Misconceptions and facts about pancreatic cancer

Causes of pancreatic cancer, key risk factors

This is a small organ that is located in the abdominal cavity below the liver and behind the lower half of the stomach. There are two types of cells in the gland: exocrine cells produce enzymes that help the body digest food, and endocrine cells produce hormones, including insulin, that help control blood glucose.

Tumors form when damaged or mutated cells grow uncontrollably, divide and damage gland tissue and surrounding organs. Most malignant processes develop in exocrine cells. The exact cause and mechanism of how pancreatic cancer develops is unknown, but several risk factors are associated with the disease. These include:

• long history of smoking and drinking alcoholic beverages;
• obesity, especially with a BMI exceeding 30;
• having a close relative with pancreatic problems;
• diabetes (mainly type 2Source: The relationship between diabetes mellitus and pancreatic cancer. Kashintsev A.A., Kokhanenko N.Yu. Siberian Journal of Oncology, 2013. pp. 36-39);
• chronic pancreatitis, especially in males Source: Chronic pancreatitis and pancreatic cancer. Lazebnik L.B., Vinokurova L.V., Yashina N.I., Bystrovskaya E.V., Bordin D.S., Dubtsova E.A., Orlova Yu.N. Experimental and clinical gastroenterology, 2012. p. 3-9.

The risk of developing signs of pancreatic cancer increases dramatically as you age. According to international statistics, 97.5% of all new diagnoses occur in people 45 years of age and older. Approximately 89% of all new diagnoses occur in people 55 years of age and older. 66.5% of all new cases are in people over 65 years of age.

What does the pancreas look like and what are its functions?

The pancreas is an organ that is built into the digestive chain of the human body and performs certain important functions in it. The gland has an elongated shape, consists of three parts (head, body and tail), is located behind the stomach, connected by ducts to the duodenum.

Through these ducts, pancreatic juice enters the intestine, which is necessary for the digestion of food, the breakdown of its components (proteins, fats, carbohydrates) and further absorption by the body. The pancreas is also needed for the synthesis of hormones involved in the functioning of various body systems.

Everyone has heard the medical term “insulin”, which is essential for maintaining blood sugar levels. So, the pancreas is the forge of this hormone. And not only it (glucagon, somatostatin, pancreatic polypeptide).

Disturbances in the functioning of this organ provoke such a serious disease as diabetes mellitus, and also cause people problems with digesting food. Inflammation of the pancreas leads to a number of diseases that are treated with medication, for example, pancreatitis.

Pancreatic cancer: possible symptoms and warning signs

Sometimes the first symptoms of pancreatic cancer are atypical, mild and vague, similar to many other problems. Pain (usually in the abdomen or back), weight loss, jaundice (yellowish discoloration of the skin and/or eyes) with or without itching, loss of appetite, nausea, bowel changes, pancreatitis and sudden onset diabetes are symptoms that may indicate pancreatic cancer. glands. If a patient experiences one or more of these symptoms, it is strongly recommended to immediately consult a doctor and undergo a diagnosis.

Neuroendocrine tumors are rarely diagnosed, accounting for about 7% of all organ cancers. They can cause the pancreas to overproduce hormones. High levels of these hormones in the blood lead to symptoms such as weight loss, nausea, vomiting, muscle weakness and skin rashes. The very first signs of pancreatic cancer:

Bloating (ascites) is an abnormal accumulation of fluid in the abdominal cavity. Excess fluid causes swelling and bloating.

Pain syndrome, mainly in the upper abdomen or middle back, can be caused by the pressure of the tumor on the nerves or organs near the pancreas as the tumor grows into them. Pain may also occur if a tumor blocks the digestive tract.

Poor appetite, indigestion and nausea are common symptoms of pancreatic cancer. Some or all of these symptoms may occur when the tumor presses on the stomach or the beginning of the small intestine. In this case, food may remain in the stomach and cause some digestive problems, including nausea and vomiting. Symptoms of indigestion may also occur due to a blockage of the pancreatic duct through which enzymes flow, or due to changes in the activity of the organ.

