Advanced age, male gender, smoking, Helicobacter pylori infection, excessive alcohol use, predominantly red meat consumption, low vegetable and fruit consumption, overweight and Type 2 diabetes. Genetic transition is also at the forefront for a group of patients.
It develops predominantly in the head of the pancreas (75%). There is a chance of relatively early diagnosis in these. Since there is also a biliary tract in the head of the pancreas, the patient may present with jaundice in the early period. A pancreatic cancer located in the trunk and tail may not show symptoms even if it reaches very large sizes. This means that the disease can be caught at a very late stage.
It may give symptoms such as jaundice, abdominal pain, weight loss, oily stools, the emergence of non-existent diabetes or worsening of the existing one. Sometimes, the tumor grows so much that the patient presents with findings due to obstruction of the duodenum.
The location and size of the tumor, whether it involves the blood vessels around the pancreas, and whether it metastasizes to local or distant lymph nodes or organs are important points in treatment planning.
If it is necessary for differential diagnosis or to start chemotherapy, then yes. However, if surgery is planned, a routine biopsy is not required.
The most common type of pancreatic cancer is pancreatic duct adenocarcinoma (pancreatic ductal adenocarcinoma). Surgical resection is the gold standard for long survival in patients without distant metastases. There are some local conditions that complicate surgery and sometimes make it impossible. These are often the tumor's relationship with the main veins and arteries in the immediate vicinity. In some cases, the segments of the vessels involved need to be resected and reconstructed. The contribution of these procedures to survival is still controversial.
In some cases, it is a suitable option to start with chemotherapy first and to perform surgery if the tumor shrinks.
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Prof. Dr. Sedat Karademir
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