The Importance of Early Detection of Pancreatic Cancer in Indonesia

The Importance of Early Detection of Pancreatic Cancer in Indonesia — The Importance of Early Detection of Pancreatic Cancer in Indonesia. According to data from Globocan in 2020, pancreatic cancer cases rank 16th most of all types of cancer in Indonesia.

Meanwhile, the number of deaths from pancreatic cancer is at number 11th. Although the death rate is quite high, there are still many people in Indonesia who are not aware and aware of this disease.

The dangers of pancreatic cancer

The pancreas has a very important role in the digestive system. Every day, this organ located at the back of the stomach produces digestive enzymes such as amylase and lipase which function to break down sugar, fat, and starch.

In addition, the pancreas also produces hormones that can help control blood sugar levels and appetite.

Pancreatic cancer can occur when cells in the pancreas undergo mutations in their DNA. These mutations make cells grow uncontrollably and continue to live even though they should have died.

The accumulation of cells will form a tumor. If left untreated, the enlarged tumor can interfere with the function of the pancreas in digesting food.

At the beginning of the disease, pancreatic cancer will not cause symptoms. New symptoms will be felt when the disease has entered an advanced stage.

Patients who come to RSK Dharmais are mostly late, when the disease is already at stage 3 or stage 4. At that stage the cancer is usually unresectable, which means the cancer or tumor cannot be completely removed through surgery.

If so, then the treatment that will be given is no longer aimed at curing, but rather to maintain the patient’s quality of life, increase life expectancy, and prevent further spread of cancer.

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Factors delaying the treatment of pancreatic cancer

Based on my experience, there are several factors that can make pancreatic cancer treatment late. These factors can be seen in terms of patients, doctors, and hospitals that treat them.

Indeed, the appearance of early symptoms of pancreatic cancer similar to other diseases makes the patient unaware of the possibility of cancer developing in the body.

Many patients complain of ulcer-like symptoms, such as pain or discomfort in the pit of the stomach. Because of this, patients often ignore it and consider it a normal symptom.

In fact, it is at this time that the patient must start to be vigilant, especially if the symptoms continue to appear repeatedly and do not subside even though they have been given medication.

Doctors at the first health facility should also be more aware of the possibility of cancer. Because sometimes doctors feel that it is enough just to do a physical examination so that the disease sometimes escapes detection.

Further factors such as a poor referral system, limited facilities, and the unpreparedness of the hospital in the management of the disease can also be a factor in delaying the treatment of pancreatic cancer.

When to do early detection?

Patients are advised to start early detection at the age of 40 years. Detection can be done when the patient undergoes a medical check-up.

Unfortunately, medical check-ups generally do not involve an examination of the abdomen or abdominal organs such as ultrasound. In fact, ultrasound is more often an optional examination.

Therefore, in my opinion physical examination alone cannot detect cancer. Unlike thyroid cancer or breast cancer, which can detect a lump, signs of pancreatic cancer cannot be seen from the surface.

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Therefore, imaging examinations such as ultrasound or CT scan are needed so that doctors can see a clear picture of the conditions inside the pancreas.

Patients also need to be more aware of their body condition. As a first step, it’s a good idea for patients to get checked out immediately if they start to feel pain or other unusual symptoms. If after being given medication his condition does not improve, visit the doctor again and do a follow-up examination.

The patient must have the initiative to ask for a referral if he feels his condition is not improving so that a follow-up examination can be carried out.

The sooner cancer is detected, the easier it will be to treat it and the higher the chance of recovery.

Pancreatic cancer treatment in Indonesia

If the cancer is still at an early stage, surgical removal of the cancer can still be done. At this stage, the patient has the possibility to recover.

Usually, curative surgery is performed to treat cancer in the head of the pancreas. Because the cancer is located near the bile ducts, patients often experience jaundice-like symptoms which sometimes allow the cancer to be found early.

There are several types of surgical removal of pancreatic cancer, namely the whipple procedure (pancreaticoduodenectomy), distal pancreatectomy, and total pancreatectomy.

The Whipple procedure involves removing the head of the pancreas and sometimes the body of the pancreas. Next, nearby organs such as small portions of the small intestine, bile duct, gallbladder, lymph nodes near the pancreas, and part of the stomach are also removed.

While distal pancreatectomy and total pancreatectomy are usually performed for pancreatic cancer that is in the tail or body of the pancreas. The difference is, a distal pancreatectomy only removes the tail of the pancreas or the tail and part of the body of the pancreas. Total pancreatectomy involves removing the entire pancreas and a small portion of the abdominal organs.

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However, if the stage increases to 3 to 4, the doctor will provide palliative surgery in the form of bypass. This operation aims to open the digestive tract that is blocked due to a tumor in the pancreas.

Furthermore, the patient still has to undergo chemotherapy. Sometimes after a few rounds of chemotherapy, doctors do a re-examination to see if the cancer is shrinking.

If the result is that the tumor remains unresectable, the patient must undergo chemotherapy on a regular basis in order to maintain quality of life and increase life expectancy.

The importance of increasing public awareness in Indonesia against pancreatic cancer

Medical technology and doctors in Indonesia are very qualified to treat pancreatic cancer. However, public knowledge is also needed to facilitate the course of treatment.

I really hope that the community can actively contribute to preventing pancreatic cancer. One way is through improvements in diet by reducing the consumption of foods that contain carcinogens such as foods with preservatives or baked foods.

The health facility providers themselves must also intensify education about pancreatic disease and its malignancy. The more information provided, the higher public awareness of this condition will be.

In addition, regular medical check-ups are important to detect early conditions in the body. So, if later found abnormalities in the abdominal organs, then the treatment can be done as soon as possible.

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