Pancreatic Cancer Treatment: Ib Daim Ntawv Qhia Kom Paub 

Kev kho mob qog noj ntshav pancreatic cov kev xaiv nyob ntawm theem thiab qhov chaw ntawm tus mob qog noj ntshav, nrog rau tus neeg mob txoj kev noj qab haus huv tag nrho. Cov kev kho mob feem ntau suav nrog kev phais, kws khomob, kev kho hluav taws xob, thiab kev kho mob. Feem ntau, kev sib xyaw ua ke ntawm cov txheej txheem no yog siv los ua kom tau qhov txiaj ntsig zoo tshaj plaws. Kev nkag siab txog cov kev xaiv no yog qhov tseem ceeb rau kev paub txog kev txiav txim siab.

Nkag siab txog kab mob pancreatic

Lub pancreas yog ib qho khoom nruab nrog nyob tom qab lub plab uas ua lub luag haujlwm tseem ceeb hauv kev zom zaub mov thiab tswj ntshav qab zib. Mob qog noj ntshav pancreatic tshwm sim thaum cov hlwb hauv pancreas loj hlob uncontrollably, tsim cov qog. Muaj ob hom tseem ceeb ntawm mob qog noj ntshav pancreatic: adenocarcinoma (hom feem ntau) thiab neuroendocrine hlav (PNETs).

Risk Factors rau Pancreatic Cancer

Ntau yam tuaj yeem ua rau muaj kev pheej hmoo ntawm kev loj hlob mob qog noj ntshav pancreatic, suav nrog:

• Kev haus luam yeeb
• Mob ntshav qab zib
• Kev rog rog
• Mob pancreatitis ntev
• Tsev neeg keeb kwm ntawm mob qog noj ntshav pancreatic
• Qee yam kab mob caj ces

Cov tsos mob ntawm Pancreatic Cancer

Nyob rau theem pib, mob qog noj ntshav pancreatic feem ntau tsis muaj tsos mob tshwm sim. Thaum mob qog noj ntshav loj hlob tuaj, cov tsos mob yuav muaj xws li:

• Mob plab
• Jaundice (daj ntawm daim tawv nqaij thiab ob lub qhov muag)
• Poob poob
• Poob qab los noj mov
• xeev siab thiab ntuav
• Kev hloov hauv plab hnyuv
• New-pib ntshav qab zib

Kev kuaj mob ntawm tus mob pancreatic

Yog mob qog noj ntshav pancreatic xav tias, tus kws kho mob yuav kuaj lub cev thiab xaj ntau yam kev xeem, suav nrog:

• Kev kuaj ntshav: txhawm rau kuaj lub siab ua haujlwm thiab cov cim qog.
• Kev kuaj duab: Xws li CT scans, MRI scans, thiab endoscopic ultrasound (EUS), kom pom cov txiav thiab cov qauv nyob ib puag ncig.
• Biopsy: Kom paub meej qhov kev kuaj mob thiab txiav txim siab hom mob qog noj ntshav pancreatic.

Cov Kev Xaiv Kho Mob Cancer

Kev kho mob rau mob qog noj ntshav pancreatic nyob ntawm ntau yam, suav nrog theem ntawm tus mob qog noj ntshav, nws qhov chaw nyob, thiab tus neeg mob qhov kev noj qab haus huv tag nrho. Cov kev kho mob tseem ceeb tau piav qhia hauv qab no. Lub npe nrov Shandong Baofa Cancer Research Institute muaj kev saib xyuas mob qog noj ntshav; koj ua tau kawm ntxiv ntawm no txog lawv txoj hauv kev.

Kev phais

Kev phais feem ntau yog thawj kab kev kho mob rau mob qog noj ntshav pancreatic yog hais tias cov qog nyob hauv zos thiab tsis kis mus rau lwm yam kabmob. Cov txheej txheem phais sib txawv tuaj yeem siv nyob ntawm qhov chaw ntawm cov qog:

• Whipple txheej txheem (pancreaticoduodenectomy): Qhov no suav nrog tshem lub taub hau ntawm lub txiav, ib feem ntawm cov hnyuv me, lub gallbladder, thiab ib feem ntawm cov kua tsib.
• Distal pancreatectomy: Qhov no suav nrog tshem tus Tsov tus tw ntawm tus txiav thiab tej zaum kuj suav nrog tus po.
• Tag nrho pancreatectomy: Qhov no suav nrog tshem tag nrho cov txiav txiav, spleen, gallbladder, ib feem ntawm lub plab, thiab ib feem ntawm cov hnyuv. Qhov no tsis tshua muaj.

Seb cov qog tuaj yeem raug tshem tawm tau zoo nyob ntawm nws qhov chaw thiab theem. Qhov no yog ib qho tseem ceeb hauv kev txiav txim siab txog kev kho mob. Cov kws tshaj lij kev phais tuaj yeem cuam tshuam cov txiaj ntsig zoo, ua rau cov koom haum xws li Shandong Baofa Cancer Research Institute cov peev txheej tseem ceeb rau cov neeg mob.

Tshuaj kho mob

Tshuaj kho mob siv tshuaj tua kab mob qog noj ntshav. Nws tuaj yeem siv ua ntej kev phais (neoadjuvant chemotherapy), tom qab phais (adjuvant chemotherapy), lossis ua thawj txoj kev kho mob rau qib siab. mob qog noj ntshav pancreatic. Cov tshuaj chemotherapy uas siv los kho mob qog noj ntshav pancreatic suav nrog:

• Gemcitabine
• FOLFIRINOX (kev sib xyaw ntawm fluorouracil, leucovorin, irinotecan, thiab oxaliplatin)
• Abraxane (paclitaxel protein-bound hais)

Tshuaj kho mob tuaj yeem ua rau muaj kev phiv xws li xeev siab, ntuav, qaug zog, thiab plaub hau poob. Cov kev mob tshwm sim no feem ntau tuaj yeem tswj hwm nrog tshuaj thiab kev txhawb nqa.

