"I am very glad I can find such a good team of experts! I thought that with locally advanced pancreatic cancer, there is no hope. Now after treatment, I can be discharged from the hospital and live a normal life after the operation. Thank you very much!" Recently, Jiangsu Provincial People's Hospital (The First Affiliated Hospital of Nanjing Medical University) Pancreatic Disease Clinic welcomes a follow-up patient, Ms. Chen, who has recovered well after the operation. She has repeatedly expressed her gratitude for the careful treatment given to her by the Pancreatic Center over the past year. More than a year ago, it was the pancreatic center of the hospital that successfully applied the "translational therapy" strategy for it that enabled Ms. Chen, who was suffering from pancreatic cancer, the "king of cancer", to gain first-line life.

Despair: unfortunately suffering from the late "cancer king"
As we all know, pancreatic cancer is called the "king of cancer" because of its special location, difficult operation, high degree of malignancy, easy recurrence, and poor treatment effect. The 5-year survival rate is only 8% in developed countries in Europe and America. Resection is the only possible cure for pancreatic cancer. Ms. Chen recalled that on August 24, 2020, the 67-year-old was diagnosed with pancreatic cancer by the local hospital. What makes it more difficult for their family to accept is that the enhanced CT scan of the abdomen assessed that the tumor has completely surrounded and invaded the most important artery in the abdominal cavity-the superior mesenteric artery and its distal branches. "It shows that my tumor is locally advanced. Said that I had no chance of surgical resection. Later I heard that the Pancreas Center of Jiangsu Provincial People's Hospital was good, so I decided to show them, otherwise I would not give up." Ms. Chen said.

Hope: Multidisciplinary "relay" and "transformation therapy" open the window of life
It is understood that the multidisciplinary team led by Professor Miao Yi and Professor Jiang Kuirong from the Pancreatic Center after the hospital made a detailed evaluation for Ms. Chen. "Different from the traditional multidisciplinary model, our pancreatic center department includes surgery, digestive endoscopy, internal oncology, ICU and other disciplines. Experts cooperate 24/7 in real time, and treatment plans are seamlessly connected. After discussion, we decided Adopting'conversional therapy' methods, through comprehensive treatment methods such as chemotherapy, radiotherapy, and targeted therapy, to reduce tumor volume and reduce tumor staging, so that patients can regain the opportunity of surgical resection, and then strive for long-term survival." Professor Jiang Kuirong said.
Director Jiang introduced that on September 1, 2020, Deputy Chief Physician Xiao Bin, an endoscopy expert at the Pancreas Center, performed an endoscopic ultrasonographic biopsy for Ms. Chen. The pathology was successfully obtained once. After the pathological diagnosis, the deputy chief physician Tu Min led the The chemotherapy team of the Pancreas Center "relays" to formulate chemotherapy plans for patients.
Director Tu’s team formulated individualized chemotherapy regimens for patients based on the pathological type and the malnutrition of Ms. Chen. Thanks to the 24-hour multidisciplinary integrated MDT team at the Pancreas Center, Ms. Chen started chemotherapy on September 6, which was less than a week after she was admitted to the hospital. "According to the traditional diagnosis and treatment process, I originally had to move to at least 3 departments. I didn't delay my time here. As soon as the chemotherapy drugs were applied, my heart was half set." Ms. Chen said.
After seven cycles of conversion chemotherapy, good news came on April 22 this year: Ms. Chen's pancreatic head tumor has shrunk from the original 3.90*2.90cm to 2.27*2.33cm, and related tumor indicators have also dropped to the normal range! The result of further imaging evaluation is: Ms. Chen may still have the opportunity of surgical resection! On May 7, Professor Jiang Kuirong from the Pancreatic Center performed pancreaticoduodenectomy + removal of the superior mesenteric artery sheath for the patient. The operation was very smooth, with only 150ml of intraoperative blood loss. "The superior mesenteric artery, which was completely surrounded by the tumor during the operation, was successfully dissected, and there were no tumor cells in the rapid pathology of multiple tissues around the blood vessel," said Director Jiang. The postoperative pathology showed that all margins of the pancreas were negative. Ms. Chen's tumor was completely removed. "After the operation, our chemotherapy team continued to consolidate chemotherapy for the patients. At present, the patients are generally in good condition, and the tumor has not recurred or metastasized. It can be said that they have returned to normal life." Director Jiang said.

No longer helpless: patients with locally advanced pancreatic cancer usher in "life"
It is understood that surgical resection is the only possible cure for pancreatic cancer, and the early symptoms of pancreatic cancer are hidden. A large number of patients are already locally advanced when they first see a doctor. There is no opportunity for surgery. "Nowadays, not all patients with locally advanced pancreatic cancer are incurable. In the case of locally advanced arteries and veins that cannot be operated on, there are still opportunities for surgery after "conversion therapy"." Director Jiang Kuirong said that the key to "conversion therapy" lies in two points. One is a multidisciplinary team that requires close cooperation. The second is to have superb surgical techniques, "the two complement each other and are indispensable."
Professor Miao Yi from the Pancreas Center of Jiangsu Provincial People's Hospital told reporters that the Pancreas Center has accumulated rich experience in the field of pancreatic cancer transformation therapy, and accumulated dozens of cases of radical pancreatic cancer surgery after successful implementation of transformation therapy. "We have developed a team that is good at'tackling difficulties', and we carry out more than 1,000 pancreatic surgery operations every year. We have also innovatively pioneered arterial sheath stripping technology. We are the first to introduce Heidelberg triangle sweep technology in China, which is radically anterograde. Modular pancreatic splenectomy has cleared the technical barriers for radical resection of locally advanced pancreatic cancer after translational therapy." Professor Miao Yi said.