The incidence of pancreatic cancer is higher in developed countries, while the overall incidence in developing countries is much lower than that in developed countries, and the incidence is positively related to the economic level. Its incidence in China is on the rise, currently about 5/100,000, and there is a trend toward lower age. Currently, smoking, obesity, chronic pancreatitis, diabetes, and family history of pancreatic cancer are considered to be risk factors associated with the development of pancreatic cancer. Tian Mingguo, Department of Hepatobiliary Surgery, People’s Hospital of Ningxia Hui Autonomous Region
Because the pancreas is deep in the back of the abdominal cavity, the mass of early pancreatic cancer is not easy to be detected and the symptoms caused by it are also very insidious. Patients only show vague pain and discomfort in the upper abdomen, loss of appetite and weight loss. Only when the mass continues to grow and invade or compress the bile ducts will jaundice appear, and only when the mass invades the nerves will the pain increase. It is only when the mass invades the nerves that the pain will increase. At this time, the patient will often pay attention to and seek medical attention, but at this time, the pancreatic cancer is already at an advanced stage. Because of the deep location of the pancreas, pancreatic cancer surgery is the most difficult among abdominal surgeries and requires the highest skills and physical strength of the surgeon. Therefore, only 10%-15% of patients with pancreatic cancer have the chance to be surgically removed after diagnosis. Early detection is the main reason for the poor treatment outcome of this disease.
Surgical resection is classified according to the location of the tumor: pancreatic head and duodenectomy, pancreatic body and tail resection and total pancreatectomy. Patients who cannot be resected should choose different palliative surgery or interventional treatment according to their individual conditions in order to improve their quality of life and prolong their lives. Commonly used methods include: bile-intestinal anastomosis to relieve jaundice, gastrointestinal anastomosis to prevent or treat intestinal pressure obstruction, sympathetic nerve block to relieve pain, and intraoperative tumor supply artery cannulation for postoperative regional chemotherapy. Non-surgical endoscopic stenting can also be performed for those who cannot tolerate surgery.
How to improve the early diagnosis rate? (1) To strengthen the identification and attention to high-risk groups: for those over 40 years of age with unexplained epigastric pain and discomfort, loss of appetite and weight loss should think about the possibility of early stage of the disease. In particular, those with a family history of pancreatic cancer, those with a history of chronic pancreatitis and those with sudden onset of diabetes should be considered as a high-risk group for the disease and need to undergo ultrasound examination. For those with dilated bile ducts or pancreatic ducts detected by abdominal ultrasound and stones excluded, or those with an occupancy in the pancreas, further CT or MRI examination is required for further clarification.
Since smoking and alcohol abuse are risk factors for the development of this disease, quitting smoking and limiting alcohol will help prevent the occurrence of pancreatic cancer. With the rapid development of medical science, the early diagnosis rate and treatment efficiency of pancreatic cancer will be significantly improved.