Therapy pancreatic cancer

Synonyms

Pancreatic carcinoma (or more precise term in the narrower sense: ductal adenocarcinoma of the pancreas), pancreatic carcinoma, pancreatic cancer, pancreatic tumor

Operation

Surgery should always be the treatment of first choice. The prerequisite is that the tumor is still operable, i.e. that it is limited to the pancreas and does not grow (infiltrate) into any other adjacent organs and that the patient is in good general condition. The aim of the operation is to remove the tumor as completely as possible with sufficient safety distance and together with the lymph nodes located nearby.

In the case of a pancreatic head tumor, patients often undergo a Whippl ́sche surgery in which the bile duct, gall bladder, duodenum and parts of the stomach are removed. If possible, one should try to preserve a part of the pancreas, because if the whole gland is lost, there is a lack of the digestive proteins (enzymes) produced by the pancreas (pancreas). In this situation, the enzymes must be supplied in the form of a capsule (orally).

Even more important, however, is the resulting absolute lack of insulin (diabetes mellitus), which is produced by the β cells of the islet organ (islets of Langerhans) in the pancreas. From then on, patients have to administer the insulin to themselves from the outside. For this purpose, the insulin is injected under the skin at regular intervals.

Pathological diagnostics

The removed pancreatic carcinoma is evaluated microscopically (histologically) after removal. For this purpose, the tumor preparation is incised at specific sites and at the edges of the resection. Wafer-thin incisions are made from these samples, stained and evaluated under the microscope. The type of tumor is determined, its spread in the organ is assessed, and those with removed lymph nodes are examined for tumor infestation. Only after the pathological findings have been made can the tumor be clearly classified according to the TNM classification, which describes the primary tumor (T), lymph nodes (N) and distant metastases (M).