Jaundice is a yellowing of the skin and eyes caused by excess bilirubin (a component of bile) in the blood. A tumor in the head of the pancreas can cause a narrowing of the bile duct and block the flow of bile from the gallbladder into the small intestine. A blocked bile duct causes bilirubin to accumulate. People with jaundice may also experience itchy skin, abnormally dark urine, and light-colored or clay-colored stools.

One of the manifestations of pancreatic cancer is intestinal symptoms and stool changes. Many patients with pancreatic cancer experience diarrhea, constipation, or both. Diarrhea – loose, watery, greasy stool with an unpleasant odor, can be caused by insufficient pancreatic enzymes in the intestines. This leads to malabsorption as undigested food quickly passes through the digestive tract. Constipation is also a common problem, especially in patients taking painkillers. These medications slow down the passage of food through the intestines. If the digestive system works too slowly, stools may become dry, hard, and difficult.

Acute weight loss (also known as cancer cachexia) is a complex problem that affects how the body uses calories and protein. Cancer cachexia can cause the body to burn more calories than usual, break down muscle, and reduce appetite. The person may also notice a change in appetite or desire to eat certain foods.

Cancer causes changes in the blood that can increase the chance of clots (blood clots) forming. Blood clots may go undetected and cause no symptoms. However, they are often associated with swelling, pain, and tenderness in the affected area.

Symptoms of stage 4 cancer

Until the cancer has reached stage IV, a sick person may not experience any symptoms. This is one of the main reasons for late diagnosis of cancer. If a tumor is found at an early stage, it is usually by chance or through regular screening.

Symptoms of stage IV cancer depend on the type and size of the tumor, the presence of metastases, and the degree of growth of cancer cells into various tissues and organs.

Common symptoms include the following:

• increased fatigue, constant feeling of tiredness;
• decreased appetite;
• dyspnea;
• weight loss, up to exhaustion - cachexia;
• nausea and vomiting;
• jaundice.

Bone metastases lead to pain in the limbs and pathological fractures; to the brain – to headaches, dizziness, convulsions; into the lungs - shortness of breath; to the liver - to an enlarged abdomen and jaundice.

Some patients develop paraneoplastic syndrome - a reaction to the tumor and the biologically active substances it secretes. It manifests itself in various symptoms - from the skin, endocrine, nervous, cardiovascular, digestive systems, musculoskeletal system, blood.

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Types of pancreatic cancer

Experts identify several forms of pancreatic cancer. Exocrine cells, which make up the majority of pancreatic cells, are found in the glands and ducts of the organ. About 90% of all pancreatic cancers form in exocrine cells and are considered pancreatic adenocarcinomas. Adenocarcinomas are tumors that form in mucus-secreting glands.

About 5% of all pancreatic cancers form in endocrine cells and are considered neuroendocrine tumors (NETs). They are also called islet cell cancer because the endocrine cells are often found in clusters called islets.

What is stage 4 cancer?

The fourth stage of cancer is an irreversible, uncontrolled process of growth and spread of tumor cells throughout the body, during which damage to neighboring healthy organs and tissues occurs, and the formation of distant (metastatic) tumor foci in distant organs. In stage IV cancer, the primary lesion can be of any size: from 5-6 mm in the case of a neuroendocrine tumor of the gastrointestinal tract or melanoma and up to 10-30 cm in diameter in the case of Ewing's tumor.

Criteria for diagnosing stage 4 cancer include:

• advanced cancer that has spread to the bones, lungs, liver, pancreas and/or brain, or
• fast-growing cancers (fast-growing tumor), or
• any type of bone cancer, or
• extremely fatal cancers (eg lung cancer, pancreatic cancer, multiple myeloma, squamous cell carcinoma, melanoma, etc.)

