Pancreatic Cancer: Kev nkag siab, kev kuaj mob, thiab kev xaiv kho 

Mob qog noj ntshav pancreatic Nws yog ib qho kab mob uas ua rau cov hlwb tsis zoo hauv cov ntaub so ntswg ntawm lub txiav, ib qho khoom nruab nrog nyob tom qab lub plab uas ua lub luag haujlwm tseem ceeb hauv kev zom zaub mov thiab kev tswj ntshav qab zib. Cov tsos mob feem ntau tsis meej thiab tej zaum yuav muaj xws li mob plab, jaundice, thiab poob phaus. Kev tshawb pom ntxov thiab kev kho mob yog qhov tseem ceeb rau kev txhim kho cov txiaj ntsig.

Nkag siab txog tus kab mob pancreas thiab Pancreatic Cancer

Pancreas yog dab tsi?

Lub pancreas yog ib yam kabmob uas nyob hauv lub plab. Nws plays ob lub luag haujlwm tseem ceeb:

• Exocrine muaj nuj nqi: Tsim cov enzymes uas pab zom zaub mov.
• Endocrine muaj nuj nqi: Tsim cov tshuaj hormones zoo li insulin thiab glucagon uas tswj cov ntshav qab zib.

Vim nws qhov chaw tob hauv lub plab, mob qog noj ntshav pancreatic tuaj yeem nrhiav tau yooj yim hauv nws cov theem pib.

Hom ntawm Pancreatic Cancer

Feem ntau ntawm mob qog noj ntshav pancreatic yog cov qog exocrine, tshwj xeeb yog adenocarcinomas. Cov qog no tshwm sim los ntawm cov hlwb uas ua rau cov kab mob pancreatic.

• Adenocarcinoma: Feem ntau hom, suav txog kwv yees li 95% ntawm cov neeg mob.
• Neuroendocrine Tumors (NETs): Tsis tshua muaj, tshwm sim los ntawm cov tshuaj hormones tsim tawm. Cov no yuav loj hlob qeeb dua li adenocarcinomas.

Shandong Baofa Cancer Research Institute tshwj xeeb hauv kev tshawb fawb thiab kho cov tswv yim rau ntau hom qog noj ntshav, suav nrog mob qog noj ntshav pancreatic. Kev nkag siab txog hom mob qog noj ntshav yog qhov tseem ceeb rau kev npaj kho tus kheej. Mus saib Shandong Baofa Cancer Research Institute yog xav paub ntxiv.

Risk Factors rau Pancreatic Cancer

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

• Kev haus luam yeeb: Ib qho tseem ceeb txaus ntshai.
• Mob ntshav qab zib: Mob ntshav qab zib ntev ntev ua rau muaj kev pheej hmoo.
• Kev rog rog: Kev rog dhau los yog rog yog txuam nrog kev pheej hmoo ntxiv.
• Tsev Neeg Keeb Kwm: Muaj tsev neeg keeb kwm ntawm mob qog noj ntshav pancreatic nce qhov kev pheej hmoo.
• Mob pancreatitis ntev: Ntev mus ntev o ntawm tus txiav.
• Hnub nyoog: Qhov kev pheej hmoo yuav nce nrog lub hnub nyoog, feem ntau kuaj pom hauv cov neeg laus.
• Qee yam kab mob caj ces: Xws li BRCA1/2 kev hloov pauv, Lynch syndrome, thiab Peutz-Jeghers syndrome.

Cov tsos mob ntawm Pancreatic Cancer

Thaum ntxov mob qog noj ntshav pancreatic feem ntau tsis muaj tsos mob. Thaum mob qog noj ntshav loj hlob tuaj, cov tsos mob yuav muaj xws li:

• Mob plab: Feem ntau ib qho mob npub nyob rau hauv lub plab sab sauv uas yuav tawg mus rau sab nraub qaum.
• Jaundice: Yellowing ntawm daim tawv nqaij thiab qhov muag, feem ntau nrog cov zis tsaus nti thiab cov quav daj.
• Poob poob: Unexplained poob phaus.
• Poob qab los noj mov: Txaus siab sai sai lossis tsis tshaib plab.
• Nausea thiab ntuav:
• Mob ntshav qab zib: Mob ntshav qab zib mellitus tshiab lossis nyuaj los tswj cov ntshav qab zib uas twb muaj lawm.
• Kev hloov hauv plab hnyuv: Nrog rau raws plab lossis cem quav.

Nws yog ib qho tseem ceeb kom sab laj nrog kws kho mob yog tias koj ntsib ib qho ntawm cov tsos mob no, tshwj xeeb tshaj yog tias koj muaj kev pheej hmoo rau mob qog noj ntshav pancreatic.

Kev kuaj mob ntawm Pancreatic Cancer

Kev kuaj mob mob qog noj ntshav pancreatic Feem ntau muaj kev sib xyaw ua ke ntawm kev kuaj duab thiab biopsies:

• Kev kuaj duab:
  • CT Scan: Muab cov duab ntxaws ntxaws ntawm cov txiav txiav thiab cov kab mob ib puag ncig.
  • MRI: Siv magnetic teb los tsim cov duab ntawm lub txiav.
  • Endoscopic Ultrasound (EUS): Siv lub endoscope nrog kev sojntsuam ultrasound kom pom qhov txiav txiav.
  • PET Scan: Nws tuaj yeem pab tshawb xyuas yog tias mob qog noj ntshav tau kis mus rau lwm qhov hauv lub cev.
• Biopsy: Ib qho piv txwv ntawm cov ntaub so ntswg yog muab los ntawm cov txiav txiav thiab tshuaj xyuas hauv lub tshuab kuaj kab mob kom paub meej tias muaj cov qog nqaij hlav cancer. Qhov no tuaj yeem ua tiav thaum lub sij hawm EUS lossis los ntawm kev siv koob txhaj tshuaj los ntawm kev kos duab.
• Ntshav kuaj: Nws tuaj yeem ntsuas qib ntawm qee cov proteins lossis cov enzymes uas tuaj yeem nce siab hauv mob qog noj ntshav pancreatic.

