellow skin, or yellow whites of the eyes, which is jaundice
• Dark urine, or stools turned pale or clay-colored
• Upper abdominal pain that bores through to the back
• Weight loss you did not plan, with loss of appetite
• New itching all over the body
• New diabetes after age 50 in someone not overweight
• Repeated attacks of upper belly pain called pancreatitis

Painless jaundice deserves its own line. If the eye whites turn yellow and nothing hurts, do not relax about it.

Who carries more risk

NCI's patient guidance names smoking, excess body weight, and a personal history of diabetes or chronic pancreatitis. It also names family history of pancreatic cancer or pancreatitis. Several inherited conditions raise risk too: Lynch syndrome, Peutz-Jeghers syndrome, and hereditary breast and ovarian cancer syndrome.

That last group matters more than most people realize. If pancreatic cancer runs in your family, genetic counseling is a reasonable request. The same holds if a relative has a known inherited cancer syndrome. There is no routine screening test for the general public. People at defined high risk are managed differently.

Making the diagnosis

NCI lists the working tools as helical computed tomography, magnetic resonance imaging, and endoscopic ultrasonography. That last one puts an ultrasound probe on the end of a scope. The scope passes into the stomach and small bowel. It gets closest to the pancreas, and it can take a biopsy in the same session.

CA 19-9 is a blood marker used in this disease. It is not a screening test and it is not a diagnosis. It is most useful for tracking a known cancer over time.

The four words that shape everything

Pancreatic cancer is sorted into four categories. Treatment follows directly from which one applies. NCI defines them as "Resectable: tumors without vascular involvement. Borderline resectable: tumors with involvement of vasculature, involvement of local structures, or other evidence of a high risk of R1 resection. Locally advanced: tumors with local invasion (primarily vascular involvement) that preclude surgical intervention. Metastatic: cancer that has spread beyond the primary pancreatic tumor to other organs."

Vasculature means the major blood vessels running past the pancreas. Whether the tumor has wrapped around them decides whether an operation is possible. That is a technical judgment. It is worth having a high-volume pancreatic surgery center weigh in.

What treatment involves

Surgery is the only route to cure, and it is major. For tumors in the head of the pancreas, NCI names the Whipple procedure. Its formal name is pancreaticoduodenal resection. It takes out the head of the pancreas, part of the small bowel, the gallbladder, and the bile duct. The surgeon then reconnects what remains. For tumors in the body or tail, a distal pancreatectomy removes that portion instead.

Chemotherapy carries much of the load. NCI names FOLFIRINOX, a four-drug combination. It also names gemcitabine-based combinations. Both are used after surgery and in advanced disease. Radiation therapy and chemoradiation are also used, depending on the category.

Symptom management is not optional here. Jaundice can be relieved by placing a stent in the blocked bile duct. Enzyme replacement helps with digestion and weight. Specialist pain management matters too. The pain here is often nerve-related, and ordinary painkillers do not handle it well.

What a clinical trial actually is

Reid joined a trial, and the term deserves plain definition. NCI describes clinical trials as "research studies that test how well new medical approaches work in people." It sorts them into four kinds: treatment trials, prevention trials, screening trials, and supportive or palliative care trials.

In pancreatic cancer, trials are mainstream care rather than a last resort. Standard results remain poor. Ask what trials are open at diagnosis, and again at each change in the disease. Eligibility is narrow and time-sensitive, so asking early loses nothing.

The numbers, stated plainly

NCI does not soften this. "Exocrine pancreatic cancer is rarely curable and has an overall survival (OS) rate of less than 6%." For those whose tumors are completely removed, NCI reports an actuarial five-year survival rate of 18 to 24 percent.

SEER, NCI's cancer surveillance program, records five-year relative survival of 43.6 percent for localized disease, 17.0 percent for regional spread, and 3.4 percent once the cancer has reached distant sites, using cases from 2016 through 2022. Its overall figure across all stages is 13.7 percent. Only 15 percent of cases are found while still localized, and 51 percent are already distant.

Those figures are population averages from patients diagnosed years ago. They say nothing about any single person's course. They do explain why symptom recognition and early referral carry unusual weight here.

Sources

• https://pancan.org/news/former-senate-majority-leader-harry-reid-dies-after-pancreatic-cancer-battle/
• https://rollcall.com/2021/12/28/former-senate-majority-leader-harry-reid-dies-at-82/
• https://www.cancer.gov/types/pancreatic/hp/pancreatic-treatment-pdq
• https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq
• https://www.cancer.gov/research/participate/clinical-trials/what-are-clinical-trials
• https://seer.cancer.gov/statfacts/html/pancreas.html
• https://www.cancer.org/research/cancer-facts-statistics.html