Stages of pancreatic cancer

After a diagnosis of pancreatic cancer is made, doctors will try to find out the stage. It describes how serious cancer is and how best to treat it. Doctors also use cancer stage when talking about survival statistics.

The earliest stage of pancreatic cancer is stage 0 (carcinoma in situ), followed by stages I (1) to IV. Typically, the lower the number, the less the cancer has spread. A higher number, such as stage IV, means the cancer is in the most advanced stage.

The most commonly used system for pancreatic cancer is the TNM system, which is based on 3 key pieces of information:

Tumor size (T): How big the tumor is and whether it has grown outside the pancreas into nearby blood vessels.

Spread to nearby lymph nodes (N): Whether the cancer has spread to nearby lymph nodes. If yes, how many lymph nodes are affected by cancer.

Spread (metastasis) to distant sites (M): Whether the cancer has spread to distant lymph nodes or distant organs, such as the liver, peritoneum (the lining of the abdomen), lungs, or bones.

Tumor architecture describes how cancer cells look like normal tissue under a microscope.

Level 1 (G1) means the cancer is very similar to normal pancreatic tissue.

Grade 3 (G3) means the cancer appears very abnormal.

Level 2 (G2) is somewhere in the middle.

Low-grade (G1) cancers tend to grow and spread more slowly than high-grade (G3) cancers. In most cases, grade 3 pancreatic cancer has a poor prognosis compared to grade 1 or 2 pancreatic cancer.

Possibility of resection. For patients, an important factor is the size of the resection – whether the entire tumor will be removed:

R0 : The cancer is considered completely removed. (There are no visible or microscopic signs indicating that cancer remains)

R1 : All visible cancer was removed, but laboratory tests of the removed tissue indicate that some small areas of cancer likely remain.

R2 : Some visible tumors could not be removed.

Life prognosis for stage 4 cancer

A key indicator of prognosis for stage 4 cancer is five-year survival rate, the percentage of patients who are still alive 5 years after diagnosis of stage 4 cancer.

In the early stages of cancer, the five-year survival rate is highest and in some cases approaches 100%. At stage 4 it is the lowest, but this does not mean that there is no chance at all. The five-year survival rate is statistical in nature. It is calculated based on observation of a large number of patients. But every patient is unique. It is necessary to make allowances for age, concomitant diseases, and general health.

In addition, 5-year survival rates are calculated based on follow-up of patients whose cancer was diagnosed at least 5 years ago. Since then, new drugs have appeared and approaches to treatment have changed. Modern cancer patients have reason to expect slightly better prognoses.

Only your attending physician can give the most accurate prognosis for you. Even if the survival rate for this type of cancer is very low, and the prognosis is most likely unfavorable, the doctor can always prescribe supportive treatment that will help prolong life and relieve painful symptoms.

Diagnosis of pancreatic cancer

Often in the initial stages there are almost no symptoms Source: Difficulties in diagnosing pancreatic cancer. Evdokimova S.Yu. E-Scio, 2021. This may make diagnosis difficult. In addition to examination and standard tests, it is necessary:

An ultrasound scan is a painless procedure that uses high-frequency sound waves to create images of the body's organs. However, this type of scan can often miss the early stages of pancreatic cancer because the ultrasound waves do not always penetrate deep into body tissue well.

Computed tomography (CT) scans provide detailed images of internal organs using a series of X-rays. The doctor can use the results of the CT scan to check for abnormalities and estimate the size of the tumor.

Magnetic resonance imaging (MRI) also provides images of the gland, but uses strong magnetic and radio waves instead of X-rays. An MRI allows the doctor to check for signs of metastases.

A positron emission tomography (PET) scan can help show where the cancer is and whether it has spread throughout the body.

Endoscopic retrograde cholangiopancreatography is a procedure used to insert a plastic tube or stent into the bile duct for jaundice.

