No more helplessness! Dealing with the "cancer king", the patient is desperate

Modern Express News (correspondent Xu Dongjiang Haiyan He Yutian reporter Liu Jun) "I thought that with locally advanced pancreatic cancer, there was no hope. Now after treatment, you can still be discharged from the hospital after surgery to live a normal life, thank you very much! Recently, Ms. Chen recovered well after surgery and came to the Pancreatic Disease Clinic of Jiangsu Provincial People's Hospital (the First Affiliated Hospital of Nanjing Medical University) to express her gratitude for the careful treatment given to her by the Pancreatic Center over the past year. More than a year ago, it was the successful application of the "translational treatment" strategy by the pancreatic center of the hospital that allowed Ms. Chen, who suffered from the "king of cancer", pancreatic cancer, to gain a glimmer of life.

△ Pancreatic center daily MDT early shift

Despair: unfortunate to suffer from advanced "cancer king"

As we all know, pancreatic cancer because of its special location, difficult surgery, high degree of malignancy, easy to recur, poor treatment effect, 5-year survival rate in developed countries in Europe and the United States is only 8%, so it is known as the "king of cancer", surgical resection is the only way to cure pancreatic cancer. Ms. Chen recalled that on August 24, 2020, at the age of 67, she was diagnosed with pancreatic cancer by the local hospital. What made it even more difficult for the family to accept was that the abdominal enhancement CT examination assessed that the tumor had completely encapsulated and violated the most important artery in the abdominal cavity, the superior mesenteric artery and its distal branches, "indicating that my tumor was locally advanced, and the doctor said that I had no chance of surgery to remove it." Later, I heard that the pancreatic center of the Jiangsu Provincial People's Hospital was good, so I decided to let them see it, otherwise I would not die. Ms. Chen said.

Hope: multidisciplinary "relay", "transformational therapy" opens the window of life

It is understood that the multidisciplinary team led by Professor Miao Yi and Professor Jiang Kuirong of the Pancreas Center after arriving at the hospital made a detailed assessment for Ms. Chen. "Different from the traditional multidisciplinary model, our pancreatic center department room includes surgery, gastrointestinal endoscopy, oncology, ICU and other multidisciplinary disciplines, and experts cooperate all day and in real time, and the treatment plan is seamlessly connected." After discussion, we decided to take the 'translational therapy' approach, through chemotherapy, radiotherapy, targeted therapy and other comprehensive treatment methods, reduce the tumor volume, reduce the tumor staging, so that patients can regain the opportunity for surgical resection, and then strive for long-term survival." Professor Jiang Kuirong said.

Director Jiang introduced that on September 1, 2020, Xiao Bin, deputy chief physician of the pancreatic center endoscopy expert, conducted an ultrasound endoscopic biopsy for Ms. Chen, and successfully obtained pathology at one time, and the chemotherapy team of the pancreas center led by deputy chief physician Tu Min immediately after the pathology was confirmed was "relayed" to formulate a chemotherapy plan for the patient.

△ The expert team of the Pancreas Center of the Provincial People's Hospital

According to the type of pathology and taking into account Ms. Chen's malnourished physical condition, Director Tu's team formulated an individualized chemotherapy program for the patient. Thanks to the Pancreatic Center's 24/7 multidisciplinary MDT team, Ms. Chen began chemotherapy on September 6, less than a week before she was admitted to the hospital. "According to the traditional diagnosis and treatment process, I originally had to go to at least 3 departments, and there was no delay in the time here, and as soon as the chemotherapy drugs were put on, my heart was half fixed." Ms. Chen said.

After seven cycles of transformative chemotherapy, on April 22 this year, the good news came: Ms. Chen's pancreatic head tumor was reduced from the initial 3.90 * 2.90cm to 2.27 * 2.33cm, and the relevant tumor indicators also dropped to the normal range! Further imaging assessment results: Ms. Chen may still have a chance of surgical resection! On May 7, Professor Jiang Kuirong of the Pancreatic Center performed pancreatic duodenal resection + superior mesenteric artery sheath peeling for the patient, and the operation was very smooth, and the intraoperative bleeding was only 150ml. "The superior mesenteric artery that was originally completely surrounded by the tumor during the operation was successfully dissected, and no tumor cells were seen in the rapid pathology of many tissues around the blood vessels", director Jiang introduced, postoperative pathology suggested that all the incisions of the pancreas were negative, indicating that Ms. Chen's tumor was completely removed. "After the operation, our chemotherapy team continued to consolidate chemotherapy for the patient, and the current patient is generally in good condition, the tumor has not recurred or metastasized, and it can be said that normal life has returned." Director Jiang said.

No more helplessness: patients with locally advanced pancreatic cancer usher in "vitality"

It is understood that surgical resection is the only possible way to cure pancreatic cancer, and the early symptoms of pancreatic cancer are hidden, and a large number of patients are already locally advanced when they first visit the doctor, and do not have the opportunity to operate, "Today, not all patients with locally advanced pancreatic cancer are incurable." Some cases of locally advanced invasion of arteries and veins that could not be operated on before are still available for surgery after 'conversion treatment'. Director Jiang Kuirong introduced that the key to "transformational treatment" lies in two points, one is to cooperate closely with a multidisciplinary team, and the other is to have superb surgical skills, "the two complement each other and are indispensable." ”

Professor Miao Yi of the Pancreatic Center of Jiangsu Provincial People's Hospital told reporters that at present, the Pancreatic Center has accumulated rich experience in the field of translational treatment of pancreatic cancer, and has accumulated dozens of cases of radical surgery for pancreatic cancer after successful conversion therapy. "We have honed a team that is good at 'overcoming difficulties', carrying out more than 1,000 pancreatic surgeries every year, and we have also innovatively created arterial sheath stripping technology, taking the lead in introducing Heidelberg triangular cleaning technology and radical anterograde modular pancreatic splenectomy in China, which has cleared the technical barriers for radical resection of local advanced pancreatic cancer after conversion treatment." Professor Miao Yi said.

Source: Hyundai Express All Media