Pancreatic tumours are not common. They usually present late (meaning in the advanced stage). Surgery is still the best treatment option aiming for a cure. Pancreatic surgery is complex and technically difficult. People who require pancreatic surgery should have a lengthy discussion with a liver and pancreatic surgeon before deciding on the most appropriate treatment choice.
In Singapore, pancreatic cancer may not be the most common cancer. However, it is one of the most common causes of cancer death.
The function of the pancreas is to help us digest food and to produce hormones that keep our body healthy and in equilibrium. Insulin is one of the hormones that the pancreas produces. It keeps our blood sugar level low. High blood sugar levels will lead to diabetes. Diabetes, when not managed properly, will lead to cardiovascular disease, strokes, kidney failure, blindness etc.
What causes pancreatic cancer is still unknown, but some factors suggest a strong link to pancreatic cancer such as diabetes and smoking.
Patients with pancreatic cancers may not have symptoms until the very late stage. Symptoms may include abdominal pain, jaundice (skin and eyes turning yellow), weight loss and new onset of diabetes. Patients also frequently complain of poor appetite and back pain. Patients tend to present late to see doctors. They may even bear with these signs of pancreatic cancer for weeks or months. By the time they decide to see a doctor, it may be too late. Anyone with persistent abdominal pain should see a surgeon to exclude intraabdominal malignancies (cancers).
Pancreatic cancer tends to progress fairly rapidly. If diagnosed, it is important to consult a pancreatic surgeon as soon as possible. The surgeon will then assess the suitability for surgery. Staging of cancer will be done before the surgery to ensure that the tumour has not spread to other organs such as the liver or lungs. Staging will involve a computer tomography (CT) and/or magnetic resonant imaging (MRI) scan.
Surgery for pancreatic cancer is the only curative form of treatment. Pancreatic cancers can affect different parts of the pancreas. The location of the tumour will determine the type of surgery performed to remove the tumour. For example, a tumour located in the head of the pancreas will require a pancreaticoduodenectomy. A tumour in the body or the tail of the pancreas will require a distal pancreatectomy which might involve taking out the spleen as well.
Pancreatic surgery can be performed using minimally invasive techniques. Techniques such as laparoscopic and robotic surgery are options for selected groups of patients. Outcomes have been shown to be comparable to traditional open surgery. With minimally invasive surgery, patients experience less pain after surgery, and they tend to have a shorter hospital stay.
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