like , though some cases are extremely ill . I think doctors should listen to patients who decide they are done fighting , but they should not determine that for themselves , � she said .
Diagnostic hurdles The pancreas is located behind the stomach , in a position where cancers have space to grow to a large size before signs and symptoms become noticeable . Combined with the lack of widespread screening for pancreatic cancer , this results in most patients being diagnosed at a late stage when a cure is not an option .
“ We have screening programmes for breast and colon cancers , but there isn ’ t any proven screening programme to detect pancreatic cancer early ,” Dr Zee Ying Kiat , a medical oncologist and pancreatic cancer specialist at Parkway Cancer Centre in Singapore , told Global Health Asia-Pacific�
Endoscopic ultrasound ( EUS ) is one approach that plays a pivotal role in the diagnosis and treatment of pancreatic cancer because it offers a complete visualisation of the pancreas . Indeed , EUS-guided biopsies can help doctors determine the tumour stage and type .
Another common diagnostic tool for pancreas cancer is computed tomography ( CT ), which uses X-rays and computer processing to provide images of internal tissues . �ut doctors have a hard time interpreting them as some pictures can be unclear and mistaken for cancer , leading to false positive results , said Dr Gulam Manji , Assistant Professor of Medicine at Columbia University Medical Center and a pancreatic cancer specialist . To make a definitive diagnosis , a sample of pancreas cells has to be removed with a small tube inserted through the mouth and analysed in the lab , an invasive procedure called biopsy that can also inflame the pancreas .
Though biopsies are easily obtained under direct vision and can be carried out as daycare procedure , one challenge is that pancreas cancers may be surrounded by lots of desmoplastic ( non-cancerous inflammatory and fibrous ) tissue that makes it tough for doctors to harvest the right cells to test , meaning that even biopsies could turn out false negative results , explained Dr Sharmila .
And with pancreatic cancer being a relatively rare malignancy , it wouldn ’ t be feasible to start a routine screening programme for the entire population above a certain age , like we do for breast and colon cancers . Dr Manji explains that this is because , in a
GlobalHealthAsiaPacific . com AUGUST 2021
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