Beyond the tests, a symptom that should raise alarm is the appearance of an unexplainable thirst in people who do not have other disorders
In the family we recently had a case of pancreatic cancer, unfortunately already with metastatic disease. Are there no tests that allow us to arrive at an early diagnosis for this neoplasm?
He answers Stefano Cascinudirector of Cancer Center, San Raffaele Hospital, lecturer at San Raffaele University, Milan (GO TO THE FORUM)
Pancreatic cancer is a sneaky disease e only 10% of patients are eligible for surgery. When it gives symptoms it is never limited and the early diagnosis is the only way to hope for a cure. Unfortunately, we do not have screening programs for this neoplasm as in breast or colorectal cancer. Recently it has been seen as a small group of sufferers, around 7-8%, has mutations of the Brca1 and 2 genes, the same ones that determine an increased risk of carcinomas of the breast, ovary and prostate. Individuals with these alterations must be included in specific screening programs that include, in addition to the breast, ovarian and prostate study, also that of the pancreas, with sophisticated methods such as magnetic resonance. For all other patients we have no tests that can lead to an early diagnosis.
Disorders underestimated
Generally the disease is discovered after months of underestimated ailments. Research has recently been published that evaluated the presence of pre-diagnosis symptoms in pancreatic cancer patients in England. The number of patients is very high, more than 24 thousand, and the results are important. The researchers showed how at least 21 disorders are linked to the presence of pancreatic cancer and in some cases they precede the diagnosis by many months, even up to a year. The most frequent symptoms are attributable to digestive difficulties (loss of appetite, abdominal pain, greasy stools, nausea). Sometimes these symptoms are attributed to problems related to gastric disorders. For this reason a gastroscopy is suggested by the treating doctors, which obviously results negative or with trivial signs of inflammation, for which the disorders are attributed to psychological problems and therefore underestimated for other months.
An inexplicable thirst
A symptom that should raise a particular alarm the appearance of an unexplainable thirst in people who otherwise have no other ailments. Blood tests often show diabetes. The patient is treated with oral hypoglycemic agents and perhaps there is improvement of the disorders for some time. This is a situation that requires great attention. Underestimating it can really waste valuable diagnosis time. In other words, a sudden onset of diabetes and which cannot be explained by the common risk factors (obesity, familiarity) must lead to a diagnostic investigation at the level of the pancreas. In fact, it can hide the presence of an early stage pancreatic tumor. It should be emphasized that an ultrasound of the abdomen is not sufficient. The reliability of this test for diagnosing pancreatic problems is far too low. In an important clinical suspicion one must always think of investigations such as the abdomen CT scan or even the magnetic resonance.
The role of doctors
The article by the English group, coordinated by Weiqi Liao of the University of Oxford, has precisely the merit of having recalled the value of these disorders. General practitioners can play an important role in this regard. To answer the reader, we have no screening programs, but we can all work to offer patients an earlier diagnosis.
April 2, 2022 (change April 2, 2022 | 21:50)
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