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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Early symptoms and signs of pancreatic cancer

Pancreatic cancer is a malignant tumor of the digestive system and does not have a high clinical incidence rate. Early symptoms of pancreatic cancer are not typical; some patients experience abdominal pain, primarily a persistent episodic pain that may radiate to the shoulder and back. Additionally, early-stage pancreatic head cancer patients may exhibit jaundice, often caused by obstructive jaundice due to tumor compression. Besides this, patients may also have clay-colored stools or urine the color of strong tea. Beyond these symptoms, early-stage patients exhibit no other signs. When typical clinical manifestations occur, they are generally indicative of mid to late-stage pancreatic cancer. Precursors to pancreatic cancer include persistent hidden pain in the shoulder or a stiff pain in the back. This continuous pain, often caused by the invasion of the abdominal nervous plexus, results in radiating pain.

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How is pancreatic cancer diagnosed?

Ultrasound, CT, MRI, ERCP (Endoscopic Retrograde Cholangiopancreatography), PTCD (Percutaneous Transhepatic Cholangio Drainage), angiography, laparoscopy, tumor markers measurement, cancer gene analysis, etc., are significantly helpful in confirming the diagnosis of pancreatic cancer and determining whether it is resectable surgically. Generally, ultrasound, CA199, and CEA can be used as screening tests. Once pancreatic cancer is suspected, a CT scan is necessary. If the patient has jaundice, especially severe, and a CT scan cannot confirm the diagnosis, ERCP and PTCD can be considered. If internal drainage is successful, surgery can be delayed for one to two weeks for patients with severe jaundice. The diagnostic value of MRI for pancreatic cancer is not superior to CT. If pancreatic cancer has been confirmed but it is uncertain whether it can be surgically removed, choosing angiography and laparoscopy is also clinically meaningful.

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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.

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What are the signs of pancreatic cancer?

Pancreatic cancer is a type of malignant tumor of the digestive tract that is difficult to detect in its early stages. The signs of pancreatic cancer mainly include the following: First, among people with diabetes, if there is a sudden occurrence of uncontrollable blood sugar levels, unexplained general fatigue, abdominal pain, decreased appetite, or even jaundice, one should highly suspect the possibility of pancreatic cancer. Second, individuals with a family history of cancer who recently experience unexplained symptoms related to the digestive tract should also be alert to the possibility of pancreatic cancer. Third, some patients may experience unexplained rapid weight loss accompanied by significant jaundice, which should also be considered as potentially indicating pancreatic cancer.

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What are the symptoms of pancreatic cancer?

Pancreatic cancer is a malignant tumor of the digestive system and its incidence has been increasing year by year. The symptoms of pancreatic cancer patients mainly include the following clinically: 1. Abdominal pain, which is a common manifestation in pancreatic cancer patients. It appears as intermittent pain in the early stages and as persistent severe abdominal pain in the middle and late stages. 2. Jaundice, especially common in patients with cancer of the head of the pancreas, tends to appear early. This jaundice is due to the compression of the bile duct by the tumor, often presenting as obstructive jaundice. Patients may also experience dark tea-colored urine and pale clay-colored stools. Additionally, pancreatic cancer patients may also experience symptoms like weight loss, fatigue, fever, and when the cancer metastasizes to other organs, symptoms related to the metastases may appear.