Gianluca Vialli, pancreatic cancer and the doctor who operated on him: «The first symptom? Jaundice»

The disease that took Gianluca Vialli was pancreatic cancer. It is a condition that affects about 14,000 patients every year. Among the famous victims are tenor Luciano Pavarotti and Apple founder Steve Jobs. In 70% of cases, it is located in the head of the pancreas, in 15-20% in the body, and in 5-10% in the tail. The disease is currently the fourth leading cause of death in women and the sixth in men, with a 5-year survival rate of just 8%. Only 3% of those who fall ill manage to survive 10 years. The disease manifests itself in different forms. The most common is adenocarcinoma, but in all cases it does not present with recognizable symptoms. For this reason, one of the biggest problems is diagnosis, which very often comes when the tumor is already in an advanced stage and has generated metastases.

The surgery

Alessandro Zerbi, head of the pancreatic surgery unit at Humanitas in Milan, explains today that Vialli's first symptom was jaundice. That is, yellowing of the skin and the whites of the eyes. But the Istituto Superiore di Sanità warns that any disease that interferes with the transport of bilirubin from the blood to the liver and its elimination can cause it. Other signs of jaundice are light-colored stools and dark urine. There are three different types. Intrahepatic jaundice and post-hepatic jaundice are more common in middle-aged and elderly people than in young people. Pre-hepatic jaundice can affect people of all ages, including children. Zerbi operated on Vialli in 2017. Pancreatic cancer also claimed the lives of the first American astronaut Sally Ride and actresses Anna Magnani and Mariangela Melato. In the world of football, Giacinto Facchetti, Giuseppe Meazza, and Omar Sivori. "That duodenopancreatectomy surgery went well," the doctor recalls today in an interview with Il Giornale. The surgery consists "of removing the duodenum and the head of the pancreas. It is extremely complex." Because "it can cause infections, hemorrhages, and fistulas in the first weeks after surgery. Recovery is not very quick, it takes a few weeks." Risk factors, Zerbi explains, are “smoking, overweight, a diet rich in fats and low in fiber, and a sedentary lifestyle. Also family history, defined as having two close relatives who have had this cancer." The doctor also debunks a very common urban legend: "It is not true that the tumor progresses more slowly if the patient is older. Every tumor progresses faster or slower depending on how aggressive it is. And pancreatic cancer is a very aggressive tumor from a biological point of view. So much so that it has a generally worse prognosis than others."

Other symptoms

In addition to jaundice, other symptoms of pancreatic cancer are pancreatitis, that is, an inflammation that causes very severe pain. And sudden diabetes, which is usually a symptom of an early stage of the disease. Unfortunately, there is no screening. Only in 10% of cases, that is, patients who have a family history of the disease because they have had two sick relatives. Periodic check-ups can be done: a magnetic resonance imaging once a year to keep the situation under control. Only in 20-30% of cases do patients notice it in time." In these cases, the most common surgery is "removal of the pancreas. Otherwise, chemotherapy or other treatments and radiotherapy are used. After 5 years from surgery, 20/30 percent of patients survive because there is a high risk of metastasis or recurrence: unfortunately, this is what happened to Vialli."

The oncologist and pancreatic cancer

In an interview with the news agency Dire Michele Reni, associate professor of Oncology at the Vita e Salute University and coordinator of the oncology area at Irccs San Raffaele in Milan, explains that "the only targeted therapy that had been shown to have some advantage in controlling the disease for longer was the drug Olaparib, indicated for BRCA-mutated patients. But Aifa did not grant reimbursement and therefore prevents us from using it." Pancreatic cancer, notes the oncologist, "unfortunately does not make distinctions. It affects everyone. And it is a neoplasm that is increasing in numbers. In fact, we treat patients of all ages, from 20 to 100 years old. It is true that the incidence is higher in people over 65, but, in fact, pancreatic cancer affects many. There is no particular category of people at risk and this represents one of the difficulties we face with this disease, because not being able to precisely identify the at-risk population, in fact we cannot do screening."

Original Article: https://www.open.online/2023/01/07/gianluca-vialli-malattia-tumore-pancreas-cosa-e-sintomi/