Pancreatic cancer is silent and difficult to detect

Information provided by Associate Professor, PhD. Nguyen Cong Long, Director of the Digestive – Hepatobiliary Center, Bach Mai Hospital, said at Scientific conference on interventional ultrasound endoscopy in gastrointestinal and pancreaticobiliary diseases 2024, October 26 in Hanoi. This is an opportunity for doctors to update their professional knowledge and exchange experiences in the fields of digestion and endoscopy.

The pancreas is an organ of the digestive system, located behind the peritoneum, close to the posterior abdominal wall, in front of the pancreas is covered by the stomach. The pancreas is divided into three main parts from right to left, including: pancreatic head, pancreatic body, and pancreatic tail. Pancreatic cancer is malignant lesions originating from any component of pancreatic tissue. According to statistics, 60-70% of tumors are located in the head of the pancreas, 20-25% are located in the body/tail of the pancreas, and a low percentage of tumors occupy the entire volume of the pancreas.

According to the Global Cancer Organization (GLOBOCAN), in 2022, Vietnam will have more than 1,250 people newly diagnosed with pancreatic cancer and 1,220 people will die from this disease. Thus, the number of new cases and deaths are equivalent. The cause of pancreatic cancer is unknown. Some risk factors include smoking, obesity, genetics, diabetes, diet, and sedentary lifestyle.

According to Professor Long, pancreatic cancer progresses silently, in the early stages there are often no specific symptoms, clinical manifestations are vague, and the disease is often discovered accidentally. Patients may have pain often in the epigastric area, so it is easy to mistake it for stomach pain. Some signs such as abdominal pain, jaundice, dark urine, body weakness, loss of appetite… can warn of pancreatic cancer.

“This is a difficult disease to diagnose because the pancreas is located behind the stomach, tests are only predictive, and imaging diagnostics are progressing rapidly but it is still difficult to diagnose pancreatic cancer early,” Associate Professor Long said.

Currently, early pancreatic cancer diagnosis techniques have made many advances, including endoscopic ultrasound, according to Associate Professor Long. The hospital uses an endoscope with a high-frequency ultrasound probe, allowing doctors to observe and detect small lesions – previously difficult to assess with conventional ultrasound.

Interventional endoscopic ultrasound has many advances, is gentle, and painless. Doctors can take samples from the pancreas suspected of cancer through endoscopic ultrasound to diagnose whether the lesion is cancerous or not, see how the lesion responds to chemicals and drugs, and from there develop a treatment plan. suitable treatment.

Depending on the location and stage of the disease, there are corresponding treatment methods. For pancreatic head tumors, pancreaticoduodenectomy is the only radical method, helping to prolong the patient’s survival. Some other methods include pancreaticoduodenectomy, bypass, exploratory surgery, biopsy, chemical treatment, and adjuvant chemotherapy.

People at high risk need early screening, including patients with acute pancreatitis, recurrent pancreatitis, and chronic pancreatitis; People who abuse alcohol and smoke, especially patients with diabetes and obesity related to metabolic disorders.

At the conference, Associate Professor Dr. Dao Xuan Co, Director of Bach Mai Hospital, said that in the field of digestion, pancreaticobiliary diseases are becoming more and more common. Today, doctors can perform specialized techniques such as intensive pancreaticobiliary intervention under the guidance of endoscopic ultrasound, such as biliary-enteric stent placement, intervention to remove pancreatic necrosis… for the treatment of pancreatitis, pancreatic stones, and common bile duct stones. The endoscopist coordinates with the surgeon to optimize the treatment regimen for the patient.