Its incidence is increasing gradually, it does not give symptoms immediately because it progresses insidiously, so the diagnosis is made late. Moreover, it is at the top of the list of deadly cancers… Despite all these negative news, physicians never give up hope of their patients, as the success rate in treatment has increased thanks to new developments.
"What disease is this?" If you're wondering, the answer is pancreatic cancer. Stating that approximately 4 new pancreatic cancer is diagnosed every year in our country, Acıbadem Altunizade Hospital General Surgery Specialist Prof. Dr. Murat Gönenç said, “However, thanks to the developments in medicine, life expectancy in pancreatic cancer treatments is gradually getting longer. Therefore, pancreatic cancer is not as desperate as it was previously thought, ”he says. Stating that the most effective treatment method of pancreatic cancer is surgery. Dr. Murat Gönenç states that by removing the tumor as a whole without spreading it to the environment, that is, without fragmenting or blasting, with the possible spread areas, the success of the treatment increases.
Possible to reduce the risk
The pancreas is an organ that produces very important secretions for our body. Since it contains many different cell types, different tumors can develop in its structure. Stating that 85-90 percent of pancreatic cancers are the type called "ductal adenocarcinoma". Dr. Murat Gönenç continues his words as follows:
“The incidence of pancreatic cancer is increasing both in our country and in the world. It ranks 11th among the most common cancers and is responsible for about 5 percent of cancer-related deaths. We can mention many factors that increase the risk of this disease. However, the most important ones are listed as chronic pancreatitis, long-term diabetes, familial predisposition, advanced age, obesity, smoking and alcohol. Even if it is not possible to prevent the disease, it may be possible to reduce the risks and early diagnosis. For this reason, not smoking, not consuming alcohol, being at ideal weight and eating a healthy diet help reduce the risk. "
Sudden diabetes can also be a messenger
Although pancreatic cancer causes complaints such as jaundice, back pain, sudden onset of diabetes or inability to control existing diabetes, it is usually late for diagnosis when these complaints are taken into account. Radiological imaging methods constitute the basis of the diagnosis of the disease. Thanks to CT (Computed Tomography) or MRI (Magnetic Resonance Imaging), pancreatic cancers are diagnosed with high accuracy. Noting that tumor markers such as CEA (CarcinoEmbryonic Antigen) and CA 19-9 (Carbohydrate Antigen 19-9) can also be used for diagnosis in blood tests, Prof. Dr. Murat Gönenç, the frequently asked "Is it possible to diagnose pancreatic cancer more easily with biopsy?" gives the following answer to his question:
“It is not a routine practice to take a biopsy from tissue suspicious for cancer in the pancreas. Because in pancreatic cancer, cancer tissue does not have the same structure. Therefore, if the biopsy is not taken from the right place, the result may be false negative, meaning the person may not appear to have cancer, but not. Therefore, biopsy is not performed in patients whose other diagnostic methods support the diagnosis of pancreatic cancer because even if the biopsy result is clean, it does not change the decision of surgery. In addition, there is a theoretical risk that the tumor's integrity may deteriorate and spread around, especially in biopsies performed through the skin. For this reason, biopsy is preferably taken endoscopically and is preferred in two groups of patients; In the foreground, patients who are planned to undergo chemotherapy rather than surgical treatment and patients who are suspected of benign diseases that mimic pancreatic cancer. "
Being late for surgery
Since their symptoms appear in the late period, more than 75 percent of those who have pancreatic cancer have passed the stage where they can benefit from surgical treatment, which is the only effective treatment. Stating that less than 25 percent of patients can be treated with surgery, Prof. Dr. Murat Gönenç, “The only effective treatment of pancreatic cancer is surgery, ie surgery. Because, the best results in the treatment of pancreatic cancer is obtained with surgery, which provides complete removal of cancerous tissues. However, since pancreatic cancer has a very aggressive nature, it is not possible to treat the disease with a single treatment method. Therefore, surgical treatment, chemotherapy and radiotherapy (radiotherapy) are used together, ”he says.
Pancreatic surgery requires serious experience
Pancreatic cancer surgeries cannot be performed when the tumor cannot be removed or the disease has metastasized to distant organs. Chemotherapy and radiotherapy methods are used in these patients. Explaining that surgery can become an option again in patients who respond well to this treatment. Dr. Murat Gönenç said, “However, this decision must be made on patient basis and in the presence of multidisciplinary meetings. Pancreatic surgery is technically difficult and requires serious experience. The probability of problems related to these surgeries is still high, but thanks to huge advances in anesthesia and surgical techniques, the mortality rate due to pancreatic surgery has dropped significantly, ”he says.
Oncological surgery does not only mean surgery where the tumor is removed. It describes removing the tumor as a whole with clean boundaries, that is, with the least possible amount of tissue where cancer is not seen, without spreading it to the environment, that is, without rupturing or blasting, with possible spread areas. Stating that for this, it may be necessary to sacrifice sometimes completely innocent tissues, organs or vessels surrounded by a tumor. Dr. Murat Gönenç emphasizes that "All these principles should be followed in the surgical treatment of pancreatic cancer".