How long can patients with advanced pancreatic cancer live? Rarely more than 12 months

Pancreatic cancer is usually diagnosed at an advanced stage, and few patients survive more than 12 months.

Pancreatic cancer is a malignant tumor with a relatively high degree of malignancy. Once pancreatic cancer is diagnosed, the general survival period is very, very short, and few patients can survive for more than 12 months. The treatment of pancreatic cancer is also divided into surgery, radiotherapy and chemotherapy. However, the general condition of the patient must be comprehensively evaluated. Blind, high-intensity treatment is not recommended, which may not bring the desired results and may accelerate the progression of the disease. At the same time, it is recommended to actively carry out supportive treatment, on the one hand to control pain, and at the same time to improve cachexia. Medroxyprogesterone or medroxyprogesterone acetate can be used to improve appetite, pay attention to nutritional support, and promptly detect and correct liver and kidney dysfunction and water and electrolyte disorders. For patients with nutrient absorption disorders, an elemental diet is given, and for patients who cannot eat, parenteral nutritional support therapy can be given.

Regarding specific treatments:

(1) Avoid or avoid drugs that can promote the release of 5-HT, such as morphine, halothane, dextran, polymyxin, etc. At the same time, factors that easily induce carcinoid syndrome, such as drinking, mood swings and strenuous exercise, should also be avoided or reduced. (2) Use histamine 1 and histamine 2 antagonists to inhibit the secretion of histamine and peptide hormones by carcinoids. ① Methyllysergic acid butanolamide (methysergide): used for the treatment of carcinoid syndrome, 1-4 mg once intravenously; or 10-20 mg added to 100-200 ml of normal saline, intravenous drip within 1-2 hours, can control symptoms such as skin flushing, asthma and diarrhea. ② Cyproheptadine: 4-8 mg orally each time, 3-4 times a day, can relieve symptoms and achieve the purpose of palliative treatment. (3) Tryptophan hydroxylase inhibitors: This type of drug can inhibit the activity of tryptophan hydroxylase, thereby reducing the synthesis of 5-HT and relieving the symptoms of this disease. ① Parachlophenylalanine, 1 g each time, 3 to 4 times a day, orally. It can relieve or reduce the severity of nausea, vomiting, diarrhea and skin flushing. Its side effects can lead to central nervous system dysfunction or hypothermia. ② Methyldopa: This drug can be used to treat pancreatic carcinoid that secretes 5-hydroxytryptophan, 0.25 to 0.5 g each time, orally, 4 times a day. (4) Somatostatin can widely inhibit the release of endocrine hormones. It is used in patients with pancreatic islet cell carcinoid to inhibit facial flushing caused by pentagastrin stimulation. (5) Chemotherapy: The use of chemotherapy drugs such as 5-Fu, cyclophosphamide, etc. can relieve the symptoms of this disease, but the efficacy is poor. Pathological changes

EC cells have the characteristics of APUD cells and are widely distributed in the gastrointestinal tract, pancreas and lungs. When the carcinoid is small in size and does not exceed 3.5 cm in diameter, it generally does not cause symptoms and signs; when the carcinoid is large in size, due to the production of a large amount of amine and polypeptide hormones such as 5-HT, the liver cannot effectively metabolize and inactivate the secretory products of these carcinoids, so 5-HT, 5-HTP, bradykinin, pancreatic polypeptide, etc. enter the systemic circulation; in addition, when the carcinoid metastasizes to the liver, the hormones secreted by the metastatic cancer in the liver can directly enter the systemic circulation without being metabolized by liver cells and act on target cells, resulting in carcinoid syndrome.