Pancreatic Cancer affects the main organ of the body i.e. “pancreas”. Men & women both are equally affected after the age of 45 years. Tendency of pancreatic cancer is to spread silently before diagnosis, making it the 4th deadliest cancer in which more than 50,000 people are expected to die each year. There are a number of reasons which are responsible for development of pancreatic cancer within human body. However, several effective treatment methods are available for pancreatic cancer. According to recent reports, pancreatic cancer can be successfully treated in majority of patients world-wide with the help of advanced techniques that help in early diagnosis of this disease.
What is Pancreatic Cancer?
Cancer which starts from the pancreatic tissue is called Pancreatic Cancer. This gland is located in front of the spine & behind stomach. Function of this gland is to produce hormones & digestive juices so as to regulate blood sugar. Exocrine cells of pancreas produce digestive juices while endocrine cells produce hormones. Mainly, pancreatic cancer starts within the exocrine cells.
How it develops is still a mystery but as per studies conducted it is said that acquired damage to cell’s DNA within pancreas cause it to behave & multiply unusually. These cells grow & divide rapidly transforming into a tumor that does not respect normal boundaries in the body. These cells from the tumor travel elsewhere within the body through blood or the lymphatic system. Other factors that may cause pancreatic cancer are given below.
- Cigarette smoking
- Family history
- Low levels of Lycopene & Selenium in diet
- Obesity & inactiveness
There are no specific signs & symptoms of identifying pancreatic cancer because early signs of pancreatic cancer may be misunderstood as some digestive problem. However, certain symptoms can indicate pancreatic cancer.Following is a list of such symptoms.
- Abdominal & back pains as tumor grow
- Stomach bloating
- Unexplained weight loss
- Loss of appetite
- Pale-colored stools
- Elevated blood sugar levels causing diabetes
If these signs & symptoms are observed, patients must visit an oncologist to confirm the situation. If pancreatic cancer is diagnosed early, there are high chances of a successful outcome.
Pancreatic cancer is broadly categorized into two types – exocrine cancer & endocrine cancer.
- Exocrine Pancreatic Cancer – 96 percent of cases are of Pancreatic Adenocarcinoma which is a type of exocrine pancreatic cancer. Exocrine makes up for about 95 percent of the portion of pancreas. Other cancers of exocrine pancreas include the following.
- Adenosquamous Carcinoma
- Squamous Cell Carcinoma
- Giant Cell Carcinoma
- Acinar Cell Carcinoma
- Small Cell Carcinoma
- Endocrine Pancreatic Cancer – Endocrines make hormones which directly release into the bloodstream. Cancer starts from pancreatic neuroendocrine tumors or islet cell tumors of endocrine. The names of endocrine pancreatic cancers are classified according to the hormones they produce.
- Insulinomas – An insulin-producing cells
- Glucagonomas – Glucagon-producing cells
- Somatostatinomas – Somatostatin-making cells
- Gastrinomas – Gastrin-producing cells
- VIPomas – From vasoactive intestinal peptide-making cells
When surgeons suspect pancreatic cancer, patients may have to undergo the following tests in order to diagnose the cancer.
- Imaging Tests – Surgeons may recommend imaging tests to produce pictures of internal organs of patients. Imaging tests help surgeons to visualize internal organs, including patient’s pancreas. Significant imaging tests used to diagnose frightful pancreatic cancer may include computerized tomography scan, magnetic resonance imaging, ultrasound & positron emission tomography (PET) scan.
- Biopsy – Biopsy is a technique to take off a sample of tissue from the patient’s pancreas for evaluating it under microscope.
- Blood Test – Oncologists may advice blood tests for particular proteins shed by cancerous cells in pancreas.
- ERCP – Surgeons may suggest endoscopic retrograde cholangio pancreatography test (ERCP) to take images of the ducts.
When pancreatic cancer is confirmed by these tests, oncologists will work to determine the most suitable treatment for patients. This is the most crucial decision & it will be taken carefully by the surgeons.
- Physical Test – Patients will be asked to undergo diagnosis tests & along with this oncologists will evaluate complete body of the patient to examine fitness level.
- Consent Form – Surgeons will make sure that patients understand exactly what is going to happen during the treatment & ask them to sign a consent form to that effect.
- Pain Control Mechanism – Anesthetists will talk to patients about the anesthetic which will be administered during surgery & pain control medications to be used post-surgery.
- Clean Body – Patients should have a bath or shower prior to the treatment. In addition to this, patients also need to take off any make-up, jewelry & remove piercings & dentures as well.
Patients should ask as many questions as possible before pancreatic cancer treatment in order to properly understand the whole procedure along with the risk factors.
- What kind of pancreatic cancer do I have?
- Is my cancer situated only in the pancreas?
- What is my chance of recovery?
- What are my treatment alternatives?
- What treatment plan do you suggest for me? Why?
- What is the goal of this treatment which is available for pancreatic cancer? Is it to remove the cancer completely, help me feel good, or both?