Laparoscopy is a surgical procedure that allows the surgeon to gain access to the inside of the abdomen and pelvis. During the procedure, a small incision is made in the abdomen and a laparoscope (a thin, flexible microscope) is inserted. This will allow the surgeon to look into the abdomen and make sure that the tumor has not spread before recommending its removal.

A biopsy involves taking a sample from a suspected tumor, which can then be tested to determine whether it is cancerous.

What can be done for stage 4 cancer?

To alleviate the general condition of the patient in the later stages of cancer, basic methods of maintaining vital functions are used, including intensified intravenous therapy, plasmapheresis, hemosorption, blood transfusion and blood components.

Infusion port systems Installation of vena cava filters Chemotherapy courses Blood transfusion Plasmapheresis Pain relief

In the Department of Interventional Oncology we perform palliative and auxiliary operations such as:

• implantation of venous and arterial infusion port systems for chemotherapy;
• application of nephrostomy for kidney damage;
• drainage and stenting of bile ducts for obstructive jaundice of tumor origin;
• installation of vena cava filters in the inferior vena cava to prevent thromboembolism;
• stenting of the superior vena cava in case of its obstruction due to tumorigenesis and a number of others.

At the fourth stage of cancer, modern pain therapy is important.

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Pancreatic cancer: treatment

The treatment regimen is drawn up taking into account the stages, size of the lesion and age, general condition and personal preferences of the patients. The first goal will be to completely remove the tumor and any other cancer cells in your body. If this is not possible, the focus will be on preventing tumor growth while improving overall health. Source: Diagnosis and Treatment of Pancreatic Cancer. Patyutko Yu. I., Sagaidak I. V. Bulletin of the Russian Cancer Research Center named after. N. N. Blokhin RAMS No. 2, 2006. p. 36-37.

There are three main methods of treatment:

• operation;
• chemotherapy;
• radiation therapy.

Some types of cancer in this location require only one form of treatment, while others may require two or a combination of all three.

Typically, surgery is the only way to completely cure pancreatic cancer. However, because the condition usually progresses by the time it is diagnosed, surgery is only suitable for about 15-20% of people.

This is not a suitable option if the tumor is localized around important blood vessels or has spread to other parts of the body.

Although surgery may not be an appropriate way to remove the tumor, doctors may suggest it to relieve symptoms. This type of surgery will not cure the cancer, but it will delay complicationsSource: Pancreatic Cancer: Indications for Surgery. Keck T. Medical Council, 2010. p. 65-68.

Chemotherapy is a type of cancer treatment that uses anti-cancer drugs that either kill cancer cells or stop them from multiplying. Chemotherapy treatment is often used along with surgery and radiation therapy to ensure that as much of the cancer as possible is treated.

Chemotherapy may be prescribed:

• before surgery - try to shrink the cancer;
• after surgery - to reduce the risk of cancer recurrence;
• when surgery is not possible, try to shrink the cancer, slow its growth and relieve symptoms.

Some chemotherapy drugs can be taken by mouth, but some must be given intravenously.

Radiation therapy is a form of cancer treatment that uses high-energy beams of radiation to shrink tumors and relieve pain.

What treatment measures are carried out at stage 4 cancer?

Treatment of the fourth stage of cancer of any location with extensive tumor damage and the presence of distant metastases is predominantly palliative and symptomatic. The main tasks of the doctor in treating such patients are as follows:

• Limiting the spread of the tumor.
• Reducing the rate of tumor growth, delaying the progression of the tumor process.
• Preservation of the functioning of organs and systems.
• Prevention of life-threatening complications - thromboembolism, strokes, heart attacks.

The main treatments for stage 4 cancer include palliative surgery, chemotherapy, radiation therapy, hormone therapy, immunotherapy and other methods used alone and in combination, depending on the type of malignant tumor.

Improvements in treatment methods for late-stage cancer have led to the introduction of procedures that can significantly improve the quality of life of patients, as well as extend life to a year or more. At the same time, some patients retain their ability to work and the ability to communicate with family and friends.

