Pancreatic Cancer Treatment
Pancreatic cancer is a threat to public health, causing about one-fourth of a million deaths annually world over. In fact, it is the 13th most common cancer in the world and 11th in India. The condition develops due to an uncharacteristic growth in cell count in the pancreas, a glandular organ that aids metabolism and controls sugar levels. The unwarranted cells form malignant tumours invade other body parts via the bloodstream, leading to organ failures and death. The condition is classified on basis of the site of a tumour, which can be either exocrine or endocrine. Exocrine tumours originate within the pancreatic region where digestive substances are generated while exocrine tumours are formed in the area responsible for hormone production.
Of all pancreatic cancers, exocrine cancers are the most prevalent, accounting for 95% cases globally. Pancreatic Adenocarcinoma is the commonest form of exocrine cancers followed by Adenosquamous carcinoma, Squamous cell carcinoma and Giant cell carcinoma. On the other hand, endocrine pancreatic cancers, also called islet cell tumours, are rare and bear the name of the hormone generating site where they originate. If the tumour site is an insulin-producing region of the pancreas, the cancer is known as Insulinomas; whereas, Glucagonomas, Gastrinomas and VIPomas originate in regions producing Glucagon, Gastrin and Vasoactive Intestinal Peptide respectively. Additionally, there is a certain category of tumours known as Non-secreting Islet Tumours that does not emit any hormone whatsoever.
Signs and symptoms of pancreatic cancer
Pancreatic cancer does not reveal any aggressive symptoms until it reaches criticality. The symptoms are vague and often coincide with general disorders. However, getting screened for pancreatic cancer becomes imperative if the following symptoms crop up unannounced and persist over a period. Remember, early presentations can save a life.
- A constant pain in the belly area and the back, which worsens when you lie down.
- A drastic and unexplained weight loss.
- Uneven bowel movements.
- Fever off and on.
- loss of appetite and indigestion.
- Skin losing its texture and moisture
- nausea and vomiting
- Pale-coloured faeces.
- high blood sugar levels.
Medical science may be close to finding the exact cause for pancreatic cancer but the final pieces of the puzzle are yet to be found. However, it has identified several factors that collectively or individually expose a person to the condition. Take a look at some of the risk factors below.
- Smoking: Smoking is a prominent cause for exocrine pancreatic cancers, elevating the chances by 20 to 30 per cent.
- Genetics: People with a family history of pancreatic cancer are 5 to 10 per cent more vulnerable.
- Obesity and sedentary lifestyle: Scientific studies have uncovered that individuals with a body mass index upwards of 30 run the risk of pancreatic malignancies.
- Diabetes: It’s not necessary that a diabetic will develop malignancies of the pancreas but the likelihood is always there.
- Miscellaneous: People with a high-fat diet, the presence of pancreatic cysts in conjunction with chronic pancreatitis and low Lycopene and selenium are candidates of this condition.
Stages of Pancreatic Cancer
Like every other malignancy, pancreatic cancers advance in five well-defined stages.
- Stage 1: When a tumour is achieving localized growth of about 2cm to 4cm and does not contaminate surrounding parts.
- Stage 2: When a tumour now measures over 4cm and is either restricted within the pancreas or has spread to surrounding sites. However, distant parts are off limit as yet.
- Stage 3: When a tumour invades the major blood vessels around the pancreas while distant sites are still safe.
- Stage 4: Finally, the tumour spreads to all nearby and distant body parts.
Pancreatic Cancer Treatment Options
The treatment options for pancreatic malignancy depend on the stage or severity. To determine the course of treatment, our oncologist is likely to factor in the patient’s overall health status and the result of various diagnostic modalities, such as tumour marker test, PET scan, CT scan, MRI, Ultrasound, Biopsy, Blood chemistry studies and more. If presented early, the patient may have a malignant tumour removed through surgical intervention for complete recovery. Let’s consider some of the popular response approaches.
- Whipple procedure: One of the elaborate, complicated response strategies, Whipple procedure involves getting rid of the pancreas’ head and nearby parts like stomach, intestine and more. The entire digestive system is then reframed for easy digestion.
- Distal pancreatectomy: Herein, the elongated part of the pancreas, known as the tail, is eliminated while keeping the head intact.
- Total pancreatectomy: A strategy becoming rarer with time, total pancreatectomy involves removing the pancreas, as well as the spleen.
- Chemotherapy: Chemotherapy exclusively or in conjunction with radiation therapy is a widely administered response strategy. It is also coupled with surgeries in many cases.
DM (Medical Oncology), FRCP (U.K), DNB (Medicine), FICP, FIMSA, MNAMS
Dr. Vineet Talwar Medical Oncology
MBBS, MS (General Surgery), DNB (General Surgery), Fellow (Liver Transplantation & Hepatobiliary Surgery)
Dr. Shivendra Singh GI Onco Surgery & Liver Transplant
MBBS, MS and DNB Surgical Oncology
Dr. Sayed Assif Iqbal GI Onco Surgery & Liver Transplant
M.B.B.S, M.D, D.N.B (Medical Oncology), ECMO (Europe), MRCP- UK (Medical Oncology)
Dr. Varun Goel Medical Oncology
MBBS, MD, DNB (Medical Oncology), ECMO (Europe), MRCP-UK (Medical Oncology)
Dr. Prasanta Kumar Dash Medical Oncology