[Health Byte] What You Need to Know About the Deadliest Cancer

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The 'King of Cancers,' Up Close: Pancreatic Cancer

Cancer is scary, full stop. But pancreatic cancer – grimly nicknamed the King of Cancer for its sky-high mortality rate and brutally short survival time – sits at the top of the fear pyramid. With World Pancreatic Cancer Day falling this month, some of Shanghai's top specialists gathered for a public health talk organized by the Shanghai Health Promotion Center, hoping to bring a little clarity (and maybe a little calm) to a disease most people would rather not think about.

Why It's So Hard to Catch

"The reason pancreatic cancer is so deadly is that it's extremely difficult to detect early," explained Dr Yu Xianjun, president of the Fudan University Shanghai Cancer Center and one of China's leading experts on pancreatic disease.

Part of the challenge is geography: the pancreas sits deep in the abdomen, hiding behind the stomach, the duodenum (the first part of the small intestine), and the spleen. That means routine health checkups – even the comprehensive ones many expats get through work packages – can miss it.

The other issue is that early-stage pancreatic cancer often doesn't announce itself. When symptoms do show up, they're usually written off as the usual suspects: stomach trouble, liver irritation, gallbladder issues, too many late-night malatang sessions – and the best treatment window quietly closes.

Subtle Early Signals

"Pancreatic cancer does give off early signals," Dr Yu added, "but they're vague, and easily confused with more common conditions."

1. Persistent Fullness or Discomfort in the Upper Abdomen

This isn't always a simple gastrointestinal issue. Ongoing, irregular nausea and pain in the center of the upper abdomen – especially pain that worsens at night – are common early signs of pancreatic cancer. Most people chalk it up to gastritis or indigestion and carry on.

2. Back or Waist Pain

Not always a posture problem. In Shanghai, where half the city seems to spend their lives hunched over laptops in cafés, it's easy to blame back or waist pain on bad ergonomics or gym strain. But pancreatic cancer can also cause steady, stabbing or radiating pain in the same area.

3. Yellowing Eyes or Skin

This isn't always hepatitis. If a tumor forms at the head of the pancreas, one of the earliest signs can be jaundice (yellowing of skin and eyes) and darkened urine. Unfortunately, hepatitis, gallstones and gallbladder inflammation can look the same, making misdiagnosis common.

4. Rising Blood Sugar After Middle Age

Not always diabetes. When cancer affects the pancreas's islet cells (the cells responsible for insulin production), people can suddenly develop higher blood glucose levels, unexplained weight loss and fatigue.

How Pancreatic Cancer Is Treated

Surgery First – And Now, Less Brutal

For pancreatic cancer, surgery is still the first-line, gold-standard treatment. The good news: In China – and especially at top-tier centers like Fudan University Shanghai Cancer Center – surgery has become far more minimally invasive than it used to be. Smaller incisions, faster recovery, less time stuck in a hospital bed wondering why the cafeteria noodles are always lukewarm.

Personalized Care, Not One-Size-Fits-All

Doctors now break pancreatic cancers into more detailed subgroups, which lets them tailor treatment plans to each patient rather than applying a blunt, uniform approach. For expats used to international-style care, this shift toward personalized therapy is a welcome development – and it's happening right here in Shanghai.

Precision Medicine Brings New Hope

"Pancreatic cancer treatment is becoming more precise," Dr Yu said. "With the development of new targeted therapies (drugs that attack specific cancer-related genes or proteins) and advances in immunotherapy (treatments that help your immune system recognize and fight cancer), we're seeing more hope than ever."

One standout example: Antibody – Drug Conjugates (ADCs) – a new class of cancer medication that works like a guided missile, linking a targeted antibody to a chemotherapy drug. This lets doctors deliver high-powered treatment directly to cancer cells while sparing more of the healthy tissue. The result: better survival rates, lower toxicity (fewer side effects), and improved safety, even for patients in middle or late stages of the disease.

