Pancreatic tumors double after 3 months without treatment, the surgery is more complicated

Ms. Nga, 43 years old, discovered a pancreatic tumor three months ago but did not have surgery. Now the cancer has increased from 6 cm to 12 cm, making the surgery more complicated.

Ms. Nga came to Tam Anh General Hospital in Ho Chi Minh City for examination three months ago because of epigastric pain, poor appetite, bloating, indigestion, and rapid weight loss. CT scan results showed a mass lesion in the body and tail of the pancreas, larger than 6 cm in size, cystic structure, compressing the stomach and splenic vein.

Dr. Pham Cong Khanh, Head of the Department of Hepatology - Biliary - Pancreas, Center for Endoscopy and Gastrointestinal Surgery, said that the tumor in this location is close to many important blood vessels and organs, so early surgery is needed to avoid repeated invasions. However, Ms. Nga did not have surgery but stayed home and took herbal medicine.

Recently, her stomach pain got worse and she ate poorly, so she went to the hospital. The results of this CT scan showed that the tumor increased in size to 12 cm, had a heterogeneous structure, and increased blood vessels inside. The tumor compressed the splenic hilum, left renal vein, left adrenal gland, transverse colon, loops of small intestine and lower border of the stomach.

The endoscopic surgeon noted a large tumor in the body and tail of the pancreas, pushing the stomach up and the transverse colon down, with no metastases detected. However, the tumor was tightly attached to the mesentery of the transverse colon and had poor mobility, so the team had to switch to open surgery.

The tumor had spread to the neck of the pancreas and was attached to nearby organs that could not be removed safely and thoroughly. The team cut the body and tail of the pancreas along with the spleen to remove the entire lesion and cut part of the blood vessels.

Postoperatively, the patient recovered well, no complications were noted, and was discharged after a week.

The pathology result was grade two pancreatic ductal adenocarcinoma. All resections were negative, no cancer cells had infiltrated the blood vessels or around the nerves, and 7 lymph nodes were removed with no signs of metastasis. Ms. Nga continues to receive monitoring and adjuvant treatment at the oncology department to reduce the risk of recurrence.

Pancreatic cancer is dangerous because it progresses silently, has few symptoms and progresses quickly. Initial symptoms such as dull pain in the epigastric area, loss of appetite, bloating, indigestion, weight loss, and fatigue are often easily mistaken for stomach diseases or common digestive disorders.

Dr. Khanh recommends that when a pancreatic tumor is detected and surgery is indicated, patients need to follow the treatment regimen. Delaying or arbitrarily using unproven methods such as traditional medicine or oral medicine can cause the tumor to grow, invade blood vessels and nearby organs, losing the opportunity for radical surgery.

Quyen Phan

*Patient's name has been changed