New methods of treating cancer are effective and have minimal side effects and include:

• individual antitumor vaccines,
• use of monoclonal antibodies,
• radioembolization,
• chemoembolization,
• radiofrequency ablation.

Contact your doctor

Individual antitumor vaccines are prepared in parallel with surgery, during which a large volume of the tumor is removed. A cell culture is grown from the removed tumor, and lymphatic dendritic cells are isolated from the patient’s blood leukocytes. In special laboratory conditions, immune cells are trained to respond to antigens from a removed tumor. The result is a personalized cancer vaccine that further protects the patient from recurrence and metastasis.

Monoclonal antibodies , including drugs such as imuteran, Erlotinib, prescribed for colon cancer, and SU11248, used to treat stomach cancer, selectively act on malignant cells and cause their isolated death after intravenous administration. The drugs Opdivo, Keytruda, and Tafinlar are used in the treatment of melanoma.

Radioembolization of liver metastases is performed for various oncological diseases in late stages. It includes intravascular selective catheterization of liver vessels under the control of an angiograph and the introduction of embolic particles with the radioactive isotope yttrium-90. The isotopes remain active and fight tumor cells for 64 hours.

Chemoembolization with microspheres is an endovascular operation during which microspheres with immobilized chemotherapy are injected directly into the artery feeding the metastasis. Chemoembolization is performed for inoperable neoplasms, with severe volumetric liver damage, and severe concomitant somatic diseases. The use of digital X-ray surgical devices and high-tech intravascular instruments allows this operation to be performed repeatedly without side effects or complications. The chemoembolization technique can be combined with other methods of treating tumors.

Radiofrequency RF ablation of liver tumors is performed for primary liver tumors and metastatic liver lesions up to 5 cm in diameter. It is the world standard in the complex treatment of late stages and metastases of colorectal cancer.

RFA is contraindicated when the tumor focus is located in close proximity to the portal vein, gallbladder, or large bile ducts.

• In percutaneous transhepatic radiofrequency ablation, under ultrasound guidance and general anesthesia, a hollow needle is inserted through the skin and liver parenchyma, through which a monopolar radio wave electrode is then inserted.
• The electrode locally heats up an area of ​​the liver parenchyma, causing coagulation of tumor tissue and local necrosis.
• In some cases, radiofrequency RF ablation of liver tumors is performed during laparotomy, during the elimination of intestinal obstruction with anastomosis, or when removing the tumor infiltrate.
• Performing radiofrequency RF ablation of the liver significantly expands the indications for surgical treatment of patients with multiple polysegmental liver lesions.

In general, even palliative and symptomatic treatment of stage 4 cancer of any location prolongs the patient’s life and improves its quality.

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Pancreatic cancer: prognosis for life

To develop treatment, doctors use a simpler staging system that divides cancers into groups based on whether they can be removed by surgery:

• operable cancer;
• border operability;
• inoperable (locally advanced or metastatic).

Operable cancer . When the lesion is located only in the pancreas (or has spread not far beyond), the treating surgeon considers that the entire tumor can be removed, this is called resectable. (Usually includes most TNM stage IA, IB, and IIA cancers.)

Borderline . This term is used to describe certain types of cancer that may have just reached nearby blood vessels, but which doctors believe can be completely removed by surgery.

Inoperable . These cancers cannot be completely removed by surgery. If the cancer has spread to distant organs, it is called metastatic (stage IV). These cancers cannot be completely removed. Surgery is still an option, but the goal will be to prevent or relieve symptoms rather than try to cure the cancer.

Tumor markers are substances that can sometimes be found in the blood due to cancer. CA 19-9 is a tumor marker that may be useful in therapy. Decreased CA 19-9 levels after surgery (compared to preoperative levels) and low CA 19-9 levels after pancreatic surgery often predict a better prognosis.

