Pancreatic cancer has the characteristics of “three highs and three lows” in clinical treatment: high incidence rate, high recurrence rate, and high mortality rate; low early diagnosis rate, low surgical resection rate, and low drug effectiveness. Most patients with pancreatic cancer are in the mid-to-late stage when they are diagnosed, and the surgical resection rate is less than 20%. The average survival time of pancreatic cancer patients without any treatment is only 3 to 6 months. Therefore, pancreatic cancer is called the “king of cancers.”
High-risk factors must be paid attention to
The direct cause of pancreatic cancer is still unclear. Currently, the known risk factors for pancreatic cancer mainly include the following.
Non-genetic factors: smoking. The incidence of pancreatic cancer is significantly increased in those who are obese and have a body mass index (BMI) ≥30. People with an unreasonable diet and excessive intake of saturated fatty acids and/or meat have a significantly increased incidence of pancreatic cancer. Diabetes, especially new-onset diabetes. In chronic pancreatitis, repeated inflammation stimulates pancreatic cells to become cancerous. Occupational exposure, such as long-term exposure to asbestos, pesticides, fuels, oil, etc. People with non-hereditary high-risk factors should adjust their living habits in a timely manner and focus on prevention.
Genetic factors: Studies have found that 10% to 20% of pancreatic cancer patients have a family history, so those who have immediate relatives with a history of pancreatic cancer should be more vigilant.
Early diagnosis and early treatment can improve prognosis
Since the long-term prognosis of patients with intermediate and advanced pancreatic cancer is poor, early diagnosis and early treatment are the keys to improving the patient’s prognosis. People with high-risk factors need regular examinations to be alert to the occurrence of pancreatic cancer, focusing on prevention and early detection.
Because the pancreas is located deep in the retroperitoneum and is surrounded by other organs, pancreatic cancer does not have typical clinical symptoms in the early stage. It simply presents with gastrointestinal symptoms such as abdominal distension, loss of appetite, indigestion, and abdominal pain. As the disease progresses, the clinical symptoms that gradually appear include: jaundice (caused by pancreatic cancer in the pancreatic head area that invades and compresses the common bile duct), abdominal pain (caused by tumors blocking the pancreatic duct or invading the celiac plexus) and weight loss ( Loss of appetite and tumor consumption), but these symptoms are not specific and can be easily confused with gastrointestinal diseases or biliary system diseases. Therefore, people with high-risk factors should be alert to the possibility of pancreatic cancer if they experience unexplained or unexplained symptoms.
People undergoing routine physical examinations can undergo regular screening of ultrasound and tumor markers every year. Among them, CA19-9 is a relatively sensitive indicator and is used to monitor the occurrence and progression of the disease. Its sensitivity and specificity reach more than 80%. When abnormalities are found in ultrasonic examination or tumor markers are abnormally elevated, enhanced imaging examinations should be further improved to confirm the diagnosis. If the diagnosis is still difficult, endoscopic ultrasonography and needle biopsy can be considered to confirm the diagnosis. People with high-risk factors should undergo regular screenings every six months, and regular enhanced imaging examinations should be considered.
Choose treatment methods based on tumor stage
Clinically, doctors mainly use different treatment plans based on the tumor stage of pancreatic cancer patients at the time of diagnosis. Common clinical treatment options for pancreatic cancer include surgical resection, chemotherapy, radiotherapy, targeted therapy, immunotherapy and symptomatic palliative care. However, due to the lack of effective radiotherapy, chemotherapy and targeted therapy, the current clinical treatment of pancreatic cancer is still based on surgery, supplemented by chemotherapy and radiotherapy, and combined with interventional, targeted, immune, traditional Chinese medicine and other treatment measures. , and follow the principle of individualized treatment.
Since the surgical resection rate of pancreatic cancer is less than 20% at the time of initial diagnosis, the resectability assessment based on the local condition of the tumor is the main basis for formulating the preferred treatment plan.
Pancreatic cancer is divided into resectable pancreatic cancer, borderline resectable pancreatic cancer, locally advanced pancreatic cancer and metastatic pancreatic cancer based on tumor resectability assessment. For patients with resectable pancreatic cancer, surgical resection should be the first choice, followed by comprehensive treatment after surgery. For patients with borderline resectable pancreatic cancer, neoadjuvant treatment followed by surgical resection should be the first choice, followed by comprehensive treatment after surgery. Patients with locally advanced pancreatic cancer should choose conversion therapy with a view to subsequent surgical resection. Patients with metastatic pancreatic cancer should choose non-surgical treatment options.
Everyone should pay attention to the following warning signs.
If symptoms such as poor appetite, fullness, and nausea occur, seek medical attention promptly. When the weight loss exceeds 10%, more attention should be paid.
Changes in blood sugar
If you have no family history of diabetes and your blood sugar suddenly changes from normal to high, or becomes unstable, you must be vigilant.
Especially the pain in the lower back, which is mainly on the left side, continues to worsen and has a banding sensation. It is more severe at night and may be relieved during the day due to the diversion of attention caused by activities. The pain is aggravated when doing spinal stretching movements such as lying on your back, stretching, etc., and the pain can be relieved to a certain extent when doing spinal bending movements such as prone, squatting, and bending.
The urine first turns yellow, and gradually becomes soy sauce color. Then the eyes and skin quickly turn yellow within a few days, and the stool turns white and clay color.