Retired teacher Mr. Chen has always been in good health, but a physical examination six months ago found that his blood sugar was high. The doctor advised him to take some hypoglycemic drugs to control his blood sugar.
After taking the medicine for a period of time, Mr. Chen’s blood sugar is still not well controlled. Fasting blood sugar is often above 10 mol/L, and sometimes it can reach 16 or 17 mmol/L after meals. He does not pay too much attention.
Knowing that in the last half month, Mr. Chen felt that his upper abdomen often felt a little distended and painful, his back also felt uncomfortable, and his appetite was not as good as before, so he remembered to go to the hospital again.
The doctor took a CT scan of his abdomen and found that there was a tumor on the pancreas. Further examination suggested that it might be pancreatic cancer and he was referred to surgery. After the operation, not only the pancreatic cancer was cured, but also Teacher Chen’s blood sugar stabilized.
Is there a what relationship between diabetes and pancreatic cancer?
Clinically, about 40% of pancreatic cancer patients will have diabetes or hyperglycemia. Some studies also suggest that the risk of pancreatic cancer in diabetic patients is higher than that in people with normal blood sugar.
The relationship between the two is more complicated. On the one hand, too high blood sugar may stimulate the pancreas, resulting in canceration of pancreatic cells; On the other hand, pancreatic cancer will damage the function of pancreas in regulating blood sugar, and pancreatic cancer cells may also cause insulin resistance in the body, causing patients to show manifestations similar to type 2 diabetes.
This is also the aforementioned Teacher Chen. Before the discovery of pancreatic cancer, the blood sugar control was not ideal. On the contrary, after the pancreatic cancer surgery, the blood sugar was normal even though half of the pancreas was removed.
What kind of diabetic patients should suspect pancreatic cancer?
It is not to say that pancreatic cancer will occur if you have diabetes, but if you have diabetes under the following conditions, you should be on guard against the possibility of pancreatic cancer.
1. New diabetes discovered only in the last year;
2. Blood sugar suddenly rises to a very high level, and it is difficult to control with drugs at the same time, which soon forms insulin resistance;
3. The symptoms are atypical, lacking more than three typical manifestations of [drinking more, urinating more and eating more], but [weight loss] emaciation is obvious;
4. Older, generally over 55 years old;
5. There is no what in the family. Other people have diabetes.
6. Generally, they are not particularly fat and have no problems such as hyperlipidemia.
Suspected pancreatic cancer requires what examination?
If the doctor suspects that it is not simple diabetes but may be tumor, he needs to do some examination for the patient.
1. Enhanced CT
Also called enhanced CT, this is the first examination that doctors will choose if they suspect that a patient has pancreatic tumor.
To do this CT, you need to give the patient a shot of contrast agent first, which can make the pancreas and other organs in the stomach see clearly. If it is really a tumor, in general, the size, location and metastasis of the tumor can also be seen on CT, and doctors can make the operation plan according to this.
2. Blood test for tumor markers
Tumor markers are a large category of blood tests, which may indicate the disease condition of tumors.
The most commonly used pancreatic tumor is a marker called sugar chain antigen 19-9 (CA19-9), but most of the time it is not pancreatic cancer that some problems will also make this value rise, so it cannot be said that blood tests found that this value is high, it must be cancer. It must also be combined with other tumor marker detection, as well as CT examination results, comprehensive evaluation.
3. Endoscopic ultrasound (EUS)
If the doctor suspects that the patient has a tumor but cannot find it on CT, he may also do this gastroscopy-like examination.
Under endoscopic ultrasound, doctors may find very small tumors and puncture pathology.
Then why didn’t you do such a good examination at the beginning? Because gastroscopy is more painful than CT for patients, and it is a traumatic examination, CT is recommended first.
4. Endoscopic retrograde cholangiopancreatography (ERCP)
This examination is similar to gastroscopy, but it is more difficult and takes slightly longer. Doctors can find possible problems at an early stage through this examination.
5. Other
There are also some other examinations, such as pancreatoscopy, intrapancreaticobiliary ultrasound, gene detection, etc., which can help doctors diagnose pancreatic cancer at an early stage, but they are not applied much in practice due to less clinical practice.
Why do doctors repeatedly stress the need for early diagnosis of pancreatic cancer?
Pancreatic cancer is not the most common tumor, ranking 9th in the incidence rate of male tumors in China. However, the death rate of pancreatic cancer is very high, ranking 7th in China according to the death rate, while western countries rank 4th.
About three quarters of pancreatic cancer patients die one year after diagnosis, and the survival rate after five years is less than 5%, which is truly the “king of cancer”. On average, only one in five patients can be cured by surgery, while most patients are already in the middle or advanced stage of cancer at the time of diagnosis.
Pancreatic cancer can become the [king of cancer], on the one hand, due to the high degree of malignancy of the tumor itself, it is easy to metastasize; On the other hand, it is also because pancreatic cancer does not have typical clinical symptoms of what in the early stage, is good at [disguise], and is not easy to detect.
However, if early detection and surgical treatment can be carried out, it can not only improve the surgical resection rate, but also significantly improve the 5-year survival rate and the quality of life of pancreatic cancer patients.
Therefore, if there is a risk [signal] of pancreatic cancer, such as newly discovered but poorly controlled diabetes, screening must be carried out in time, and surgery must be carried out as soon as possible after diagnosis, so as to strangle the devil in its infancy.