I am Dr. Xiao Ying. Pancreatic cancer is known as the king of cancers, early detection is difficult, most of them are already in the middle or late stage when they are found, and the survival period is usually counted in months. 5-year survival is only 5-10%. Compared with the common lung cancer, the cure rate of early resection reaches 80%. In comparison, pancreatic cancer is highly malignant. Therefore, pancreatic cancer should be diagnosed early and treated early. How can early screening and diagnosis be done? However, pancreatic cancer usually has no symptoms in the early stage, and by the time symptoms appear, it is already in the middle or late stage. The most direct way for early diagnosis is to do CT or MR scan + enhancement scan, and ultrasound can not see the small pancreatic occupation.

How to diagnose pancreatic cancer early?

Small pancreatic cancer in the early stage can have no symptoms, and early surgical removal is effective and has a high chance of cure. Pancreatic cancer grows slowly and easily invades to the surrounding area, then symptoms will appear, unfortunately, even if it is found at this time, the chance of surgery has been lost. How to detect pancreatic cancer at an early stage? There are three major imaging tests that can visualize pancreatic lumps, and for screening pancreatic cancer, let's talk about the advantages and disadvantages of these three tests.

Ultrasound, is the most routine test. Generally, an ultrasound of the liver, gallbladder, pancreas and spleen is done in the upper abdomen. The ultrasound shows well for the liver, gallbladder and spleen, and the detection rate of lesions is also high, but for the pancreas, the ultrasound does not show well, because the pancreas is located deep, and there is the interference of the intestinal tube and intestinal gas in the surrounding area, so it is difficult to observe the small lesions. Moreover, it has a great deal to do with the operating level of the examining doctor. So for screening pancreatic cancer, I don't recommend ultrasound.

A CT scan, which visualizes lesions in the pancreas, can show even small lesions. However, it should be noted that enhanced display is better. Simply doing a plain scan, small lesions may be missed, and even if a lesion is found, enhancement should be done just the same to assess whether it is pancreatic cancer or what kind of lesion is the tumor. For screening for pancreatic cancer, the first recommendation is to do a CT plain scan + enhancement scan. You can do a CT plain + enhancement of the upper abdomen directly, which allows you to screen the liver, gallbladder, spleen, pancreas, and both kidneys for early stage cancers, rather than just looking at the pancreas alone.

The MR test, which is a little more expensive than a CT, is not radioactive, but the test takes longer. The scope of the scan is the same as that of an upper abdominal CT, allowing you to see the liver, gallbladder, spleen, pancreas, and both kidneys, but it is best to have an additional thin-layer scan of the pancreas if you are screening for pancreatic cancer. You have to breathe well together to get a clear image for an MRI. MRI is more demanding, so it is not usually used for screening. MRI is usually done to further assist in diagnosis when ultrasound or CT is done to find a lesion that still cannot be diagnosed clearly.

These are the advantages and disadvantages of the three imaging tests for screening pancreatic cancer, and CT is recommended. these three tests are able to visualize the tumor. There are also some tumor marker tests, elevated tumor markers, can only serve as a hint of significance, but also to do imaging to find where the lesions, tumor markers are not high can not be ruled out, there is no pancreatic cancer.

What are the symptoms of pancreatic cancer?

Small pancreatic cancers can have no symptoms, and as the tumor grows, slowly symptoms appear. Many of my friends have gone to the doctor only because of the symptoms and have been found with mid to late stage pancreatic cancer.

1.腹痛

Abdominal pain is caused by pancreatic cancer invading the nerves or surrounding tissues causing tugging pain, which manifests as low back pain pain and vague pain in the upper abdomen, and should be differentiated from the pain of other liver, gallbladder and stomach lesions.

2. Jaundice

Pancreatic cancer that grows in the head area of the pancreas is prone to jaundice, which manifests itself as progressive jaundice, which in layman's terms means that a person's skin gradually becomes more and more yellow, with the face, skin, and irises waxing and waning. If you have such symptoms, you must go to the doctor, and you should go when you are a little yellow. Don't wait until it becomes more and more yellow, or it will be too late. Jaundice is a sign of bile duct obstruction, and bile duct stone obstruction can also cause jaundice.

3. Progressive wasting and loss of appetite

Progressive wasting is a manifestation of malignant tumors and is not specific for pancreatic cancer. Loss of appetite is present in all malignant tumors. At the same time pancreatic cancer will also appear steatorrhea, easy to diarrhea, eat the fat is not digested. In addition there was no diabetes before, now suddenly diabetes, mainly pancreatic cancer destroyed the normal cells of the pancreas, resulting in impaired secretion of insulin function, the emergence of diabetes.

