2023-08-17 10:30:00
Reported by Health and Medical Network/Reporter Zheng Yifen
A 45-year-old Ms. Lin was originally diagnosed with liver metastases from breast cancer. After a liver biopsy test, she was found to be “intrahepatic cholangiocarcinoma combined with breast cancer”. The treatment is very difficult! Dr. Peng Zhengming, Director of General Surgery of Zhongshan Affiliated Medicine, explained that the treatment methods for biliary tract cancer include surgical resection, chemotherapy, and immunotherapy. Ms. Lin has undergone tumor resection and various chemotherapy, but still relapsed following 2 years, and then combined immunotherapy for biliary tract cancer. Chemotherapy reduced both the degree of lymphatic invasion and the size of the tumor, and has not been defeated by the disease so far, and is under continuous and stable follow-up.
▲Dr. Peng Zhengming explained that according to the current clinical evidence, the survival period of patients who use immune drugs combined with chemotherapy can be better than that of chemotherapy in the past. He also looks forward to obtaining health insurance benefits as soon as possible to give patients more hope.
“Hidden cancer king” three major categories of symptoms are hidden and hard to find out
There are more than 2,000 new patients with biliary tract cancer in Taiwan every year. In recent years, due to factors such as Westernized diet, population aging, and exposure to factory chemicals, the incidence rate has increased year by year. Celebrities such as veteran singer Mei Dai, Koo Qiyun, son of former SEF chairman Koo Zhenfu, and former representative to Thailand Li Yingyuan all died as a result.
There are three main types of biliary tract cancer as follows. The early symptoms are not obvious, such as indigestion, abdominal pain, loss of appetite, and weight loss, which are easily confused with gastrointestinal problems. Most patients wait until obvious symptoms such as jaundice, body itching, dark urine or white stools appear before seeking medical examination. As a result, 60-70% of patients in China are already in the third, fourth or even terminal stage when they are diagnosed.
Gallbladder cancer Extrahepatic cholangiocarcinoma Intrahepatic cholangiocarcinoma
Resectable: traditional laparoscopy and new minimally invasive surgery
Surgical resection of the lesion is the most effective eradication method for the treatment of biliary tract cancer. However, because most of the patients are diagnosed at an advanced stage and the tumor is not easy to remove, only regarding 20% of the patients are suitable for surgical treatment.
Dr. Peng Zhengming said that surgical operations include traditional laparoscopy and the new Da Vinci minimally invasive surgery. The site is divided into extrahepatic and intrahepatic. Surgery for “extrahepatic cholangiocarcinoma” is like the difficult pancreatic cancer “pancreatic head duodenum”. For “resection”, the gallbladder, bile duct and other parts must be removed and then reconstructed; for “intrahepatic cholangiocarcinoma”, part of the liver needs to be removed because the cancer cells grow in the liver. Fortunately, Taiwan’s liver surgery technology is second to none in the world, so patients do not need to worry too much.
If the patient is suitable for surgery, you can discuss with the surgeon whether there is health insurance payment, the length of hospital stay, and pay attention to complications. After surgery, you should also pay attention to bile leakage and bleeding. In addition, even if part of the liver is removed, there is still a risk of recurrence. Adjuvant therapy such as chemotherapy, immunotherapy, radiotherapy, and targeted therapy is recommended, and the combined treatment has a better effect.
Unresectable: Immunization combined with chemotherapy has a good synergistic effect
Biliary tract cancer is highly malignant, regarding 80% of which cannot be operated on according to clinical statistics, such as gallbladder cancer, intrahepatic cholangiocarcinoma with lymph node invasion to the liver or adjacent organs, ascites, or extrahepatic cholangiocarcinoma with poor tumor growth, etc. Neither are suitable for surgery.
Systemic chemotherapy is the main treatment for advanced biliary tract cancer, but the effect of chemotherapy is limited, and the survival period of patients is only regarding 10 months. Fortunately, today’s medical care is booming. According to the latest phase III large-scale multinational clinical trial, the combination of chemotherapy and immunotherapy can improve the treatment effect, and there are some new targeted drugs that can be used in advanced biliary tract cancer through genetic testing. With the dual advancement of treatment and precision medicine, the risk of death can be significantly reduced. However, immunotherapy may still cause some immune-related side effects, such as skin itching, diarrhea, abnormal thyroid function, etc. The public is also encouraged to pay attention to their own physical conditions during immunotherapy and actively discuss with medical staff , Clinicians will also regularly monitor the efficacy and side effects to ensure the safety of patients.
Dr. Peng Zhengming explained that according to the current clinical evidence, the survival period of patients who use immune drugs combined with chemotherapy can be better than that of chemotherapy in the past. He also looks forward to obtaining health insurance benefits as soon as possible to give patients more hope.
Although most patients with biliary tract cancer are not suitable for surgery, Dr. Peng Zhengming appealed that immunotherapy combined with chemotherapy can help prolong the survival period. In addition to the concerted efforts of the medical team to treat, patients are also actively tracking the return. If lymphatic invasion and tumor shrinkage, ” It is expected to move towards surgical treatment, continuous follow-up and postoperative adjuvant treatment, the goal is to say BYE BYE to biliary tract cancer.”
source: healthnews.com.tw
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