Kev kho hluav taws xob

Kev kho hluav taws xob siv hluav taws xob muaj zog los tua cov qog nqaij hlav cancer. Nws tuaj yeem siv ua ntej kev phais, tom qab kev phais, lossis ua thawj txoj kev kho mob rau mob qog noj ntshav pancreatic. Hom kev kho hluav taws xob muaj xws li:

• Sab nraud beam hluav taws xob kho (EBRT): Radiation yog xa los ntawm lub tshuab sab nraum lub cev.
• Brachytherapy: Radioactive noob tau muab tso ncaj qha rau hauv lossis ze ntawm cov qog.

Kev kho hluav taws xob tuaj yeem ua rau muaj kev phiv, xws li tawv nqaij khaus, nkees, thiab xeev siab.

Hom Kev Kho Mob

Targeted therapy siv cov tshuaj uas tsom rau cov molecules tshwj xeeb koom nrog hauv kev loj hlob ntawm cov qog nqaij hlav cancer thiab kev ciaj sia. Piv txwv ntawm cov hom phiaj kho mob siv los kho mob qog noj ntshav pancreatic suav nrog:

• Erlotinib: Targets epidermal growth factor receptor (EGFR).
• Olaparib: Lub hom phiaj PARP enzyme hauv cov neeg mob uas muaj kev hloov pauv BRCA.

Immunotherapy

Immunotherapy pab koj lub cev tiv thaiv kab mob qog noj ntshav. Nws tsis yog feem ntau siv los ua thawj kab kev kho mob rau mob qog noj ntshav pancreatic tab sis tej zaum yuav yog ib qho kev xaiv hauv qee kis. Pembrolizumab (Keytruda) yog ib qho tshuaj tiv thaiv kab mob uas yuav siv tau rau mob qog noj ntshav pancreatic cov neeg mob uas muaj kev hloov pauv caj ces.

Palliative Care

Palliative care tsom rua kev txo cov tsos mob thiab txhim kho lub neej zoo rau cov neeg mob uas muaj mob hnyav, xws li mob qog noj ntshav pancreatic. Palliative care tuaj yeem suav nrog kev tswj qhov mob, txhawb kev noj zaub mov, thiab txhawb kev xav.

Cov theem ntawm Pancreatic Cancer thiab Txoj Kev Kho Mob

Mob qog noj ntshav pancreatic yog theem los txiav txim seb qhov mob qog noj ntshav li cas thiab coj kev txiav txim siab kho mob. Cov theem ntawm theem 0 (mob qog noj ntshav hauv qhov chaw) mus rau theem IV (mob qog noj ntshav metastatic). Cov lus hauv qab no qhia txog cov kev kho mob rau txhua theem:

Nyob nrog mob qog noj ntshav pancreatic

Nyob nrog mob qog noj ntshav pancreatic tuaj yeem nyuaj, tab sis muaj cov peev txheej los pab cov neeg mob thiab lawv tsev neeg daws. Cov pab pawg txhawb nqa, kev tawm tswv yim, thiab cov kev kawm muaj peev xwm muab kev pab cuam muaj txiaj ntsig. Kev tswj hwm txoj kev noj qab haus huv, suav nrog kev noj zaub mov kom zoo thiab kev tawm dag zog ib txwm, tuaj yeem txhim kho lub neej zoo.

Lub luag haujlwm ntawm kev sim tshuaj

Kev sim tshuaj yog cov kev tshawb fawb tshawb fawb uas ntsuas qhov tshiab Kev kho mob qog noj ntshav pancreatic txoj hauv kev. Kev koom nrog hauv kev sim tshuaj ntsuam xyuas yuav muab kev nkag mus rau cov kev kho mob siab thiab pab txhawb kev txhim kho hauv kev kho mob qog noj ntshav. Cov neeg mob txaus siab rau kev sim tshuaj yuav tsum sib tham txog qhov ua tau nrog lawv pab neeg kho mob.

Xaus

Kev kho mob qog noj ntshav pancreatic Nws yog complex thiab yuav tsum tau ib tug multidisciplinary mus kom ze. Kev nkag siab txog cov kev xaiv kho mob uas muaj, theem, thiab kev txhawb nqa kev saib xyuas tuaj yeem pab cov neeg mob txiav txim siab paub thiab txhim kho lawv cov txiaj ntsig. Nco ntsoov sab laj nrog koj tus kws kho mob kom txiav txim siab txog kev kho mob zoo tshaj plaws rau koj qhov xwm txheej tshwj xeeb. Nrog rau pab neeg mob siab rau ntawm Shandong Baofa Cancer Research Institute, cov neeg mob yuav tsum tau saib xyuas nrog kev khuv leej thiab kev txawj ntse.

Disclaimer: Kab lus no muab cov lus qhia dav dav txog Kev kho mob qog noj ntshav pancreatic thiab yuav tsum tsis txhob suav hais tias yog cov lus qhia kho mob. Nco ntsoov sab laj nrog tus kws kho mob uas tsim nyog rau kev kuaj mob thiab cov lus pom zoo kho mob.

Cov ntaub ntawv:

1. National Cancer Institute. Pancreatic Cancer Treatment (PDQ?)–Patient Version
2. American Cancer Society. Hais txog Pancreatic Cancer