[TUMORS OF THE PANCREAS IN FAMILY PHYSICIAN PRACTICE]

In the past few decades, tumors of the pancreas have been recorded to increase. The incidence increases with age and peaks in 7th and 8th decades of life. Late onset of symptoms and inability of early detection are the reasons why the disease is diagnosed at a stage when cure is no longer possible. There are no specific tests for early detection of pancreatic tumors. The low absolute risk of developing the most common form of cancer, ductal adenocarcinoma, does not justify early screening of general population. The recognition and treatment of symptoms related to the disease are priorities, approaching the patient as a whole person. It is important to alleviate the symptoms and side effects of treatment. The most common symptoms are pain, intestinal obstruction, bile duct obstruction, pancreatic insufficiency, anorexia-cachexia, and depression. Pain is the symptom most disturbing for patients regardless of the stage and type of malignancy, and it is a symptom patients are most afraid of. Modern pharmacotherapy of pain is based on the concept of ‘three steps in the treatment of pain’, issued by the World Health Organization, which is universally applicable and allows for flexibility in the selection and application of analgesics. There are also non-pharmacological modalities of pain treatment, as well as the ‘elevator model’. Family physician has a responsible role in helping the patient and his family in the organization of palliative care and providing support for its coordination and implementation.