4. Abdominal mass or metastatic symptoms

Pancreatic cancer grows bigger and bigger, forming lumps that can be touched, and it goes without saying that it is already in an advanced stage at this time. And there will be multiple metastases in other parts of the body, causing symptoms in other parts of the body, such as lung metastases, coughing and breathing difficulties. Bone metastasis, bone pain all over the body. Brain metastasis, headache and dizziness, etc.

Pancreatic cancer is very malignant and an early diagnosis makes a cure possible. To screen for early pancreatic cancer, a CT scan of the upper abdomen + enhancement scan is recommended. Although the degree of malignancy is high, there is no need for everyone to panic, the incidence of pancreatic cancer is relatively low. It is recommended that people >40 years old, with chronic pancreatitis, bile duct stones, chronic cholangitis, alcohol consumption, and a family history of cancer should be actively screened for pancreatic cancer.

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Pancreatic cancer is known as the king of cancers and has a very poor prognosis, so being able to detect it early has become a top priority.

1、Why is pancreatic cancer known as the king of cancers?

Pancreatic tumors 90% are ductal carcinomas, which have a 5-year survival rate of less than 5% , in addition, most have no chance of surgery at the time of discovery, and only about 15%-20% can be resected. It is more prevalent in males. Pathologic examination of resected pancreatic cancer cases revealed that only 3.8% of T1 and T2 pancreatic cancers had no infiltration of peripancreatic tissues and were confined to the pancreas, which means that even if pancreatic cancers can be operated on, the vast majority of them are not in the early stages.

2. Why is it difficult to detect?

The pancreas is a deeply located retroperitoneal organ that is deep, has no plasma layer, and is covered by the stomach and transverse colon. Therefore it is greatly discounted from the convenience and ease of examination. Moreover, the surrounding blood vessels and nerves are densely packed and vital organs are surrounded, resulting in rapid progression of pancreatic cancer, leaving us with less time for early diagnosis and treatment.

In addition, there are no specific symptoms when pancreatic cancer first develops.

1) Upper abdominal discomfort.

Adults experience epigastric discomfort more or less throughout their lives, mostly without much significance or as a result of chronic gastritis. So, this epigastric discomfort of pancreatic cancer is mechanically deceptive.

2) Jaundice.

Cancer that occurs in the head of the pancreas can cause obstruction of the biliary tract, leading to jaundice. Therefore, clinically, many patients with painless jaundice are prone to early detection of pancreatic cancer. On the other hand, patients who develop in the body and tail of the pancreas are more likely to be found later.

3) Epigastric pain.

Pancreatic cancer can be neurophilic and tends to cause intractable pain. Painkillers are ineffective.

4) Poor appetite and significant short-term weight loss.

5) Appearance of ascites or corresponding symptoms in case of involvement of other parts.

3. How is it diagnosed?

Some tumor markers are elevated in pancreatic cancer, such as CA199, but they are not specific.

Usually ultrasound is most often used for epigastric examination, although it is more difficult to detect small lesions because the pancreas is so deeply located. Lessons learned in this regard are very common in clinical practice. There was a patient, because of epigastric discomfort, went to a physical examination organization, told that it may be chronic gastritis, did ultrasound, and did not find abdominal organs have substantial lesions. The patient bought some stomach medicine home, then after six months, jaundice are out. He went to the hospital for examination, and the pancreatic cancer metastasized to the liver!

This patient, made a very serious mistake: the physical examination organization is only applicable to the health checkup without any symptoms, and any symptoms should be examined in the corresponding department of the regular hospital. Moreover, you should not go to an independent medical examination organization with unknown qualifications.

For the detection and differential diagnosis of pancreatic cancer, the better approach is currently enhanced CT or MRI.

With advanced enhanced CT and MRI, small pancreatic cancers can be detected as early as possible.

At the same time, the fact that there are many lesions that can occur in the pancreas also allows for a maximal differential diagnosis to be made.

To summarize, for the king of cancers - pancreatic cancer. If you experience unexplained and persistent epigastric discomfort and weight loss, do not diagnose yourself, but go to the general surgery department of a regular hospital, or to the hepatobiliary surgery department.

