Chen Renxi, director of the Department of Hematology and Oncology at Chang Gung Memorial Hospital in Linkou, Lai Jiming, executive director of Taiwan Cancer Foundation, Mr. Liu, a patient, and Rao Kunming, deputy director of the Department of Hematology and Oncology at Yida Cancer Treatment Hospital (from left to right).

(Provided by Taiwan Cancer Foundation)

[Reporter Qiu Zhirou/Taipei Report] "Biliary tract cancer (or cholangiocarcinoma)" is relatively unfamiliar to Chinese people, because the early symptoms are not obvious, once diagnosed, most of them have entered the advanced stage, and the treatment is difficult, and the choice of drugs is also limited. The speed is as fast as the well-known cancer king "pancreatic cancer". Doctors recommend that people over the age of 40 should take regular abdominal ultrasound examinations.

Lai Jiming, executive director of the Taiwan Cancer Foundation, pointed out that biliary tract cancer usually has no signs or symptoms in the early stage, and Chinese people have limited knowledge of biliary tract cancer. Even if symptoms such as indigestion, abdominal pain, poor appetite, and weight loss appear, it is difficult to Thinking of the possibility of cancer, people often wait until obvious symptoms such as jaundice, itching, dark urine or light stools appear before seeking medical attention. Therefore, more than 60% of patients are diagnosed at an advanced stage.

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Chen Renxi, director of the Department of Hematology and Oncology at Chang Gung Memorial Hospital in Linkou, said that biliary tract cancer can be divided into four types: intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, gallbladder cancer, and ampullary carcinoma according to the location of the tumor. The rate is relatively high, followed by gallbladder cancer; surgical resection is the most effective way to treat biliary tract cancer, but less than 30% of patients can receive surgical treatment, and recurrence is easy after surgery, with an average 5-year survival rate of only 10% to 10%. 30%, for patients who cannot be operated and can only receive chemotherapy, only 20% to 30% of patients have tumor shrinkage, and the median survival period is only about 8 to 10 months. The 5-year survival rate of advanced biliary tract cancer is less than 5%.

Chen Renxi said that the cause of tumor formation is not yet clear, but currently known risk factors include diseases that cause long-term cholestasis, suffering from diseases that easily cause repeated inflammation of the biliary tract, chronic hepatitis B, C or cirrhosis, specific liver fluke infection, Frequent exposure to harmful substances such as dioxins or PCBs, benign bile duct tumors, etc. In addition, obesity, diabetes, smoking, and alcoholism are also high-risk groups. It is recommended that the public should develop the habit of regular inspections.

This year, the Ministry of Health and Welfare approved immunotherapy for the treatment of biliary tract cancer. Mr. Liu, the 57-year-old owner of a Chinese medicine shop, shared that he began to suffer from indigestion 5 years ago, and he became flatulent after eating. At first, he took Chinese medicine for treatment, and the symptoms continued from good to bad. It took half a year to see a doctor. The doctor found that his eyes were obviously yellow. Further examination confirmed that he was stage 3 intrahepatic cholangiocarcinoma. At that time, the tumor had grown to 10.5 cm. Significantly shrunk and the symptoms improved.

Rao Kunming, deputy director of the Department of Hematology and Oncology at Yida Cancer Treatment Hospital, said that the principle of immunotherapy is to destroy the mechanism by which cancer cells deceive the human immune system, so that the patient's own immune cells can re-identify and eliminate cancer cells.

According to clinical data, the use of immunotherapy combined with chemotherapy can significantly reduce the risk of death of patients. Not only did 30% of patients not only significantly shrink their tumors, but their overall survival period exceeded 1 year, and more than 25% of patients survived for more than 2 years. The dilemma of cancer treatment for more than 10 years; however, the huge economic burden brought by emerging treatments is still very heavy for patients. It is hoped that immunotherapy can be included in the national health insurance payment as soon as possible, so that patients with advanced biliary tract cancer can have one more option in treatment selection.

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keywords

  • Cholangiocarcinoma

  • indigestion

  • Immunotherapy

  • Periodic inspection

  • abdominal ultrasound

  • Biliary tract cancer

  • high risk group

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