Pancreatic cancer ranks seventh in the world with nearly 500,000 deaths in 2020 amid cancer-related deaths. Stating that pancreatic cancer is a type of cancer that is difficult to diagnose because it does not show symptoms in the early period, General Surgery Specialist Prof. Dr. Süleyman Yedibela said, “Surgery is very valuable in the treatment of pancreatic cancer. Surgical techniques may differ depending on the location of the tumor. For example, in patients where the tumor is in the head of the pancreas, the ‘whipple’ technique is used. Whipple is, of course, a big and tedious surgery for patients and surgeons alike. However, after the surgeries performed by experienced groups in this field, patients can return to their normal lives within two weeks. prof. Dr. Süleyman Yedibela answered the 5 most frequently asked questions about the disease, especially the whipple technique, on the occasion of November Pancreatic Cancer Awareness Month.
1. What Causes Pancreatic Cancer?
According to the results of scientific studies, the existence of some genes that are known to cause cancer tendency in the formation of pancreatic cancer and familial are valuable. In addition, the possibility of developing pancreatic cancer is higher in men and individuals over the age of 65. In addition, some studies strongly indicate that obesity and diabetes are also linked to pancreatic cancer.
2. What are the Symptoms of Pancreatic Cancer?
Symptoms that are not seen in the first stages of pancreatic cancer begin to appear in the advanced stages of the disease. Symptoms are mostly jaundice, itching, indigestion, weight loss and pain. However, let’s underline the following about the symptoms: If a “painless” jaundice develops in the early stage, this is interpreted as a cancer in the pancreas first. If jaundice is accompanied by pain, the underlying cause is mostly stones in the gallbladder. When a mass is detected in the pancreas, if it is suspected to be malignant, it may rarely be an endocrine tumor. However, the basic one, which is more common and comes to mind first, is the appearance of the pancreas due to the external secretion glands. At this stage, for a definitive diagnosis, a cut is taken from the mass for biopsy, and the cellular origin of the mass is determined. In the next step, the connection of the mass with the surrounding tissues and vessels and whether it has spread to other organs are checked. If there is no distant metastasis and the disease is only finite in that area, it is decided whether it is suitable for surgery according to its relation to the surrounding tissues.
3. How Is Late Diagnosis Treated?
Due to the lack of symptoms, patients with pancreatic cancer often apply to the hospital when the cancer progresses. In these patients who are diagnosed late, the best treatment option is surgery. In recent years there have also been valuable advances in targeted therapies, including new spies in chemotherapy. Options such as radiotherapy and immunotherapy now have a strong place in the treatment planning of pancreatic cancer. A new generation of sequencing and targeted therapies, including genetic examination of tumors, which are recommended especially for patients who are not suitable for surgery, are yielding more and more remarkable results for the benefit of the patient.
According to statistics, since pancreatic cancer does not show any symptoms in the early period, the rate of patients in stage 1 who are suitable for surgery to consult a doctor without changing the stage is quite low. Therefore, systematic check-ups in pancreatic cancer are a critical measure for early detection.
4. Is the “Whipple technique” Suitable for Everyone?
Surgical techniques may differ depending on where the tumor is located. For example, in patients where the tumor is in the head of the pancreas, the “whipple” technique is used. In the whipple technique, which has a lot of power and high complications; The lowest part of the stomach, duodenum, pancreatic head, bile duct and sac are removed. It is also valuable to remove the lymph nodes in these regions. Finally, the pancreatic duct, bile duct and stomach are combined with the small intestine and the operation is completed. The application of the technique is decided by looking at the patient’s condition within the framework of certain criteria. It is valuable to observe certain criteria in order to use this technique in patients with arterial involvement. However, sometimes holding the veins is not a problem.
5. What should patients pay attention to after pancreas surgery?
Since a part of the pancreas is removed, diabetes can develop in patients, so it is very valuable to inform the patients. The head of the pancreas is a region where some valuable enzymes are formed, and some drug treatments may be needed in order to fulfill these enzymes.
If a technique other than whipple is applied in pancreatic cancer, different restrictions may be required in the life of patients after surgery, depending on how much areas such as the pancreas or intestine are affected. Depending on the stage of the tumor, additional chemotherapy is also used (BSHA).