World Pancreatic Cancer Day丨I thought it was stomach pain, but it was actually the "king of cancer"! This cancer is so "violent" that the five-year survival rate is less than 10%

Pancreatic cancer, a malignant disease originating from pancreatic duct and acinar cells, is known as the "king of cancer" in the medical community due to its high mortality rate and treatment challenges. Although its exact cause remains a mystery, scientific research has gradually revealed several important risk factors: long-term smoking habits, unhealthy eating patterns, obesity and persistent damage to the pancreas, all of which quietly increase the risk of pancreatic cancer and put people in danger without realizing it.

Every November, the World Pancreatic Cancer Alliance selects the third Thursday as "World Pancreatic Cancer Day" to attract global attention. The 2024 "World Pancreatic Cancer Day" is November 21. So, why is pancreatic cancer so deadly? What measures can we take to prevent it? Which groups of people are more likely to become its target? It is crucial to identify these early signs of "cancer king" as early as possible, and do not take it lightly!

Why is pancreatic cancer the king of all cancers?

1. Late diagnosis is difficult

For malignant tumors, early diagnosis and early treatment are the key to improving survival rate and prognosis. However, data show that the early diagnosis rate of pancreatic cancer is less than 5%.

Why is it so difficult to detect early on?

First, because the pancreas grows in the center of the abdominal cavity, with the stomach in front, the liver on top, and the intestines at the bottom, it is surrounded on all sides and is in a very hidden position. Even if cancer cells spread quietly in the pancreas, it will take a long time to see any abnormalities from the outside.

In addition, although pancreatic cancer does cause physical abnormalities in the early stages, early symptoms include upper abdominal discomfort, back pain, indigestion, and diarrhea. Doesn't it sound like a common digestive system problem? Yes, because its early symptoms lack obvious characteristics, it is easy for us to mistake it for common indigestion and treat it as a digestive system disease, and it is difficult to link it with cancer.

Even if you go to a professional medical institution for examination, early diagnosis is still challenging. Currently, there is no specific tumor marker that can accurately detect pancreatic cancer, making it difficult to confirm the diagnosis through blood tests. Some common imaging examinations, such as enhanced CT, magnetic resonance imaging (MRI), and endoscopic ultrasound (EUS), can provide more information, but due to the risk of radiation exposure or high costs, these methods are difficult to be widely used in large-scale early screening.

Therefore, cancer cells lurk in this "ignored" situation, conquering cities and areas in the body and proliferating rapidly. This is also the second "evil" of the "king of all cancers" - it progresses quickly and is easy to metastasize.

2 Rapid progression and easy transfer

Cancer cells already proliferate abnormally fast, but pancreatic tumor cancer cells also have their own boost, causing them to progress abnormally quickly.

First, more than 90% of pancreatic cancer cells carry KRAS gene mutations, which aggravate the inactivation of "tumor suppressors", thereby removing the constraints on tumor growth and greatly promoting the proliferation of tumor cells.

At the same time, the tumor microenvironment of pancreatic cancer also provides it with unique growth advantages. This microenvironment not only produces a large number of growth factors to maintain the survival of cancer cells, but also effectively shields the immune system from attack and hinders the penetration of drugs, further increasing the difficulty of treatment.

In addition, pancreatic cancer cells spread very quickly and have a strong ability to metastasize. About 60% of patients have metastasized when they first visit the doctor. This is closely related to the rich lymphatic and vascular networks in the pancreas, which provide convenient channels for cancer cells to reach organs far away from the primary site, such as the liver, lungs, bones, brain, and kidneys.

All these factors are intertwined, making pancreatic cancer prone to widespread metastasis at an early stage. Statistics show that about 70% of pancreatic cancer patients die from widespread metastatic disease.

3. Difficult to treat and poor prognosis

As one of the most malignant tumors, pancreatic cancer is highly invasive.

Due to the particularity of its microenvironment, drugs are often difficult to penetrate and are not sensitive to chemotherapy and radiotherapy, further limiting the therapeutic effect.

Currently, surgical resection remains the only potential curative treatment, but only 15% to 20% of patients are suitable for surgery. In most cases, the best time for surgery has been missed when the disease is discovered, and the risk of postoperative recurrence or metastasis is also very high. The survival rate after surgery is not significantly improved, and the overall five-year survival rate after surgery is less than 10%.

In addition, although targeted drugs have been effective in trials for advanced pancreatic cancer, extending the median survival by 5 to 10 months, this is still a negligible improvement for patients and the cost of treatment is expensive. Even so, this progress still brings hope for the treatment of pancreatic cancer. Despite the challenges, the future is still full of hope as research continues to advance and treatment effects continue to improve.