Survival forecast for stage 4 cancer: statistics from Russia and other countries

In Japan, the USA, Germany, Switzerland, Israel and a number of other countries, terminal stage cancer is diagnosed much less frequently than in Russia.
This is due to the peculiarities of the organization of medical care. Citizens of these countries have known since childhood about the benefits of prevention over treatment. In Russia, cancer diagnosed at stage 4 is not uncommon, and the survival rate for such a diagnosis ranges from six months to two and a half years. For comparison, in Germany and the USA the survival prognosis is at least 5 years. The statistics are the same at Euroonko; our clinics have several cases of destaging. What is the reason for this difference?

Firstly, as already noted, there are different principles for organizing medical care. Unfortunately, the Ministry of Health, until recently, did not set deadlines for the start of treatment for detected cancer. Patients could wait several months to start therapy, which, of course, has a detrimental effect on prognosis.

Secondly, medications, their price and quality. Almost all truly effective drugs are produced in Europe or the USA. Most of them are very expensive and not everyone can buy them. Analogues available in Russia, as a rule, are much inferior in quality to foreign ones.

Thirdly, treatment protocols. There are international regulations for the treatment of this or that type of tumor, which are constantly being updated and improved. However, in Russia, for the most part, they treat according to their own protocols, many of which are outdated and show much less effectiveness compared to foreign ones.

Euroonko clinics know how to help and achieve the best prognosis:

• The organization of medical care is built according to the “gold standard” of clinics in the USA and Europe.
• Foreign-made drugs that have proven their effectiveness are used. Authenticity is checked at every stage from purchase from the official representative office of the manufacturer to delivery of the drug.
• The clinic’s specialists are guided by international treatment protocols.
• We know how to treat cancer, and we do it in the same way as the best clinics in the world.

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• Stage 4 lung cancer
• Stage 4 liver cancer
• Stage 4 stomach cancer
• Stage 4 pancreatic cancer
• Stage 4 colon cancer
• Stage 4 breast cancer
• Stage 4 prostate cancer
• Stage 4 uterine cancer

Stage 4 lung cancer

For stage 4 lung cancer, the average five-year survival rate averages about 10%. For small cell lung cancer, this figure is about 1%, and for non-small cell lung cancer, survival rate is significantly higher and varies from 2 to 13%, depending on the degree of metastasis to other organs and tissues, as well as damage to the pleura and pericardium. If the patient has previously undergone radical surgery - resection of the lung or its lobe - this indicator is significantly higher.

In the fourth stage of lung cancer, radiation therapy is performed to reduce the size of the tumor and alleviate the symptoms of the disease. In some patients, radiation therapy is supplemented with a course of chemotherapy, which significantly improves the patient’s general condition. In cases of metastatic damage to the pleura and the development of pleurisy, thoracentesis is actively used to reduce the volume of fluid in the lungs.

Liver cancer stage 4

For stage 4 liver cancer, the prognosis is the least favorable - only 6% of patients will live more than 5 years. Stage 4 liver cancer is characterized by multiple tumor foci in both lobes of the liver, as well as damage to the main branches of the hepatic or portal vein. Liver cancer is a rapidly progressing disease, usually taking 3-4 months between stages 1 and 4 of liver cancer.

Unfortunately, for stage 4 liver cancer, classical chemotherapy treatment is ineffective. Currently, new medical technologies are being used - radiofrequency ablation of cancer foci in the liver and chemoembolization. Previously, predominantly analgesic treatment was carried out to eliminate pain and laparocentesis to reduce ascites and alleviate the patient's condition.

Stage 4 stomach cancer

Stage 4 gastric cancer has the highest favorable prognosis. The 5-year survival rate is about 15-20%. More favorable results were observed in patients with cancer of the cardiac part of the stomach, especially with squamous cell cancer of the stomach after radiation therapy. The diagnosis of the fourth stage of gastric cancer is established when neighboring organs and at least one regional lymph node are affected, or when the stomach and more than 15 nearby lymph nodes are affected, or when there are metastases to distant organs and tissues. Palliative chemotherapy allows achieving relatively stable stabilization of the disease in 40-45% of cases. Surgical treatment for stage 4 gastric cancer is used primarily for palliative treatment of life-threatening conditions - bleeding from the tumor and others.

