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Mr. Xu (pseudonym), 60, is a veritable winner in life in the eyes of others – he runs a company with a smooth career and a harmonious and happy family.
It's just that after so many years of hard work and never caring about his body, he thought of doing a comprehensive physical examination just before retiring.
After this investigation, Mr. Xu's life has undergone earth-shaking changes - he has become a patient with advanced pancreatic cancer.
The moment he received the report, he couldn't believe it, he never thought he would get cancer, and it had progressed to an advanced stage.
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When he entered the keyword "pancreatic cancer" on the Internet to search, most of the replies were "cancer king" and "extremely malignant, with a very poor prognosis". And when "advanced" and "pancreatic cancer" appear at the same time, it basically means "no rescue".
Such a result is like a thunderbolt on a sunny day, so that Mr. Xu fell silent, and the past scenes flashed through his mind as quickly as a movie rewind, the hardships of starting a business, the joy of becoming a new father, and the smooth development of the company...
But years of hard work have also shaped his tenacious character, and after a silence, he decided to fight cancer.
Pancreatic cancer liver metastasis
Is there no chance?
With anxiety and expectation, Mr. Xu was accompanied by his family to the specialist clinic of Professor Cao Liping of the Department of General Surgery of Run Shaw Hospital affiliated to Zhejiang University.
Professor Cao said after carefully watching the film: "This is a tumor in the tail of the pancreas, considering pancreatic cancer. Metastases have also been found on your liver. Based on imaging findings, the preliminary diagnosis is pancreatic cancer liver metastases. Treatment is needed as soon as possible. ”
Mr. Xu asked nervously, "Is there no chance of surgery?" ”
Professor Cao patiently replied: "At present, the possibility of expanding radical resection also exists, but the recurrence rate after surgery is extremely high, in order to achieve better surgical results, I recommend that you perform adjuvant chemotherapy before surgery, if the tumor is controlled, indicating that chemotherapy is effective, and then expanded radical resection can achieve better results." Professor Cao Liping's words gave Mr. Xu great confidence and encouragement.
The next day, Mr. Xu was admitted to Run Run Shaw Hospital, and the chief physician Ding Guoping, the chief physician, conducted a detailed examination for Mr. Xu, and after the puncture biopsy, the pathological indication was indeed pancreatic cancer.
Multidisciplinary development of the program
Early treatment is clearly effective
Subsequently, Professor Cao convened a number of experts from the Department of Oncology, Radiology, Radiotherapy, Pathology and other experts to conduct multidisciplinary discussions, and finally formulated a translational treatment plan for Mr. Xu that was mainly based on chemotherapy and actively supplemented by nutrition, immunity and symptomatic support for comprehensive treatment.
After 3 months, Mr. Xu reviewed the CT again and found that the metastases in the liver and the primary lesions in the pancreas had been significantly reduced, and the tumor marker indicators were basically normal, and after PET-CT examination, the activity of liver metastases had basically disappeared. This shows that the tumor has been controlled and that the conversion therapy is clearly effective!
After another multidisciplinary discussion, Professor Cao Liping and Chief Physician Ding Guoping successfully performed laparoscopic radical modular anterosplenectomy (L-RAMPS) combined with partial hepatic resection for Mr. Xu. Mr. Xu recovered well after the operation and was discharged from the hospital after 10 days.
High-energy warning!
Before treatment
After treatment
Related knowledge science
Pancreatic cancer is one of the most malignant malignant tumors, with more than 80% of patients diagnosed with advanced inability to operate, and a five-year survival rate of less than 10%.
Symptoms of pancreatic cancer
Pancreatic cancer is known as a "silent" disease. Typically, symptoms do not appear in the early stages. But as the tumor grows and spreads, the pain often occurs in the upper abdomen and sometimes spreads to the back. Other symptoms include jaundice, nausea, loss of appetite, weight loss, greasy stools, fatigue, and weakness. Symptoms lack specificity, but if you experience any unexplained symptoms that worry you, see a doctor.
Causes and risk factors for pancreatic cancer
The exact trigger/cause is not yet known, but smoking is one of the risk factors, and smokers are 2 times more likely to develop pancreatic cancer than non-smokers. It is also related to age, usually at the age of 45 years and older. Diabetes is also a potential risk factor for pancreatic cancer. Other high-risk factors include chronic pancreatitis, cirrhosis, and pancreatic cysts; high-fat diets, obesity and inactivity, and a family history of cancer may also be intrinsic factors.
How is pancreatic cancer treated?
Multidisciplinary comprehensive diagnosis and treatment is the basis for any staged pancreatic cancer treatment, and the Pancreatic Cancer Diagnosis and Treatment Center at Run Run Shaw uses a multidisciplinary consultation (MDT) model to provide patients with individualized treatment options. The treatment of pancreatic cancer mainly includes surgical treatment, chemotherapy, radiation therapy, interventional therapy and optimal supportive care.
What is non-resectable pancreatic cancer?
Based on the relationship between the tumor and its surrounding important blood vessels and distant metastasis suggested by imaging results, the tumor resectability was evaluated and divided into three types: resectable, junctional resectable and non-resectable.
Unresectable pancreatic cancers include locally progressive pancreatic cancer and concomitant distant metastatic pancreatic cancer. Mr. Xu in the text belongs to pancreatic cancer with distant metastasis.
What is translational therapy for pancreatic cancer
And transformation surgery?
Conversion therapy refers to the multimodal treatments received by patients with unresectable pancreatic cancer, including chemotherapy, radiotherapy, targeted therapy, and immunotherapy.
Translational surgery is defined as surgery aimed at achieving a curable purpose after a tumor that was initially considered technically or oncologically unresectable or only barely resectable responds to conversion therapy.
Non-resectable translational surgery for pancreatic cancer
How's it going?
For advanced or metastatic pancreatic cancer, there is growing evidence that surgical resection after conversion therapy can prolong survival.
For locally advanced pancreatic cancer, about 60% to 70% of patients can control tumor development with neoadjuvant chemotherapy, and about 20% of patients may achieve radical cure goals through translational chemotherapy, and the prognosis of these patients is significantly better than that of patients without neoadjuvant chemotherapy.
After conversion therapy
When is surgery?
Patients with suppressed tumors after conversion therapy, who have the possibility of combined vasectomy and reconstruction, and who are in good physical condition are subjected to laparoscopic surgical exploration, and strive for surgical resection as soon as possible.
We generally choose to perform surgery in 3 to 6 months after conversion therapy, and the operation time is mainly determined according to the patient's tumor assessment and physical condition.
Source: General Surgery, Shaw Hospital
Original works, reprinted please indicate the source and source
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