Treatment:

Although pancreatic cancer is extremely difficult to treat, doctors at home and abroad have explored a variety of treatment methods over the past few decades, including surgery, chemotherapy, radiotherapy, immunotherapy, etc. Although it is impossible to completely cure the tumor, it can extend the patient's life expectancy and improve the patient's quality of life.

Surgery is the only potential curative treatment. As the most direct treatment, it is the key to cure or prolong survival for patients in the early or locally advanced stages. Surgical methods include pancreaticoduodenectomy, extended pancreaticoduodenectomy, pylorus-preserving pancreaticoduodenectomy, and total pancreatectomy. However, since many patients are already in the middle and advanced stages when diagnosed, surgical resection is no longer feasible. At this time, chemotherapy, radiotherapy, and interventional therapy become the main treatment methods.

Chemotherapy, which kills or inhibits the growth of cancer cells through drugs, is of great significance in slowing down the progression of the disease, reducing the size of tumors, improving the success rate of surgery and reducing the recurrence rate after surgery. Radiotherapy uses high-energy rays to precisely irradiate the tumor area, destroying the DNA structure of cancer cells, thereby achieving the purpose of treatment.

For patients who cannot receive traditional treatment due to the special location of the tumor or poor physical condition, interventional therapies such as radiofrequency ablation and particle implantation provide new treatment options. They act directly on the tumor through physical or chemical means, reducing trauma to the body.

In addition, supportive therapy is also an indispensable part of the treatment process. It covers pain management, nutritional support, psychological intervention and other aspects, aiming to improve the quality of life of patients, help them better tolerate the treatment process and enhance the body's resistance.

Since it is difficult to treat, is there any way to prevent it?

Before talking about prevention, let us first identify the group of people who are most susceptible to pancreatic cancer.

Which types of people are most susceptible to pancreatic cancer?

1. People with a family history of pancreatic cancer and those who carry a pancreatic cancer susceptibility gene. It is estimated that 5% to 10% of pancreatic cancer has a genetic component, which is also a factor we cannot control. If a relative has pancreatic cancer, the risk of pancreatic cancer increases by 4 times, so more attention should be paid to regular targeted screening.

3. Newly diagnosed diabetes patients. Diabetes and pancreatic cancer are in cahoots with each other. The incidence of pancreatic cancer in diabetic patients is twice that of ordinary people. Conversely, the incidence of diabetes in pancreatic cancer patients is also twice that of ordinary people. If it is a newly diagnosed diabetes, then you need to be alert to whether there is pancreatic tumor involved.

4. Patients with chronic pancreatitis. Pancreatitis is divided into chronic and acute. The former is a precancerous lesion of pancreatic cancer, and the acute disease may escalate to chronic disease if it occurs frequently.

6. Aged ≥ 40, middle-aged or elderly male with a long history of smoking and alcoholism. Age is an important factor in the onset of all malignant tumors. In addition, the toxic components in tobacco and excessive alcohol intake can also cause certain damage to the pancreas, leading to chronic pancreatitis and an increased incidence of pancreatic cancer.

How to prevent:

Although the exact cause of pancreatic cancer is still unclear, by understanding the population most susceptible to pancreatic cancer, we can still take appropriate intervention measures to reduce the risk of disease.

First of all, it is commonplace to quit smoking and limit alcohol consumption, eat a balanced diet, maintain a suitable weight, and exercise regularly. Obesity and diabetes, nicotine and alcohol are all high-risk factors for increasing the incidence of pancreatic cancer!

In addition, avoid long-term exposure to harmful chemicals such as naphthylamine and aniline.

At the same time, for high-risk groups with a family history of genetic diseases, regular physical examinations, especially pancreatic imaging examinations, can help with early detection and diagnosis, and nip pancreatic cancer in the bud.

Early pancreatic cancer has no obvious symptoms, but you should seek medical attention as soon as possible if the following symptoms occur

1. Continuous distension and pain in the upper abdomen

2. Yellowing of the skin and sclera

3. Loss of appetite, nausea, vomiting, diarrhea and other digestive tract symptoms

4. Weight loss and fatigue

Fat Bear Reminder:

If you are in a high-risk group for pancreatic cancer, it is recommended that you have an abdominal color ultrasound, blood tumor marker CA19-9, and CEA examination once every 6 months. If any abnormalities are found, further MRI or CT scans are required. When differentiation is difficult, PET-CT or laparoscopy may be required.