ขอบคุณแหล่งข้อมูล : ศาสตร์เกษตรดินปุ๋ย : หนังสือพิมพ์ The Nation
http://www.nationmultimedia.com/life/Pancreatic-cancer–the-silent-killer-30257499.html
HEALTH MATTER
The ninth most common cancer in the Western world, pancreatic cancer has probably the lowest survival rate of any cancer known to man.
Often referred to as a silent disease because it does not cause identifiable symptoms, patients will usually experience abdominal bloating, a sense of fullness, weight loss and back pain. But these are not specific symptoms of pancreatic cancer, and thus it is hard to detect it early. It is mostly detected in suspected cases. Sometimes the tumour will grow in a way that it blocks the bile duct or the main pancreatic duct, causing yellowing of the eyes and skin. When pancreatic cancer is in the middle or tail of the pancreas and does not block anything, symptoms are not usually present. The cancer is often already advanced and surgery cannot be performed by the time symptoms appear, among them upper abdominal pain radiating to the back, loss of appetite, unexplained weight loss and fatigue.
Pancreatic cancer, which is more common in people aged 40 and over than younger individuals, has 4 stages.
In stage 1, the cancer is smaller than 2 cm and is confined to the pancreas. In stage 2, the cancer has grown larger than 2 cm and has spread beyond the pancreas or to the lymph nodes near the pancreas. By stage 3, the cancer has spread to the major blood vessels around the pancreas. In stage 4, the cancer has spread to other organs, such as the liver or lungs, or even to bones that are far from the original point of the cancer.
The exact cause of pancreatic cancer is unknown. However, the factors thought to increase risk include a history of chronic inflammation of the pancreas caused by long-term alcohol consumption and a family history of pancreatic cancer.
A radiology procedure is used to assess the pancreas for the presence of cancer because a blood test cannot clearly identify the disease. An ultrasound can show only part of the pancreas because it is hidden behind the stomach. A CT Scan or MRI can be used to look for the cancer, but the pancreas is small making it hard to diagnose cancer. As a result, only about 80 to 90 per cent of small tumours can be seen. Large tumours can be clearly seen but mostly in the advanced stages 3 and 4 when surgery cannot be performed. At stage 1, all malignant tumours can be removed, but there is a high chance of recurrence. For malignant tumours in stages 2 to 4, there is little chance of curing the cancer. In these cases, chemotherapy is used to slow the growth.
EUS is an innovative screening option for pancreatic cancer and involves the insertion of an endoscope with an ultrasound probe attached through the mouth, stomach and small intestine. This procedure is used to view the pancreas from the head to tail, as well as the spleen, bile duct and blood vessels around these areas. It provides more than 90-per-cent accuracy.
If the doctor suspects pancreatic cancer, a biopsy can be conducted by removing a small sample of tissue or cells from the pancreas for examination. The EUS procedure takes only 60 to 90 minutes and because the |camera is quite large, patients are given an anaesthetic.
If pancreatic cysts are found, the doctor will examine the type of cysts and risk of cancer. The cysts need to be monitored carefully as they can get bigger or turn cancerous. Removing cancer from the head of the pancreas is a major and open operation.
The risk of complications is higher than general surgery and recovery may take a long time. If the cancer is in the tail of the pancreas, a portion of the pancreas will be removed.
Pancreatic tail surgery can also be conducted by laparoscopy technique through the belly button and 3-4 holes with a width of 1 cm in the abdominal wall allowing for insertion of the surgical device. It is a minimally invasive surgical procedure with quick recovery time.
If you experience unexplained chronic stomach pain or bloating, particularly in the upper stomach or the stomach pain radiating to the back, it may be a sign of pancreatic problems.
And if you have consumed alcohol over a long period, have lost your appetite, and/or have unexplained weight loss, don’t wait before consulting a doctor for appropriate advice and diagnosis.
DR PITULAK ASWAKUL is a specialist in gastroenterology and hepatology |at Samitivej Sukhumvit Hospital. Call (02) 711 8822-4.
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