In case of inoperable cancer of the proximal (cardiac) stomach with transition to the esophagus, if the passage of food is disrupted, endoscopic installation of a stent is performed in the esophagus and stomach.

Among palliative operations for stage 4 gastric cancer, 10-15% of patients undergo gastroenterostomy to restore the passage of food through the gastrointestinal tract, correct and prevent water and electrolyte disturbances. This operation is indicated for inoperable gastric cancer with stenosis of the outlet (pyloric) stomach. In some cases, gastrostomy is performed for subsequent enteral nutrition of the patient through a tube.

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Stage 4 pancreatic cancer

With stage 4 pancreatic cancer, the five-year survival rate of patients is less than 2% in the absence of treatment and up to 10% with active treatment measures. To alleviate the patient's condition, a combination of surgery and chemotherapy is used.

The most common method of surgical treatment for pancreatic cancer is the Whipple procedure - pancreaticoduodenectomy. The operation includes removal of the head of the pancreas with the tumor, part of the duodenum, part of the stomach, gall bladder, and nearby lymph nodes. Surgical treatment of cancer is not indicated if pancreatic cancer has spread to large adjacent vessels or there are distant metastases.

When a massive cancerous tumor compresses the bile ducts in the area of ​​the porta hepatis and it is impossible to perform pancreaticoduodenal resection, percutaneous transhepatic drainage and stenting of the bile duct is performed in order to normalize the outflow of bile.

Chemotherapy treatment for advanced stages of cancer includes the use of such modern drugs as gemcitabine (Gemzar), irinotecan (Campto), as well as carboplatin, 5-fluorouracil, etc.

Stage 4 colon cancer

For stage 4 colon cancer, the five-year survival rate is less than 5%. Palliative surgical treatment of cancer includes restoration of intestinal patency in stenoses. Our clinic performs both colostomy operations and intestinal stenting during colonoscopy.

Stage 4 breast cancer

For stage IV breast cancer, the five-year survival rate is about 10-15%. Active therapy for breast cancer includes surgical sanitation of the cancer (radical mastectomy), which avoids massive intoxication of the body and bleeding from a disintegrating tumor. In the absence of significant disorders of the blood coagulation system and decompensation of liver and kidney function, chemotherapy for breast cancer can significantly improve the quality of life.

See more about treatment for stage 4 breast cancer.

Stage 4 prostate cancer

The five-year survival rate for stage 4 prostate cancer is about 30%. The main cause of death in prostate cancer is concomitant dysfunction of the liver, lungs, and kidneys. The main treatment options for stage 4 prostate cancer are:

• hormone therapy;
• external beam radiation therapy in combination with hormonal therapy;
• surgery: transurethral resection of the prostate gland to relieve the symptoms of cancer and prevent bleeding from the affected bladder or urinary tract obstruction, and, consequently, the development of acute renal failure.

Stage 4 uterine cancer

With stage 4 uterine cancer, the tumor process spreads beyond the pelvis, involving the bladder and rectum. The 5-year survival rate for stage IV uterine cancer does not exceed 3-9%. Treatment for such patients is prescribed individually; it is mainly complex, including chemotherapy, hormone therapy, and palliative surgical treatment.

For stage 4 cervical cancer, the five-year survival prognosis does not exceed 8-9%. The transition from pre-invasive cervical cancer to microinvasive, followed by rapid tumor growth and transition to stage 4, can be observed within 1-2 years. Cervical cancer is currently one of the fastest growing cancers. All pelvic organs are involved in the tumor process, including the vagina, bladder, and rectum.

Could the doctors have made a mistake in diagnosing cancer at stage 4, if the patient had not been ill with anything 2-3 months before?