Staging ntawm Pancreatic Cancer

Staging pab txiav txim seb qhov twg ntawm cov qog nqaij hlav thiab coj kev txiav txim siab kho mob. Lub staging system feem ntau siv yog TNM system (Tumor, Node, Metastasis):

• T (Tumor): Piav txog qhov loj thiab qhov loj ntawm cov qog thawj zaug.
• N (Ntxiv): Qhia seb puas mob qog noj ntshav tau kis mus rau cov qog ntshav nyob ze.
• M (Metastasis): Qhia seb puas mob qog noj ntshav tau kis mus rau cov nruab nrog cev.

Kev kho mob xaiv rau Pancreatic Cancer

Kev kho mob rau mob qog noj ntshav pancreatic nyob ntawm theem ntawm tus mob qog noj ntshav, tus neeg mob txoj kev noj qab haus huv tag nrho, thiab lwm yam. Cov kev xaiv yuav suav nrog:

Kev phais

Kev phais yog qhov kev kho mob zoo tshaj plaws rau kev kho dua tshiab mob qog noj ntshav pancreatic (mob qog noj ntshav uas tuaj yeem tshem tau tag nrho). Hom kev phais muaj xws li:

• Cov txheej txheem Whipple (Pancreaticoduodenectomy): Kev tshem tawm ntawm lub taub hau ntawm lub txiav, ib feem ntawm cov hnyuv me, lub gallbladder, thiab ib feem ntawm lub plab.
• Distal Pancreatectomy: Kev tshem tawm ntawm tus Tsov tus tw ntawm tus txiav.
• Pancreatectomy tag nrho: Kev tshem tawm tag nrho cov txiav txiav (tsis tshua muaj ua).

Tshuaj kho mob

Tshuaj kho mob siv tshuaj tua kab mob qog noj ntshav. Nws tuaj yeem siv ua ntej kev phais (kev kho neoadjuvant), tom qab phais (adjuvant therapy), lossis raws li kev kho mob tseem ceeb rau qib siab. mob qog noj ntshav pancreatic. Cov tshuaj chemotherapy feem ntau muaj xws li:

• Gemcitabine
• FOLFIRINOX (kev sib xyaw ntawm folinic acid, fluorouracil, irinotecan, thiab oxaliplatin)
• Abraxane (paclitaxel albumin-bound)

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 ke nrog kev siv tshuaj khomob, tshwj xeeb tshaj yog rau hauv zos qib siab mob qog noj ntshav pancreatic uas tsis tuaj yeem phais tshem tawm.

Hom Kev Kho Mob

Targeted therapy tshuaj tsom cov molecules tshwj xeeb koom nrog hauv kev loj hlob ntawm cov qog nqaij hlav cancer thiab kev ciaj sia. Piv txwv li, olaparib yuav siv tau rau cov neeg mob uas muaj kev hloov pauv BRCA.

Immunotherapy

Immunotherapy siv lub cev lub cev tiv thaiv kab mob los tiv thaiv qog noj ntshav. Thaum tseem tsis tau dav siv rau mob qog noj ntshav pancreatic, nws tau raug tshawb xyuas hauv kev sim tshuaj.

Kev sim tshuaj

Kev sim tshuaj yog cov kev tshawb fawb tshawb fawb uas tshawb nrhiav txoj hauv kev tshiab los kho mob qog noj ntshav. Cov neeg mob nrog mob qog noj ntshav pancreatic tuaj yeem txiav txim siab koom nrog hauv kev sim tshuaj ntsuam xyuas kom nkag mus tau txais kev cog lus tshiab.

Palliative Care

Kev kho mob Palliative tsom mus rau kev txo cov tsos mob thiab txhim kho lub neej zoo rau cov neeg mob siab mob qog noj ntshav pancreatic. Nws tuaj yeem suav nrog kev tswj kev mob, kev txhawb nqa zaub mov, thiab kev txhawb siab.

Ciaj sia taus tus nqi rau Pancreatic Cancer

Cov ciaj sia taus rau mob qog noj ntshav pancreatic Nws txawv nyob ntawm theem ntawm cov qog nqaij hlav thiab lwm yam. Kev tshawb pom ntxov thiab kev kho mob tuaj yeem txhim kho cov txiaj ntsig zoo. Raws li American Cancer Society, 5-xyoo tus txheeb ze muaj sia nyob tus nqi rau txhua theem ntawm mob qog noj ntshav pancreatic yog li ntawm 12%. Txawm li cas los xij, rau kev kuaj mob qog noj ntshav nyob rau theem ntxov tshaj plaws (loj hauv zos), 5-xyoo txoj sia nyob yog li 44%. [Source: American Cancer Society]

Cov lus hauv qab no qhia txog 5-xyoo kev ciaj sia los ntawm theem:

Cov lej no yog kwv yees thiab cov txiaj ntsig ntawm tus kheej tuaj yeem sib txawv.

Nyob nrog Pancreatic Cancer

Nyob nrog mob qog noj ntshav pancreatic tuaj yeem nyuaj, ob qho tib si lub cev thiab kev xav. Txhawb pab pawg, kev sab laj, thiab lwm yam kev pabcuam tuaj yeem pab cov neeg mob thiab lawv tsev neeg tiv thaiv tus kabmob.