Pancreatic cancer is the eighth leading cause of cancer deaths in Taiwan, according to the statistics of the Ministry of Health and Welfare in 2017. Because of the deep location of the pancreas, early pancreatic cancer manifests almost no symptoms, so pancreatic cancer is also known as "silent killer." Upper abdominal pain is the most common symptom of pancreatic cancer.

Risk factors

• Age: pancreatic cancer occurs mostly in people over age 60, and rarely in people under age 40.
• Gender: men in the majority, three times as many as women.
• Smoking: Smokers are 2 to 3 times more likely to develop pancreatic cancer than non-smokers, especially those who smoke more than 2 packs a day.
• Alcohol: Alcohol consumption has been reported to be associated with pancreatic cancer.
• Diet: The higher the proportion of meat or fat intake in life, the greater the chance of pancreatic cancer.
• Chemicals: People who have been exposed to chemicals for more than 10 years, especially petroleum products or solvents, are more susceptible to pancreatic cancer.
• Heredity: Several genetic diseases increase the risk of pancreatic cancer, such as hereditary pancreatitis.

Symptoms

Early pancreatic cancer has almost no symptoms, and "epigastric pain" is the most common clinical symptom of pancreatic cancer. Typical signs of pancreatic cancer include:

• Persistent diarrhea or gray stool.
• Significant weight loss: loss of appetite, nausea, vomiting, or fatigue. This may be related to poor eating and abnormal digestion and absorption.
• Jaundice: this is usually an advanced symptom of pancreatic cancer, which may be due to pancreatic tumors pressing on the common bile duct, or metastatic spread to the liver.

Treatment

Surgery is still the best choice for long-term survival of pancreatic cancer patients. The size of the tumors is the main factor determining whether surgery can be performed or not. Currently, surgery is not very likely to cure the disease mainly because many pancreatic tumors are found after they are too big to be resected. Therefore, only 20% of patients can have radical resection.

Patients with advanced or metastatic pancreatic cancer cannot surgically remove the tumor, and hence chemotherapy plays a leading role in the whole course of treatment. Chemotherapy for pancreatic cancer patients should carefully assess the patient's endurance, so as to avoid adverse effects caused by too many side effects. Appropriate chemotherapy, especially in conjunction with radiotherapy, can prolong the life span of patients with pancreatic cancer or relieve symptoms. Gemcitabine is the main chemotherapeutic drug available clinically.

Conclusion

At present, the etiology of pancreatic cancer is not clear, and it is not easy to prevent it. However, for some high-risk groups of patients, including smokers, alcohol users, people with a high proportion of meat or fat intake in their diet, and diabetic patients, it is advisable to receive regular examinations in order to make early diagnosis, so that the treatment rate can be further boosted.