The pancreas is one of the important digestive glands in the human body. Anatomically, it is divided into the head, neck, body and tail of the pancreas; histologically, there are two kinds of cells, endocrine and exocrine; cancer may occur in a certain part of the pancreas, but cancer from endocrine cells, i.e. neuroendocrine cancer, is less common and less malignant. The pancreatic cancer we often talk about is the cancer from exocrine cells, which is more malignant and occurs mostly in middle-aged and elderly people, but in recent years, there is a tendency to be younger and the incidence is on the rise.
Most of the cases are already in advanced stage when diagnosed, and the chance of radical surgery is lost. At this time, a combination of targeted radiotherapy (gyroscopic knife) + chemotherapy + traditional Chinese medicine can be adopted, which often obtains unexpected results. In recent years, pancreatic cancer has made great progress in the field of surgery, precise radiotherapy, chemotherapy, targeted therapy and comprehensive treatment, and the level of treatment of pancreatic cancer in China has been in line with international standards.
The continuous emergence of some new treatments, methods, modalities and new drugs for pancreatic cancer has brought new hope to patients, resulting in a significant increase in the cure rate and overall survival rate of this tumor, as well as a significant improvement in the quality of life. The 5-year survival rate for patients with access to radical treatment has exceeded 20%, with an increasing number of long-term survivors and a significantly better quality of life than before.
The cause of pancreatic cancer is still not very clear, some studies show that: the proportion of pancreatic cancer in people with chronic pancreatitis and diabetes is somewhat higher than normal people; the risk of pancreatic cancer in smokers is more than three times that of nonsmokers; high protein, high fat and high calorie food can play some bad influence on the occurrence of pancreatic cancer. To sum up, people over 50 years old, long-term smokers, alcohol drinkers, people with “three highs” diet, and people with chronic pancreatitis should pay high attention to the risk and be alert to the following symptoms.
1, low back pain, indigestion, jaundice.
2, abnormally high blood sugar in non-diabetic patients, or recurrent episodes of pancreatitis.
3, unexplained significant weight loss in a short period of time. Those who have the above symptoms should go to a specialist hospital for key examination.
The main symptom of most pancreatic cancer patients is upper abdominal discomfort, some patients may have indigestion, poor appetite, or significant weight loss for unknown reasons for a period of time, some patients will have pain, and the pain is related to the location and size of the tumor, this pain may be abdominal pain or low back pain. In addition, some patients may develop jaundice, which is more commonly seen in tumors of the jugular abdomen and lower bile duct.
The clinical data of 2340 pancreatic cancer patients showed that jaundice and abdominal pain were the most common first symptoms of pancreatic cancer, followed by emaciation, upper abdomen, fullness, lower back pain, and pain in the back. The first symptoms of pancreatic cancer are jaundice and abdominal pain, followed by weight loss, upper abdominal distension, back pain, weakness, and fever.
Tumors in the head of the pancreas are more likely to develop jaundice due to biliary obstruction because of their proximity to the lower part of the common bile duct. Tumors in the tail of the pancreatic body are close to the left side of the body and adjacent to the spleen, so jaundice rarely occurs.
The treatment of pancreatic cancer mainly includes surgery, radiotherapy, chemotherapy, interventional therapy, etc. It emphasizes the principles of comprehensive treatment, multidisciplinary collaboration and individualized treatment, and according to the physical condition, tumor site, extent of invasion, jaundice, liver, kidney and cardiopulmonary function of different patients, the existing treatment means should be applied in a planned and reasonable way to optimize the treatment effect and minimize the damage to the body.
Surgical treatment: Different surgical methods are needed for different stages of disease and the degree of local invasion of tumor lesions.
1. radical surgery (pancreaticoduodenectomy, pancreatic tail resection and total pancreatectomy).
2, surgery for pancreatic cancer combined with vascular resection (used when the tumor invades the portal vein and superior mesenteric vein).
3. palliative surgery for unresectable pancreatic cancer (gastrointestinal anastomosis, biliary-intestinal anastomosis to relieve obstruction).
With the advancement of science and technology, improvement of treatment level and the application of new generation of precise radiotherapy equipment, radiation therapy has gradually become one of the most important and effective treatments for pancreatic cancer, among which targeted radiotherapy – gyroscopic knife has the advantages of short treatment course, quick effect, no pain, little side effects and no age restriction, etc. Patients with almost all stages of pancreatic cancer can benefit from radiotherapy.
It is mainly used for the comprehensive treatment of locally progressive pancreatic cancer with indications for surgery that cannot be tolerated or the patient does not accept surgery, inoperable locally progressive pancreatic cancer, postoperative tumor residual or recurrent cases, and palliative decompensative treatment of advanced pancreatic cancer and extensive metastasis of pancreatic cancer. In recent years, preoperative neoadjuvant radiotherapy aimed at improving the effect of surgical treatment or increasing the rate of surgical resection has also been used more often and achieved very good results.
1, chemotherapy aims to prolong survival, improve quality of life and enhance the effect of surgery, radiotherapy and other treatments, commonly used drugs for gemcitabine or tegeo (S1) based programs, such as gemcitabine alone, or in combination with 5-Fu, tegeo, oxaliplatin, etc..
2.Targeted drug therapy, currently reported targeted drugs that can be used for pancreatic cancer mainly include erlotinib, cetuximab, bevacizumab, etc., but the efficacy still needs further exploration.
3.Chinese herbal medicine treatment has certain roles and advantages in promoting post-operative recovery of tumor patients, reducing toxicity and increasing effectiveness of radiotherapy, reducing pain of advanced tumor, improving survival quality and prolonging survival.
Biological therapies include cytokine therapy, biological response modifiers, cellular hyperactivity immunotherapy, tumor vaccine, gene therapy and so on. Most of the biologic therapies are still in experimental research stage.
The aim of supportive therapy is to reduce symptoms and improve the quality of life. Pain is one of the most common symptoms of pancreatic cancer, first of all, pain should be controlled. In addition to the timely administration of drugs according to the WHO three-step pain relief principle, radiotherapy is effective for pain caused by pancreatic cancer, more than 90% of patients benefit from radiotherapy, and a large proportion of patients say goodbye to painkillers.
In addition, active improvement of cachexia, the use of methylhydroxyprogesterone or megestrol to improve appetite, attention to nutritional support, timely detection and correction of liver and kidney insufficiency and water and electrolyte disorders. For patients with nutritional absorption disorders, elemental diet is given, and for patients who cannot eat, parenteral nutrition support treatment can be given.
Everyone should pay attention to their own health, and those over 30 years of age should adhere to routine medical checkups at least once a year. Once there are symptoms such as abdominal distension, abdominal pain, fever, or even diabetes, pancreatitis, weight loss, etc., you should immediately go to a specialist hospital for examination. Strive for early detection, early diagnosis and early treatment. In addition, one should try to quit bad lifestyle, quit smoking and drinking, promote healthy eating habits and physical exercise, and maintain a positive and optimistic attitude, all of which can significantly reduce the occurrence of many tumor and non-tumor diseases, including pancreatic cancer.