Pancreatic cancer has a short course, rapid progression and low survival rate, so it should be detected as early as possible. Due to its insidious onset, it is not easy to be found, but it is not without clues to follow. Below I will introduce what symptoms are highly suspicious of pancreatic cancer when you have them:

First, the recent appearance of persistent unexplained abdominal pain, pain radiating to the lower back, if it is occasional pain that can be recovered by themselves is not a big problem, abdominal pain is generally manifested as lying on the back of the aggravation, evening, aggravated by eating, lying on the side, lying on the prone side, sitting, bending the knees, or bending forward pain can be alleviated, the initial stage of abdominal pain is often in the extensive middle and upper abdomen, not easy to locate, manifested as a dull ache or pain, abdominal bloating, and gradually aggravated. It is not easy to localize, and manifests as dull pain or hidden pain, abdominal distension, and gradually worsens. Pancreatic body and tail cancers often present with low back pain.

Second, rapid wasting and indigestion in a short period of time, on the one hand, due to the poor function of pancreatic secretion, or pancreatic fluid outflow obstruction, resulting in the pancreatic fluid can not enter the duodenum, affecting the digestion and absorption, secondary diabetes mellitus occurs, on the other hand, due to the poor appetite, or the upper abdominal discomfort after eating or abdominal pain, so that the patient is reluctant to eat, and the tumor consumption will also make the patient rapidly lose weight, and the loss of weight is often accompanied by fatigue Symptoms, a few people will have diarrhea or constipation, very few people will have steatorrhea.

Third, jaundice symptoms, most of the pancreatic head cancer patients will have obstructive jaundice, which is manifested as yellowing of sclera, yellowing of skin of the whole body or accompanied by itching of skin, and the jaundice symptom will be aggravated rapidly, and the feces will be white clay-like.

Fourth, the emergence of diabetes symptoms, there is no obvious cause of the sudden emergence of diabetes, especially middle-aged and elderly people should pay attention to.

V. Symptoms similar to those of cholecystitis appear, manifested by the sudden onset of fever, right upper abdominal cramps, and jaundice.

VI. Thrombophlebitis occurs, which is often seen in pancreatic body and tail cancer.

VII. Symptoms of gastrointestinal obstruction are present; the obstruction is usually in the duodenum, a symptom that is uncommon in pancreatic cancer.

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Dr. Yu Xianjun, Chief Physician of Pancreatic Surgery Department, Affiliated Cancer Hospital of Fudan University, introduced:

Although early symptoms of pancreatic cancer are not obvious and difficult to be detected by the patients themselves, if they can raise their own vigilance and strengthen their awareness of it, even the general public can detect it as early as possible and achieve early diagnosis and treatment.

First of all, if you are a high-risk group for pancreatic cancer, i.e., long-term high-fat diet with diabetes, obesity and other diseases, bad habits such as smoking and alcoholism, or have a family history of pancreatic cancer, you can't treat the hidden pain in the upper middle abdomen as gastric or enteritis only, even if you have done a lot of gastroscopy and enteroscopy, but in the end, you have missed the pancreatic cancer. Some patients have sudden increase in blood sugar after middle age, but they only think it is diabetes, they should consider whether there is a tumor in the pancreas causing diabetes. There are also some patients who have back pain and mistakenly think that they have lumbar muscle strain or osteophytes. What's more, some patients have jaundice and think that they have jaundiced hepatitis, which may not be the case, but may be caused by pancreatic tumor.

Therefore, early diagnosis and treatment is actually around us, the general public should have a little more knowledge, pay attention to some clues, first rule out pancreatic cancer, the deadliest disease, the other, whether it is gastritis, intestinal inflammation, diabetes, osteoporosis, in comparison, are easy to treat.

As we all know, pancreatic cancer is the king of cancers, with a five-year survival rate of only 5% to 10%, and most patients die within six months after diagnosis. Therefore, pancreatic cancer is very malignant and needs early detection and treatment. However, there are no obvious symptoms in the early stage of pancreatic cancer, because the pancreas is located in the retroperitoneum, there is a distance from our belly, and there are other organs in the blockage, so there are no obvious symptoms in the early stage of pancreatic cancer, and if there is discomfort, it is usually in the middle or late stage, in general, there are three major symptoms of pancreatic cancer, and I'm going to analyze them one by one for you to hear:

(1) Jaundice

Because the pancreatic duct and the bile duct of the pancreas are at the same opening, when cancer occurs in the pancreas, the tumor can compress the common bile duct, causing bile to be unable to be discharged, which leads to bile stagnation inside the body and yellow staining of the skin and mucous membranes, which can be accompanied by itching of the skin.

(2) Abdominal pain

Pancreatic cancer in the middle and late stages, the tumor can invade the nerves, the pancreatic periosteum, can appear abdominal pain, usually manifested as hidden pain, serious can be manifested as severe pain, fidgeting.