How to Lower Your Risk of Pancreatic Cancer

Like many cancers, pancreatic cancer is closely tied to lifestyle habits. The flipside of that somewhat bleak statement is that you can lower your risk by making a few steady, sensible changes – even in a city where late-night craft beer, convenience-store snacks, and eleventh-hour Eleme orders are part of the rhythm of life.

1. Don't Smoke

Smoking is one of the strongest known risk factors for pancreatic cancer. Full stop. Quitting dramatically reduces your risk – not just for pancreatic cancer but across the board. (And yes, that includes vaping; it's not the harmless loophole many hope it is.)

2. Upgrade Your Diet, Shanghai-Style

A steady diet of high-fat, high-calorie and ultra-salty foods raises your risk. Shanghai's restaurant scene doesn't make moderation easy, but the basics still hold: diversify your plate, eat more vegetables and fruit, and don't treat dairy or soy products as optional extras.

A reliable intake of dietary fiber (think whole grains, beans, vegetables) and essential nutrients helps support pancreatic health – and keeps you from drifting into the "whatever's fastest on Meituan" trap.

3. Manage Underlying Health Conditions

Certain chronic issues put long-term stress on the pancreas.

• Chronic pancreatitis (persistent inflammation of the pancreas),
• Liver or gallbladder diseases (which can disrupt digestion and pancreatic function), and
• Diabetes (which affects how the pancreas produces insulin)

…all increase pancreatic cancer risk. Obesity is another major factor – something that surprises many expats who assume they're walking enough in Shanghai to not worry about it. Weight management, regular checkups and keeping chronic conditions under control go a long way toward lowering your risk.

Early and Proper Screening

Catching pancreatic cancer early is the whole game. If you notice persistent abdominal discomfort, unexplained back or waist pain, jaundice (yellowing of the skin or eyes), or sudden swings in your blood sugar, it's worth getting screened right away – not "after my next work trip" or "once I'm back from Thailand."

The Basics: Simple Tests That Matter

Two easy, widely available tests can raise early warning flags:

• CA19-9 tumor marker test (a blood test used to look for proteins associated with pancreatic cancer), and
• Abdominal ultrasound (a non-invasive scan that checks for abnormalities around the pancreas and nearby organs).

These aren't perfect, but they're an important first line of defense – and most international clinics in Shanghai can arrange them quickly.

When You're High-Risk, Go Deeper

For people with higher risk – including those with a family history of cancer, diabetes, chronic gallbladder or pancreatic disease, or long-term pancreatitis – a standard ultrasound isn't enough. In these cases, doctors rely on a CT scan (a more detailed imaging test that gives cross-sectional views of the abdomen) for early detection.

Not Every Pancreatic Tumor Is Cancer

The word "tumor" scares people, but pancreatic tumors fall into three broad categories: benign, malignant and borderline.

When people talk about "pancreatic cancer," they usually mean pancreatic ductal adenocarcinoma (PDAC) – the most common and aggressive type. It starts in the cells lining the pancreas's tiny ducts, grows quickly, and historically has had poor treatment outcomes.

But there's another major type: pancreatic neuroendocrine tumors (pNETs), sometimes nicknamed "Jobs' cancer" because it's the type Steve Jobs had. These tumors come from the pancreas's hormone-producing islet cells. They behave differently, respond to different treatments, and have very different biological features compared to ductal adenocarcinoma.

Early Detection Isn't Hopeless – It's Powerful

"Many people think a pancreatic cancer diagnosis is an automatic death sentence and simply give up," Dr Yu said. "But with medical advances, early detection and the right treatment strategy, we can significantly improve outcomes. Innovations in surgical techniques alone have already helped extend survival for many patients."

Shanghai's Cancer Picture: Better Than You'd Expect

According to the Shanghai Center for Disease Control and Prevention, 42.8 percent of common cancers in Shanghai are now caught at an early stage, and the city's overall five-year survival rate sits at 61.6 percent – one of the best records in China. For anyone living here long-term, that's encouraging news: The city's healthcare system isn't just improving, it's outpacing the national curve.