We have observed a steady trend over the past ten years towards an increase in the late presentation of patients with cancer. The loss of a regular medical examination system and the inattention of patients towards their own health, ignoring the initial symptoms of vital organs (heart, liver, lungs), lead to the fact that during the initial extended diagnostic examination for any ailment, a diagnosis of the fourth stage of cancer is established .

We encounter cervical cancer that developed during pregnancy in 10-12 months from precancerous changes in the cervix immediately into the 4th stage of cancer. In our practice, there are many cases of intestinal cancer in men and women aged 30-40 years who have not previously seen a doctor. During a diagnostic colonoscopy for unclear intestinal disorders, they are diagnosed with cancer (sigmoid colon cancer, rectal cancer) at a late stage.

Can stage 4 cancer be cured?

There is a widespread myth that a person with terminal cancer dies very quickly. However, a correctly selected treatment regimen will prolong life and significantly improve its quality for up to 5 years, depending on the type of tumor and the degree of damage to vital organs, as well as the presence of concomitant diseases.

What worsens the quality of life in stage 4 cancer?

The most common conditions that significantly worsen the quality of life in stage 4 cancer are:

• impaired liver function as a result of blockage of the biliary tract and the development of obstructive jaundice;
• blood clotting disorders and the development of pulmonary embolism, pneumonia or stroke;
• inhibition of the hematopoietic function of the bone marrow and the development of anemia, thrombocytopenia and leukopenia;
• pathological vertebral fractures causing paralysis of the lower limbs;
• severe pain, especially severe with bone metastasis;
• arterial thrombosis with the development of acute ischemia and gangrene of the lower limb and a number of other diseases.

Prevention

The basis of prevention is maintaining a healthy lifestyle and eliminating all possible risk factors.

Article sources:

1. Pancreas cancer. Foltz E.E. Bulletin of medical Internet conferences No. 3, 2021. p. 146-151
2. Diagnosis and treatment of pancreatic cancer. Patyutko Yu. I., Sagaidak I. V. Bulletin of the Russian Cancer Research Center named after. N. N. Blokhin RAMS No. 2, 2006. p. 36-37
3. Difficulties in diagnosing pancreatic cancer. Evdokimova S.Yu. E-Scio, 2019
4. Pancreatic cancer: indications for surgery. Keck T. Medical Council, 2010. p. 65-68
5. Chronic pancreatitis and pancreatic cancer. Lazebnik L.B., Vinokurova L.V., Yashina N.I., Bystrovskaya E.V., Bordin D.S., Dubtsova E.A., Orlova Yu.N. Experimental and clinical gastroenterology, 2012. p. 3-9
6. Genetic aspects of pancreatic cancer. Grigorieva I.N., Efimova O.V., Suvorova T.S., Tov N.L. Experimental and clinical gastroenterology, 2014. p. 70-76
7. Diagnosis and surgical treatment of pancreatic cancer. Norbert Hüser, Volker Assfalg, Daniel Hartmann, Daniel Reim, Alexander Novotny, Edouard Matevossian, Helmut Friess. Experimental and clinical gastroenterology, 2011. p. 102-111
8. Results of surgical treatment of pancreatic cancer. Mikhailov I.V., Bondarenko V.M., Kudryashov V.A., Prigozhaya T.I., Podgorny N.N., Shimanovsky G.M., Starinchik V.I., Novak S.V., Atamanenko A. .V., Dovidovich S.V., Kravchenko O.V., Nesterovich T.N., Achinovich S.L. Problems of health and ecology, 2014. p. 46-51
9. The relationship between diabetes mellitus and pancreatic cancer. Kashintsev A.A., Kokhanenko N.Yu. Siberian Journal of Oncology, 2013. p. 36-39

The information in this article is provided for reference purposes and does not replace advice from a qualified professional. Don't self-medicate! At the first signs of illness, you should consult a doctor.