(3) Sudden wasting

This is one of the symptoms of pancreatic cancer, as the tumor cells constantly consume energy, resulting in the body's nutrients being plundered by the cancer cells, and the normal cells lacking nutrients, resulting in malnutrition and wasting.

Pancreatic cancer is most common in middle-aged and old people, and the following groups of people are at high risk of pancreatic cancer: patients who drink alcohol for a long time, obese people, diabetic patients, people with pancreatic cancer in their family, and patients with chronic pancreatitis. If these people suddenly experience one or all of these three symptoms after middle age, they need to be careful of pancreatic cancer. Of course, the safest way is to have regular medical checkups, and it is recommended that from the age of 40, you need to check the color ultrasound of the pancreas every year, so as to detect the problem at an early stage, so that you can do the treatment early and get a good result.

My aunt is pancreatic cancer died, in her 53 years old that year, the beginning of the time is the stomach always feel uncomfortable, she has always thought that it is the appetite digestion is not good, always their own simple to take a little medicine, but not long after the face becomes yellow, very obvious kind of, she suspected that she is not got other aspects of the disease, and then into the Bazhou hospital check after transfer to Beijing 103 hospital diagnosed with pancreatic cancer in advanced stage.

At that time, the family refused to give up, from discovery to surgery did not take three months, but the doctor said that only one year of protection, and then it was true, a year later, my aunt died because of metastasis of cancer, the last time the person was as thin as a bone, always high fever, everywhere in pain, for our family, it is the pain that can never be forgotten.

From my aunt's disease is clearly summarized, people live a lifetime, do not be too strong, not everything is perfect, all things look away, bad temper must be cultivated, the beginning of all diseases are because of the character of the reason, there is also a diet, dinner must avoid overeating, long-term consumption of high-protein and high-fat food.

May there be no more pain in heaven, may all good people live a life of peace and health, and may sharing help those in need.

Generally speaking, most pancreatic cancer occurs in people over 40 years old, so people over 40 years old, if some of the following manifestations occur, it is recommended to go to the hospital as soon as possible for further examination without delay.

1. Unexplained progressive obstructive jaundice. Here are a few key words: unexplained, progressive, jaundice. First of all, jaundice is the yellowing of the skin and mucous membranes, turning yellow, such as the eyes, face, body and even the whole body yellow. There are many reasons for jaundice, such as hepatitis, stones, pancreatitis, etc. If there is a clear cause, of course, there is no need to consider pancreatic cancer, but if the cause of jaundice is not clear and unknown, then we have to think about whether pancreatic cancer could be the cause of jaundice. In addition, progressive, that is, getting worse and worse, starting with mild jaundice, and then jaundice is getting worse and worse.

2. Recent, unexplained anorexia and lethargy with weight loss of more than 10% or more. There are also a few key words here: recent, unexplained (that is, unexplained), anorexia and lethargy, and weight loss of more than 10% or more. Occasional poor appetite, or some weight loss, which many people have, do not have to worry too much, but if the weight loss is obvious, and is recent, time is not too long, and can not find an explanation for the reason, for example, is not due to the recent work overtime work too tired.

3. Recent unexplained epigastric or low back pain. Again, there are several key words: recent, unexplained (unexplained), epigastric or low back pain. Occasional recoverable epigastric or low back pain is usually not a big problem, but if it exists, recently appeared, and can not find an explanation for the cause, it should be taken seriously.

4. Recent vague and unexplained dyspeptic symptoms with normal endoscopy. Again, there are a few key words to keep in mind. Dyspepsia can be said that almost everyone has had it at one time or another, but most of it is only temporary or short-term will recover, and there is a cause for it, if there is a recent occurrence of the kind of dyspepsia that can not explain the cause, and a gastroscopy was done and did not find anything wrong, then think of the possibility of pancreatic cancer, because pancreatic cancer may also have symptoms of dyspepsia.

5, sudden unexplained diarrhea (steatorrhea). Diarrhea, common music diarrhea, eat bad things, diarrhea, this is very common, but if the diarrhea can not find the cause, can not explain why diarrhea, and is the kind of oil pulling pattern of thin stool.

Pancreatic cancer, known as the king of cancers, is basically diagnosed at an advanced stage, which is difficult to be diagnosed early and treated thoroughly in the current medical science, and the expected survival time is short. Moreover, even if surgery is performed, because of the adjoining relationship of the pancreas, duodenum, bile ducts, and other organs, the surgery is traumatic, difficult, and there are many postoperative complications, therefore, pancreatic cancer is a headache for the clinicians.

