Why the survival rate of pancreatic cancer is low according to an internal medicine specialist, Professor Lee Sang-hyup, Department of Internal Medicine, Seoul National University Hospital

Why the survival rate of pancreatic cancer is low according to an internal medicine specialist, Professor Lee Sang-hyup, Department of Internal Medicine, Seoul National University Hospital

Dec 14, 2024Ehotyshamull Joy

 

 

 

 

 

 

 

 

1. Pancreatic Cancer Status
What is the current status of pancreatic cancer in Korea?
Pancreatic cancer is known to be the hardest cancer to treat. It can be painful enough to require the use of narcotic painkillers, and it can progress so quickly that the cancer can spread in as little as six months. As of 2019, the prevalence rate of pancreas in Korea was approximately 1 per 10,000 people, and it ranks 8th in incidence and 5th in mortality among numerous cancers. The reason for the high mortality rate compared to the incidence rate is that pancreatic cancer is often very advanced when it is detected without symptoms, and there is no way to solve it. Every year, 4~5,000 people die from pancreatic cancer, and the age range is 70s.
2. Pancreatic Cancer Causes and Risk Factors
What causes pancreatic cancer?

Factors that can lead to pancreatic cancer include:

1. Smoking

The toxins in cigarettes can travel and spread throughout the body, irritating the pancreas and causing pancreatic cancer.

2. Chronic pancreatitis

If you have chronic pancreatitis, you are more likely to develop cancer. It is usually caused by drinking alcohol.

3. Drinking alcohol

Drinking alcohol itself does not cause pancreatic cancer, but it is a major contributor to inflammation in the body.

4. Family history

As with all cancers, a family history comes into play.

5. Pancreatic cystic tumors

Pancreatic cystic tumors, a lump in the pancreas that can be seen when an abdominal CT scan is performed, can develop into pancreatic cancer if it becomes malignant.

 

3. Symptoms of Pancreatic Cancer

What are the symptoms of pancreatic cancer?

 

The role of the pancreas is to absorb fats, digest them, and secrete bile. That is why, when pancreatic cancer develops, digestion becomes difficult, which leads to poor appetite and weight loss. In addition, jaundice develops, which causes the stool to become grayish in color. The pancreas is located in front of the spine, so when pancreatic cancer develops and infiltrates towards the spinal nerves, it causes back pain. By the time back pain occurs, it is often an advanced pancreatic cancer.

 

4. Treatment of pancreatic cancer

How is pancreatic cancer treated?

 

Here's why pancreatic cancer is notoriously difficult to treat:

 

First, it's hard to find. Because the pancreas is located in the deepest part of the human body, abdominal ultrasound cannot see about half of the pancreas, making it difficult to detect cancer.

 

Second, subjective symptoms are not significant or nonexistent. If you have noticed any of the above symptoms of pancreatic cancer, it is likely that you have already passed stage 3 pancreatic cancer.

 

Third, due to the nature of pancreatic cancer, unlike other cancers, fibrotic tissue and cancer cells are entangled together, making it difficult for anticancer drugs to work.

 

Fourth, pancreatic cancer is micrometastasis, that is, it is difficult to observe with the eye, but the cancer often spreads throughout the body. This is the reason why even if pancreatic cancer is treated and is judged to be cured, there are cases where it recurs within one year.

 

Nevertheless, if pancreatic cancer is detected, treatment should be started as soon as possible. This is because when biliary tract infection occurs due to jaundice, it is a condition in which people are more likely to die earlier due to reasons that are not caused by the cancer itself, such as dying from sepsis.

 

Treatment consists of taking anti-cancer drugs to reduce the size of the cancer for several months after the diagnosis of pancreatic cancer, and then proceeding with surgery to remove the cancer when it is operable, followed by adjuvant anti-cancer treatment and follow-up. In recent years, unlike in the past when only one anticancer drug was used, it is possible to perform a combination therapy with multiple anticancer drugs and a treatment that attacks cancer cells in a microscopic way called nanomaterials, so the surgical outcome is often better than the clinical statistics of the past.



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