Reasons for the low resection rate of pancreatic cancer

Written by Zhou Zi Hua
Oncology
Updated on September 09, 2024
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The resection rate for pancreatic cancer is relatively low because the pancreas is located behind the peritoneum in a deep position. In the early stages of pancreatic cancer, there are often no specific clinical symptoms. Therefore, by the time pancreatic cancer is detected in patients, it is usually already in the advanced stages. The pancreas is surrounded by blood vessels and nerves. Therefore, if it is found in the late stage, the surgical difficulty is very high, making it difficult to remove surgically, which is why the surgical resection rate for pancreatic cancer is low.

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What does pancreatic cancer ascites mean?

When pancreatic cancer causes ascites, particularly a large amount, we can collect the ascites to search for cancer cells. This generally indicates peritoneal metastasis, or metastasis above the liver which can also cause substantial ascites. In such cases, it typically signifies that the disease has progressed to a late stage, classified as stage IV. Patients in this category are unable to undergo surgery and their treatment primarily involves chemotherapy. If the patient's overall condition is good, chemotherapy can be chosen. If the patient's condition is relatively poor, targeted therapy or oral anti-angiogenesis medications may be selected to control the pancreatic cancer and manage the tumor. If the patient's condition is particularly poor, the approach involves placing a peritoneal drainage tube to remove the ascites and providing the best possible symptomatic supportive care.

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Which test for pancreatic cancer is the most accurate?

Abdominal ultrasound and abdominal CT scans are the most commonly used imaging methods for diagnosing pancreatic cancer. Additionally, it is important to consider the patient's symptoms and blood tests for tumor markers, mainly IP antigen, CEA, and CA19-9. Confirming pancreatic cancer requires a biopsy to find cancer cells, which is the gold standard for diagnosis. Other tests can serve as screening and adjunct diagnostic tools. Confirmation requires a biopsy for pathological diagnosis or direct radical surgery followed by a postoperative pathological confirmation.

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How to screen for pancreatic cancer

Pancreatic cancer is a common malignant tumor of the digestive tract. Due to its high malignancy and rapid progression, it severely affects human health. So how should pancreatic cancer patients be screened? Generally, abdominal ultrasound examination is the primary screening method. Another method is the examination of tumor markers, mainly carcinoembryonic antigen (CEA) and CA19-9. CA19-9 is a tumor marker with relatively high specificity and sensitivity for the diagnosis of pancreatic cancer. Therefore, during physical examinations, we can draw blood to check these tumor markers. If there is a significant increase in CA19-9 or CEA, further examinations of the pancreas, such as ultrasound or CT of the pancreas, should be conducted to further investigate whether there is a tumor in the pancreas.

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How is pancreatic cancer diagnosed?

The most common symptoms of pancreatic cancer are pain in the upper abdomen and jaundice. During physical examination, a mass in the upper abdomen can be felt, which is a common symptom. When these symptoms appear, further abdominal ultrasound or CT scans should be performed, as these two are the most commonly used imaging methods for diagnosing pancreatic cancer. Additionally, pancreatic MRI or PET-CT can also help enhance the diagnostic accuracy for pancreatic cancer. MRCP and ERCP are also used to assess the bile ducts and to evaluate the feasibility of surgery. Blood tests for pancreatic cancer-related tumor markers, such as carcinoembryonic antigen (CEA) and CA19-9, are commonly performed, with CA19-9 being particularly sensitive and specific for the diagnosis of pancreatic cancer.