Why is pancreatic cancer found in the late stage, because pancreatic cancer in the early stage does not have very obvious symptoms, many people are in the emergence of obvious clinical symptoms before going to the examination, pancreatic cancer is the most common clinical manifestations of pain and discomfort in the epigastric region, sclera and skin jaundice, abdominal distension, lethargy, fatigue, etc., that in the early stage there are no obvious symptoms that can make a person vigilant. Of course there will be, the human body is a very sensitive reaction organism, there are abnormal reactions will basically have the corresponding stress symptoms.

Early stage of pancreatic cancer due to the obstruction of pancreatic duct will lead to the increase of pressure in the lumen, and there will be discomfort in the upper abdomen, and there can be hidden pain, dull pain and other mild pain, which many people will think it is caused by gastritis or diet, and then the pain will be gradually aggravated in the middle and late stages, and it will present persistent severe abdominal pain, and there can be radiating pain to the back, and if the pain shows the tendency of aggravation, it is necessary to consult the doctor in time.

When someone says yellow eyes or yellow skin, don't think it is what is usually called bad liver function, progressive aggravation of jaundice is the main manifestation of pancreatic head cancer, accompanied by itchy skin, yellow urine and clay-colored stools, all of these are manifestations of pancreatic cancer. There are also common digestive symptoms, such as loss of appetite, dyspepsia, abdominal bloating, short-term weight loss, fatigue and other symptoms, when they appear, we should also be vigilant and go to the hospital in time to exclude pancreatic cancer.

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Pancreatic cancer is a malignant tumor that is highly malignant, difficult to treat, has a low survival rate, and has a poor healing outcome, and the following image is a typical CT image of pancreatic cancer:

Regarding the early symptoms of pancreatic cancer, although pancreatic cancer does have some symptoms, however, most of the symptoms are not particularly high in specificity, so they can be easily ignored, which requires each of us to be vigilant, even if it is some common symptoms, we have to differentiate whether it is caused by pancreatic cancer or not. Especially patients with a family history of tumors belong to a certain high-risk group, so they should be more vigilant than the general public.

The earliest symptoms of pancreatic cancer can be weakness, lethargy, and abdominal discomfort, although this symptom is too easily overlooked as simple exertion. The pancreas is a digestive organ, so a range of digestive symptoms can occur, such as loss of appetite, nausea, vomiting, abdominal pain, diarrhea or constipation. This range of digestive symptoms is really common, and a lot of gastrointestinal disorders have these symptoms, which leads to the fact that pancreatic cancer is easy to ignore, theHowever, it should be mentioned that abdominal pain in pancreatic cancer is usually in the epigastric region, and in the later stages, there is pressure pain, in addition invasion of the vascular intestinal wall may be abnormal blood in the stool, which is easy to be taken seriously.

When pancreatic cancer becomes obstructed, it affects the metabolism of bilirubin, resulting in obstructive jaundice, which is a generalized yellowing of the body.The symptoms of pancreatic cancer include yellowish skin, yellowish whites of the eyes, yellowish urine, and lighter stool color. The above are the relatively early symptoms of pancreatic cancer, and in the late stage, ascites, abdominal mass, sudden blood sugar abnormality, thrombophlebitis and so on may also appear, but these late symptoms usually appear even if they are found late. Therefore, it is very important to have regular medical checkups, such as abdominal ultrasound or CT, and if the symptoms are obvious, it is even more important to have CT checkups in time.

Here is an additional test: PET CT, high sensitivity to malignant tumors, but expensive, it is recommended that common mass lesions or priority enhancement CT examination is the main. The following picture is a PETCT image.

What are the symptoms of pancreatic cancer?

1.腹痛

The patient will have discomfort in the epigastric region, mainly vague pain, lying on the back will make the pain worse, and the pain will be more obvious at night. It needs to be distinguished from general abdominal pain to avoid misdiagnosis.

2. Loss of appetite and weight loss

Tumors in the body inhibit the discharge of pancreatic fluid and bile, causing patients to lose their appetite and often experience anorexia, nausea, and indigestion. There will be weight loss due to the body's reduced absorption capacity and poor sleep quality.

3. Jaundice

The patient often has obstructive jaundice, which is usually persistent and deepening. The stools are greasy and clay-colored, and the urine may become increasingly dark or even black. Jaundice causes yellowing and itching of the skin, with visible scratching of the skin surface.

4. Fever

Patients may experience fever, which may be high, low, or intermittent, as a result of obstruction of the bile ducts or the release of a pyrogen by the cancer cells.

5. Sudden hyperglycemia

Patients will have endocrine disruption and are prone to hyperglycemia.