揭秘乔布斯胰腺癌

When Jolie Dingle went for a routine scan 20 weeks into her pregnancy, she expected nothing more than images of her unborn baby. But the ultrasound also revealed something else — a large swelling on her spleen.

朱莉·丁格尔怀孕20周时查出肝脾肿大。

Within days, Jolie, 33, from Barnsley, South Yorkshire, had been diagnosed with cancer. Tests showed it had started in her pancreas and spread beyond the spleen to her stomach and kidneys.

约克郡巴恩斯利33岁的她随即查出胰腺癌，已从脾脏扩到胃和肾。

Yet despite the shock of a cancer diagnosis, Jolie can count herself lucky. Cancer of the pancreas — a pear-shaped organ about 6?in long that lies deep inside the body between the stomach and the spine — is notoriously difficult to spot.

震惊之余，她堪称幸运。众所周知，胰腺癌很难查出。

That’s because, in the majority of cases, it produces no symptoms until the malignant cells have migrated throughout the body and already caused irreversible damage to other organs, such as the liver or kidneys. Despite being more than halfway through her pregnancy, Jolie had little choice but to undergo emergency surgery to remove a tumour which, it turned out, had grown almost as large as a football.

总是直到恶性细胞扩散全身引起肝肾等器官的永久损伤，胰腺癌才有症状。朱莉只得切除足球般大小的肿瘤。

‘When they told me I had cancer, I thought my baby and I were both going to die,’ says Jolie, who has her own hairdressing business and is married to Jason, 43, who runs a decorating company.

朱莉经营美发生意，嫁给43岁装修公司老板杰森。“得知患癌，我想到了孩子，我们就要死了”，她说：

‘I’d not heard of pancreatic cancer and, to be honest, I didn’t even know what the pancreas was or where it was in the body.’

“我甚至不知胰腺为何物。”

Jolie and her now eight-month old son, Theo, both survived the surgery.

她和8个月的儿子西奥挺过手术。

But had she not had a pregnancy scan, doctors said, the cancer would almost certainly have killed her and her baby too.

医生表示若朱莉没做孕期检查，母子可能已经病逝。

As a survivor of the disease, Jolie is a member of a very small club. It is widely regarded as one of the most lethal of all tumours, killing around 97 per cent of its victims within five years.

她的幸存破罕见。胰腺癌是公认绝症，约97%患者五年内发病离世。

The profile of this deadly disease has been raised with the death of Apple co-founder Steve Jobs, who died earlier this month aged 56 after a five-year battle with a pancreatic tumour.

此病因苹果创始人之一乔布斯的病逝而被关注，他抗癌五年，本月初病逝，享年56岁。

Every year, around 8,000 Britons are diagnosed with cancer of the pancreas. According to the Pancreatic Cancer Research Fund, while rapid progress has been made in boosting survival from cancers affecting the breast, a pancreatic cancer sufferer today is just as likely to die from it as someone 40 or 50 years ago.

据胰脏癌症研究基金，每年约有八千英国人患胰腺绝症。

Many sufferers discover a problem only when they experience considerable and unexpected weight loss (caused by the cancer eating away at their digestive system), back pain or severe abdominal cramps from the growing tumour.

患者多在（消化系统受损）体重严重骤减、背部疼痛或由肿瘤引起的严重腹痛才确诊患癌。

But studies suggest that, if the disease is caught in the early stages, surgery to remove the tumour can transform survival rates from 3 per cent after five years to as much as 40 per cent.

研究表明如切除早期肿瘤能使患者五年后存活率提高37%。

Now research teams around the world are in a race to discover a simple way of checking otherwise healthy people for hidden signs of a pancreatic tumour.

目前全球研究人员在竞先发现尽早发现的方法。

Currently, most of those that get picked up early are spotted only because the patient happens to be undergoing an abdominal scan for some other, unrelated health matter — such as Jolie’s pregnancy scan.

多数患者在腹部扫描时查出，本为他因，如朱莉。

But in the U.S., efforts are under way to spot cancer victims as early as possible by scanning them for signs of pancreatic cysts, tiny growths that can become malignant.

These fluid-filled sacs on the pancreas usually have no known cause and, according to some estimates, affect up to one in eight people. In the vast majority of cases, they are harmless growths that never become malignant.