- Can you tell me the side effects of the recommended treatment, both in the short term & long term?
- Will I be able to exercise, work & perform my routine activities after surgery?
- Will my sex life be affected by this treatment? If so, for how long?
- How long will I have to stay in the hospital?
- Can you elaborate what my recovery from treatment will be like?
- What follow-up tests will I need afterward?
Main goal of pancreatic cancer treatment is to remove the cancer if possible. When that is not an alternative, oncologists may focus on preventing it from growing or causing further harm to the patient. Various pancreatic cancer treatments are enumerated below.
- Surgery – Surgery may be a good alternative when pancreatic cancer of patients is confined to pancreas. Surgical operations used for patients with pancreatic cancer include the following.
- Surgery for Tumors in Pancreatic Head – When patient’s pancreatic cancer is situated at the head of their pancreas, they may consider a surgery known as ‘whipple procedure’ (pancreatoduodenectomy). Whipple procedure involves eliminating the head of patient’s pancreas, as well as portions of the small intestine, the gallbladder & part of the bile duct. Portion of the patient’s stomach may also be removed as well. At the end, surgeons reconnect the remaining areas of pancreas, intestines & stomach to allow patients to digest food properly. Patients should expect a long time for recovery after Whipple surgery. Patients may have to spend several days in hospital as well.
- Surgery for Tumors in Pancreatic Tail & Body – Surgery to take off the pancreas tail & a portion of the body is referred to as distal pancreatectomy. Surgeons may also remove spleen of patients. This surgical procedure carries risk of infection & bleeding.
- Radiation Therapy – Radiation therapy involves high-energy beams, such as those made from protons & x-rays to destroy the harmful cancer cells. Radiation therapy generally comes from a device that hovers around patients, directing radiation to targeted points on the patient’s body. Radiation therapy conventionally uses x-rays to treat cancerous cells.
- Chemotherapy – Procedure of chemotherapy involves drugs to help kill cancerous cells. It can be taken orally or injected into a vein of patients. Chemoradiation is generally used to treat cancer that has spread beyond the pancreas, but only to surrounding organs & not distant areas of patient’s body. In patients with advanced stage of pancreatic cancer, chemotherapy may be used for treatment or it may be combined with targeted drug therapy.
- Supportive (Palliative) Care – Palliative care is specialized healthcare that focuses on relieving patients from pain. Palliative care specialists’ work with patients, their family & other doctors to offer more care & support that complements ongoing treatment. It can be used along with other aggressive treatments, such as radiation therapy, chemotherapy or surgery. Aim of palliative care is to improve the quality of life for patients with cancer.
As with all major treatments, recovering from pancreatic cancer treatment takes a long time. Complete recovery needs an average of three months. Patient’s recovery can be divided into various stages, each of which has a different set of goals & expectations. However, it is essential to remember that every patient’s healing is different. Patients will be discharged from the hospital after several days. At home, they should maintain a healthy diet & a healthy lifestyle. They should exercise, drink fresh juices & always have a positive set of mind. It will definitely help them live a better life.
There are various factors that may increase risk of pancreatic cancer in patients. Some of the major risk factors are given below.
- Excessive weight
- Family history of pancreatic cancer
Various complications associated with pancreatic cancer are listed below.
- Weight Loss – Various factors may cause weight loss in patients with pancreatic cancer. Vomiting & nausea caused by different cancer treatments or a tumor in patient’s stomach may make it tough for them to eat. Patient’s body may have trouble properly processing essential nutrients from food. Supplements may be advised to help in digestion.
- Jaundice – Pancreatic cancer that blocks the liver’s bile duct can result in jaundice. Most common signs include yellow eyes & skin, pale-colored stools & dark-urine.
- Pain – A tumor may press on intrinsic nerves in the patient’s abdomen, causing pain that can become persistent & severe. Various pain medicines can help patients feel comfortable.
- Bowel Obstruction – Pancreatic cancer can block the normal flow of digested food from patient’s stomach into their intestines.
These complications can be minimized with proper guidance of oncologists.
Survival rates of patients after pancreatic cancer surgery are high. As treatments for pancreatic cancer improve, so do life expectancy of patients. Additionally, some other aspects also influence the outcomes, including the following factors.
- Patient’s age
- Overall health of patients
- Attitude towards life
Oncologists can definitely help patients make sure that they are doing all they can to improve outcomes & enable patients live a healthy life. Not only will they feel like they are in control of the situation, mental health & overall health status of the patient will likely improve too.
Various cancer treatments available for pancreatic cancer are surgery, chemotherapy & radiotherapy. In surgery, there is complete removal of cancer for relieving symptoms of pancreatic cancer. It is the most effective treatment for early stage pancreatic cancers so as to increase life expectancy. Chemotherapy & radiation therapy will kill or shrink the growth of cancer. They are mainly performed after surgery so as to reduce chances of cancer coming back.
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