In Korea, pancreatic cancer occurs in approximately 8,000 people each year, and bile duct cancer occurs in approximately 7,000 people each year.
Although their incidence is relatively low compared to major cancers, their poor prognosis and difficulty in treatment have made pancreatic cancer and bile duct cancer synonymous with incurable diseases.
A bigger problem is the lack of accurate information about pancreatic and bile duct cancer treatment for the general public.
It is frustrating that patients and their families, who should be focusing solely on treatment and recovery, must also discern false information that is being spread as if it were fact.

Three experts, unable to stand by and watch this unfortunate situation, joined forces.
This book was written by faculty from the hospital that treats the largest number of pancreaticobiliary cancer patients in the country, and thus contains a wealth of information ranging from basic knowledge about cancer to actual cases.
A variety of video images and high-quality illustrations help make pancreatic cancer and bile duct cancer, which were once considered difficult, easier to understand.
Additionally, the 'case-centered' stories provide a glimpse into the sacrifices and efforts of medical staff who treat and perform surgeries based on the individual patient's diagnosis rather than following universal treatment guidelines.

Pancreaticobiliary cancer, once thought to be impregnable, has begun to crumble with the advent of multidisciplinary treatment.
What do those who once suffered from pancreatic or bile duct cancer have in common, yet have remained free of recurrence for a long time? Let's explore these stories through the eyes of specialists fighting the fierce battle of "conquering cancer."

As professors and doctors who see dozens of patients a day gathered together for multidisciplinary treatment, lunch hours were sacrificed as expected, or the late evening hours after afternoon treatment were used.
If a surgery is performed late on the date agreed upon by several professors and patients, we are sometimes forced to fast together to greet the professor of surgery who comes in hurriedly, looking exhausted.
Sometimes, patients and their families who participated in the multidisciplinary program look at us with pity and say, “Please eat, even if it’s late…” We feel sorry for them for having to participate in an unplanned fast together.
--- p.26

The incidence of pancreatic cancer in Korea was approximately 8,000 cases per year as of 2020, accounting for approximately 3.4% of the total 247,000 new cancer patients diagnosed each year.
Compared to the most common cancers in our country, such as thyroid cancer, lung cancer, colon cancer, and stomach cancer, which each have an incidence of about 26,000 to 29,000, this is a small number.
However, the number of 8,000 that pancreatic cancer has is by no means small, ranking 8th in overall cancer incidence.
Compared to major cancers, its incidence is relatively low, but the 5-year survival rate is only about 10%, and in advanced cases, it is less than 5%.
This poor prognosis has made pancreatic cancer synonymous with an incurable disease.
--- p.65~66

Treatment strategies vary depending on how the patient's current condition is assessed and how goals are set.
For locally advanced cancers diagnosed as unresectable, induction chemotherapy and palliative treatment strategies are possible depending on the cancer status, the patient's general condition, age, willingness to treat, and purpose.
This is a strategy to monitor the cancer size to a certain extent and perform surgery at an appropriate time, with the goal of achieving the target level of induction chemotherapy by administering highly effective chemotherapy even if it is highly toxic, and then converting the cancer to a state where it can be operated on.
The choice of strategy must be determined solely by careful and long-term observation of the patient's condition and treatment progress, and this can make a significant difference in the quality and outcome of treatment.
--- p.128

In Korea, bile duct cancer ranks 9th among cancers, following pancreatic cancer, which ranks 8th, and occurs in approximately 7,000 people per year.
Old age is the biggest factor in the development of bile duct cancer, and as the aging population continues in Korea, the incidence of bile duct cancer is gradually increasing.
Bile duct cancer, like pancreatic cancer, has a low incidence, but is very difficult to treat and has a poor prognosis.
This is a field that desperately needs changes in various areas, as the 5-year survival rate has remained stagnant at 20-30% for over 20 years.
--- p.198

Any malignant tumor that develops in the liver is called liver cancer.
However, there are many different types of cells in the liver, and each has a different name and property depending on which cell the cancer originated from.
When we commonly talk about liver cancer, we are referring to hepatocellular carcinoma.
However, in addition to hepatocellular carcinoma, there are various types of liver cancer, such as 'intrahepatic cholangiocarcinoma', 'hepatic neuroendocrine tumor', 'hepatic sarcoma', and 'hepatic lymphoma'.
The liver is one of the organs where other cancers most often metastasize, so 'metastatic cancer' that spreads to the liver from other places also frequently occurs.

Cancers that can metastasize to the liver include colon cancer, stomach cancer, pancreatic cancer, bile duct cancer, ovarian cancer, breast cancer, etc., and cancers that metastasize to the liver in this way are called secondary liver cancer.
These metastatic cancers do not have the properties of liver cancer, but rather have the same properties as the original cancer, that is, the primary cancer.
For example, if colon cancer has metastasized to the liver, this cancer has the characteristics of colon cancer, so treatment decisions and anticancer drug selection are made based on colon cancer.
--- p.217

When we think about parenting and education, some children do well with just a little praise, others do well with a little stimulation, and still others need absolute help.
The same goes for bottles.
There is no one-size-fits-all treatment for illness.
The more accurately you understand the disease and carefully analyze each case before taking on it, the higher your chances of winning.
Bile duct cancer is a type of cancer that is divided into detailed types, conditions, and characteristics.
Treatment strategies are also divided into details.

The phrase, “Surgery is the only curative treatment for bile duct cancer,” has been cited in most bile duct cancer papers from decades ago to the present.
This also means that there is no effective treatment other than surgery.
This is why bile duct cancer treatment basically begins with ‘determining whether surgery is possible.’
--- p.266~267

Research on this prognostic stage has been conducted and is still being conducted in many cancers, including pancreaticobiliary cancer.
And the field of so-called 'precision medicine', which develops customized strategies for each patient classified in this way, is one of the hottest fields of our time.
For example, cancer treatment is currently administered uniformly to all patients according to their stage of illness, but in the near future, all information about each patient (physiology, genetics, microbiome, behavior, exposure history, etc.) will be combined to provide customized treatment, with high doses of drugs that are suitable for the patient and exclusion or low doses of drugs that are not suitable.
Our team is also accelerating preparations and research to establish 'precision medicine for bile duct cancer' through genetic information analysis, based on our extensive experience in treating bile duct cancer and our extensive patient population.
Although more research and development of treatments are still needed, all researchers are working together to ensure that the effort continues.

--- p.319~320