Currently, people are afraid of talking about “cancer”, especially for pancreatic cancer with higher malignancy, which is known as the “king of cancer” due to the lack of effective treatment, unsatisfactory long-term outcome after surgery, early metastasis, poor prognosis and high mortality. In the past decades, with the development of medical treatment, the diagnosis and treatment of pancreatic cancer has made some progress, especially the detection rate of early stage pancreatic cancer has increased greatly, and the prognosis of this group of patients has improved significantly. Therefore, we need to recognize this disease again and stop fearing pancreatic cancer, instead, we should recognize it from a scientific perspective and pay attention to it. Clinical manifestations of pancreatic cancer: Early stage pancreatic cancer lacks specific symptoms and signs. The clinical manifestations depend on the location of the tumor, the early and late stages of the disease, the presence or absence of metastasis and the invasion of adjacent organs. The most common early manifestations are upper abdominal fullness and discomfort and epigastric pain, which may be accompanied by loss of appetite, lethargy and weakness. If the above symptoms appear recently in middle-aged people over 40 years old, they should be alert to the possibility of pancreatic cancer, in addition to common diseases such as liver and gallbladder, gastrointestinal tract, etc. Jaundice is an important symptom of pancreatic head cancer, often accompanied by itchy skin, dark urine and light stool. Other symptoms include: upper abdominal mass, newly emerged diabetes mellitus, or the recent aggravation of long-term diabetes mellitus, as well as recurrent acute or chronic pancreatitis. The possibility of pancreatic cancer should be alerted. How to prevent pancreatic cancer: At present, there are no specific preventive measures for pancreatic cancer, but only prevention against possible causes and risk factors, as well as improving the health quality of the body. The occurrence of pancreatic cancer is closely related to poor lifestyle and unreasonable nutrition such as smoking, excessive intake of fat and protein in the diet, alcohol abuse. Therefore, in order to avoid or reduce the occurrence of pancreatic cancer, we should quit drinking and smoking, and advocate a low-fat, low-protein, high-fiber and high-vitamin diet, i.e., eating more fresh fruits and vegetables, etc. Early detection, early diagnosis and treatment of pancreatic cancer have more important significance. According to the above-mentioned characteristics of pancreatic cancer, people above 40 years of age who have unprovoked upper abdominal pain, fullness and discomfort, loss of appetite, weight loss, weakness, diarrhea, back pain, recurrent pancreatitis, sudden onset of diabetes or sudden aggravation of existing diabetes should be considered as high-risk group of pancreatic cancer and should be alerted to the possibility of pancreatic cancer and need to seek medical attention and regular medical checkup. How to detect pancreatic cancer: Pancreatic cancer lacks specific symptoms and signs, and conventional laboratory tests have no special diagnostic value. Tumor markers CEA, CA19-9 and CA242 in the blood can help in the diagnosis and can be used as a means of screening or regular screening for people at high risk. The most valuable diagnostic test for pancreatic cancer is imaging, especially spiral CT, which can detect more than 90% of pancreatic cancer and is the most common test used by clinicians today. In addition magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatic ductography (MRCP) technique, abdominal ultrasound, endoscopic ultrasound (EUS), and electron emission tomography (i.e. PET-CT), all have some diagnostic value. There are many adjuvant examinations that can help in the diagnosis of pancreatic cancer, and clinicians will choose the appropriate examination methods for each patient’s situation. Generally, two or more different methods need to be applied in combination, and in addition to finding the site and size of the tumor, the relationship between the tumor and the surrounding organs and blood vessels, as well as the invasion and metastasis of the tumor, in order to assess its resectability and help judge the prognosis. For pancreatic cancer, preoperative pathological diagnosis is not necessary, and clinicians may decide on the surgical approach based only on the clinical manifestations and imaging findings of pancreatic masses, rather than radical surgery as in the case of other malignant tumors where pathological diagnosis must be obtained. At present, pancreatic surgery experts at home and abroad have basically reached a consensus that the preoperative pathological diagnosis of pancreatic masses is no longer emphasized, and radical surgery should be performed as long as pancreatic cancer is suspected. Even if the postoperative pathological diagnosis is chronic pancreatitis rather than pancreatic cancer, the surgery fundamentally eliminates the possibility of the swelling developing into pancreatic cancer later, which is still beneficial to the patient. How should pancreatic cancer be treated? The current fundamental treatment principle is a combination of surgical treatment, combined with radiation and chemotherapy. Surgery is the only treatment method that can achieve a radical effect. There are many surgical methods to treat pancreatic cancer, but due to the wide range of surgical resection and the high risk, the resection rate is generally 40%-50% and the surgical mortality rate is about 5% as reported in the literature, while in some large specialized pancreatic centers, the surgical resection rate can be as high as 60% and the mortality rate is significantly lower, ranging from 0% to 3%. -The mortality rate is significantly reduced, ranging from 0% to 3%. Therefore, patients with pancreatic cancer should try to choose a center with a high degree of specialization for treatment. However, patients with severe obstructive jaundice or tumor compression of duodenum that prevents them from eating still need palliative surgery, including biliary-intestinal anastomosis to relieve jaundice and gastrojejunostomy to solve the problem of eating. Postoperative radiotherapy, chemotherapy and immunotherapy can play an adjuvant role to a certain extent, and can play a role in prolonging the survival time for some patients. In addition, research on gene therapy and targeted therapeutic drugs for its development mechanism is underway, which may ignite new hope for the treatment of this persistent disease in the near future. What is the prognosis of pancreatic cancer? Pancreatic cancer is a highly malignant tumor with a very poor prognosis. The survival period of untreated pancreatic cancer patients is about 4-6 months, that of patients treated with palliative surgery is about 7-9 months, and the average survival of patients after radical resection is about 16 months, which is closely related to the stage of the tumor. Early diagnosis and early treatment are the keys to improve the prognosis of pancreatic cancer. Some data show that the 5-year survival rate of early pancreatic cancer can reach 20%-40% after radical resection, and the survival rate increases slightly after combined radiotherapy and chemotherapy. Thus, as long as we pay enough attention to pancreatic cancer and achieve early detection, early diagnosis and early treatment, the so-called “king of cancers” is not invincible.