英国正致力扫描出囊肿征兆尽早确诊，轻微囊肿也可为恶性。

Those that do turn malignant account for about one in five cases of pancreatic cancer. At the moment, doctors usually only discover cysts by accident when a patient is having an ultrasound or MRI scan for something else.

五分之一胰腺癌由恶性囊肿引发。目前医生多在超声波或磁核共振扫描其他疾病时偶然发现。

But at the Johns Hopkins University Hospital in Baltimore, about ten patients a week are being screened as part of a trial to see if actively looking for cysts can cut the death toll.

巴尔的摩约翰霍普金斯大学医院，每周约有十位患者被测试囊肿检查观察是否减少死亡人数。

Their efforts are being targeted at ‘high risk’ groups, such as those with a family history of pancreatic cancer, or those who have suffered a bout of pancreatitis — a persistent infection often brought on by gallstones, or frequent binge-drinking.

该院针对“高危”病患，如有家族病史或曾患过胰腺炎---胆结石或频繁暴饮暴食常引起持续感染。

By targeting potential at-risk groups, it’s hoped doctors may pick up enough problematic cysts to make a significant difference to survival rates.

医生有望查出病异囊肿来大幅提升存活率。

Another approach is being investigated by British researchers. Here, experts are pinning their hopes on research into the development of urine or blood tests that could detect pancreatic tumours before they get out of hand.

或是从尿检血检入手，在肿瘤恶化前查出。

At the Institute of Cancer in London, scientists are hunting for ‘biomarkers’ that are released in high quantities into the urine when a tumour is developing. These biomarkers are proteins that a tumour produces, or chemicals that help with the breakdown of these proteins.

伦敦癌症协会正在尿液中找病变“生物指标”。该指标是肿瘤产生的蛋白质或能分解蛋白质的化学物质。

Within the next three to five years, it’s hoped that five to ten different ‘biomarkers’ will have been identified that will not only pinpoint pancreatic cancer but perhaps even identify a person’s risk of the disease, simply from their urine.

有望三五年内鉴定出五到十个“指标”，确诊胰腺癌及其他疾病。

Dr Steve Pereira, consultant gastroenterologist and hepatologist at University College London, says: ‘Hopefully, in the next few years this will allow us to introduce a screening programme that is cheap and acceptable.

“便宜有效的检查有望面世”，

‘But it would have to be extremely accurate for us to test everybody. Instead, we will probably target those most at risk and concentrate on them.’

伦敦大学学院胃肠和肝脏病顾问史蒂夫·佩雷拉博士表示：“本是大众精检，可能以高危人群为主。

Jolie Dingle had no history of the disease in her family and had no other obvious risk factors when she complained to her midwife of feeling sick halfway through her pregnancy last year.

朱莉有孕期不适，但无家族病史和明显病因。

‘I felt terrible,’ she says. ‘It was only when I heard the doctor use the word tumour that I realised I had cancer. I had to break the news to Jason and my parents, who were all stunned.’

“很糟，”她说：“医生说是癌症。我告诉家人，他们吓坏了。”

The surgery took place a few days later and doctors removed most of her pancreas, all of her spleen, a part of her stomach and about 15 per cent of one of her kidneys.

几天后手术切除了她大部分胰腺、整个脾脏、部分胃和一个肝脏的15%。

While mother and baby survived the operation, Theo was not out of the woods.

母子平安，西奥仍可能患癌。

‘Doctors warned that in the first few days after surgery there was a high risk that I could go into premature labour or miscarry. At 22 weeks, Theo’s chances of survival would have been tiny. Every time the nurse put the monitor on me to try to pick up the baby’s heartbeat I was a bag of nerves.’

“医生警告术后几天可能早产或流产，第22周西奥活着的可能性很小。测他的心跳时我好紧张。”

Now Jolie has regular three-monthly checks and so far the cancer has shown no sign of returning.

之后她三个月检查一次，尚无复发迹象。

‘I can’t believe how lucky I am. When he was born, it was one of the best moments in my life. That’s why we called him Theo, which in Greek means God’s gift.’

“我真幸运。儿子出生是我人生最美时刻。他叫西奥，希腊语是上帝恩赐。”