Dr. Roach: I understand that there is no early screening for pancreatic cancer, and the diagnosis is not diagnosed until it is very advanced, so it has a high mortality rate. My recent loved ones were confirmed only after receiving a CT scan. Even MRI did not reveal the tumor. A prominent person was found early enough to be successfully treated because it was a survivor of colorectal cancer. A routine CT scan performed as part of follow-up revealed an early treatable tumor in the pancreas. Why can not I have regular CT scans for pancreatic tumor screening? – S.C.
Dear S.C .: Very good question. I often ask a lot about ovarian cancer as well as pancreatic cancer. The answer is rare because of pancreatic cancer (1-2 per 10,000 people per year), so you rarely have cancer early. So far, all studies of pancreatic cancer screening have not shown a decline in mortality from pancreatic cancer. The majority of patients are already too late, even if they are detected early on CT, ultrasound or blood tests. While I was pleased with Judge Ruth Bader Ginsburg, for someone who you think you mentioned, she was a lucky few.
There may be reasonable follow-up: although screening is only for a few people, is not it worth it? Unfortunately, there are disadvantages to the examination. Testing costs are in dollars. In particular, CT scans can use repeated radiation to increase the risk of developing different types of cancer over time. More importantly, the test can show results that look like cancer or other abnormalities, but none of the surgical biopsy turns out to be important. This causes people to work unnecessarily. So far, the harm of screening tests is much less likely to find treatable cancers, even if they seem small.
As treatment progresses dramatically, a new era of pancreatic cancer, where intractable disease can be successfully treated, is likely to open. If so (hopefully), the review can be reevaluated.
It should be noted that this discussion also applies to people without known risk factors for pancreatic cancer. Perhaps 10-15% of pancreatic cancer is a family component. People with a strong family history of pancreatic cancer or those who have a genetic condition that is prone to pancreatic cancer such as BRCA2 or BRCA1 should consider finding a center with expertise in registering for research or selecting people at high risk for pancreatic cancer. Testing will be more beneficial.
Dear Dr. Roach: I have a mandible. What started in the world? Was it a dose or grab like a dentist? I am 92 years old and do not want to get any worse. – I.L.
Dear I.L .: The mandible is the lower jaw, and the taurus is bone growth. They are usually called tori because they exist on both sides. Taurus (torus) can also appear in the palate. They can grow slowly over time.
It is not clear where they came from, but it is more common for men and those who exchange teeth, so it seems to be due to bone stress. They do not have to worry, and you do not have to worry if you do not bother. Sometimes they get too big to interfere with eating or speaking. If so, you can be cured by surgery. Tori is common, but I have never recommended a patient for surgery.
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