Cancer: A Slow-Moving, Preventable Disease

Cancer isn't one single disease – it's a broad category describing conditions where normal cells gradually turn abnormal and start growing out of control. It's chronic, meaning it develops over many years or even decades, and non-communicable (you can't "catch" it from anyone).

But the key thing? Many cancers are preventable, and many are treatable – especially when found early.

The problem is timing. Most cancers don't show obvious symptoms at the beginning. Combined with low awareness and delayed diagnosis, many people don't realize something is seriously wrong until they're already in advanced stages.

The Long 'Timeline' of Cancer

"We need to understand that cancer develops slowly and make use of this long process to prevent it early, detect it early, diagnose it early, and treat it early," said Wu Chunxiao from the Shanghai CDC.

According to the WHO:

• One-third of cancers can be completely prevented,
• One-third can be cured if detected early, and
• One-third can achieve long-term survival with proper treatment.

That breakdown gives ordinary people a surprising amount of control – especially if they stay on top of screenings.

Shanghai's Screening Campaigns: Quietly Saving Lives

Shanghai has been rolling out citywide cancer screening programs for more than a decade. Since 2013, eligible residents have been offered free colorectal cancer screening, starting with a risk assessment and stool blood test.

If blood is detected, the program guides patients to a follow-up colonoscopy – the gold standard diagnostic tool.

And the results have been impressive:

• 46 percent of colorectal cancers found through this screening are caught early, and
• Five-year survival for screened patients is 85 percent, far higher than for patients diagnosed through regular clinical visits.

For expats living in Shanghai, this is a good reminder: while not all public programs are open to non-locals, the overall medical ecosystem – from city hospitals to international clinics – is deeply invested in early detection and preventive care. Taking advantage of that system, rather than avoiding it, can make a real, measurable difference.

Health Byte Tips

New National Platform Makes Eye Care Easier – No More Hospital-Hopping

For anyone in Shanghai dealing with complicated eye issues – retinal problems, corneal disease, glaucoma that needs more than just a quick pressure check – there's some genuinely good news. You no longer have to schlep across half the city, or even fly to another province, to find the "right" expert.

Over the weekend, Shanghai launched a national complicated eye disease diagnosis platform, bringing top ophthalmologists from across the country into one coordinated network.

Remote Consultations + Multidisciplinary Care

The platform is built around multidisciplinary cooperation and remote consultation, meaning patients can get precise diagnoses and treatment plans without bouncing between hospitals. The local hub for the system is the Guangzheng Eye Hospital Group, which connects patients directly into the national network.

A 'Who's Who' of China's Best Eye Specialists

Some of China's most respected eye doctors are already on board:

• Dr Fan Xianqun, Shanghai Ninth People's Hospital
• Dr Zhou Xingtao and Dr Sun Xinghuai, Fudan University's Eye, Ear, Nose and Throat Hospital
• Dr Lu Yi, Shanghai Bright Eye Hospital

Together, they form a cross-hospital, cross-region medical alliance – basically the Avengers of Chinese ophthalmology – accessible through a single platform.

No More Running Around

"Patients can now get the right treatment without having to visit multiple hospitals," said Dr Liu Lin, president of Guangzheng Eye Hospital Group. "The platform screens complicated cases and recommends the most appropriate expert, making it far more convenient for patients."

For expats who've ever tried to navigate Shanghai's hospital system – paper slips, registration desks, queues that snake around hallways – this could be a game changer. Finally, eye care that comes to you, instead of the other way around.

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About the Author

Cai Wenjun is a seasoned health reporter with Shanghai Daily. With extensive experience covering the local medical system, hospitals, health officials and leading medical experts, Cai has reported on major pandemics including SARS, swine flu and COVID-19, as well as developments in the local health industry.