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Pancreatic Cancer Treatment

The pancreas is a vital organ of our body as it regulates the blood glucose levels and produces enzymes that aid the breakdown of food and digestion. However, tumour in the pancreas, which is linked with the growth of tissue that leads to the formation of an abnormal mass known as neoplasm puts a patient’s life at stake but pancreatic cancer treatment in India is revolutionised, and hence pancreatic cancer treatment cost in India is comparatively less.

Most pancreatic cancers originate in the ducts that are carriers of pancreatic juices. Cancer of the pancreas may be termed as pancreatic cancer or carcinoma of the pancreas. A rare type of pancreatic cancer originates in the cells that lead to the production of insulin and other enzymes, and hence cancer that develops in the cells is termed as islet cell cancer.

Symptoms of Pancreatic Cancer

Some of the early signs of pancreatic cancer are as follows:

•    Pain and cramping in the abdomen

•    Chronic back pain

•    Jaundice

•    Loss of appetite

•    Itchy Skin

•    Loss of weight

•    Swollen Gallbladder

The symptoms which are developed later are as follows:

•    Changes in bowel movement

•    Nausea

•    Fever and shivering

•    Diabetes

Pancreatic Cancer Diagnoses

To diagnose pancreatic cancer, a patient is advised to undergo various tests such as:

•    Physical Examination

•    Laboratory Tests

•    CT Scan (Computed Tomography)

•    Ultrasonography

•    Transabdominal Ultrasound

•    EUS (Endoscopic Ultrasound) 

•    ERCP (Endoscopic Retrograde Cholangiopancreatography)

•    PTC (Percutaneous Transhepatic Cholangiography)

•    Biopsy

Risk Factors for Pancreatic Cancer

•    Higher Body Mass Index

•    Smoking habits

•    Ageing

•    Genetic Inheritance

•    Genetic syndromes like BRCA2 gene mutation, Lynch syndrome and atypical mole-malignant melanoma (FAMMM) syndrome diagnosed among first-degree family members have been associated with higher risk of developing pancreatic cancer.

Various studies have revealed that women are at elevated risk of developing pancreatic cancer. Another class of studies have potentially found a link between emotional and psychological stress and risk of developing pancreatic tumours.

Pancreatic Cancer Types

There two types of pancreatic cancer develop either in the exocrine gland or the endocrine gland. Close to 95 percent of cancers in the pancreas originate in the exocrine cells of the pancreas.

•    Exocrine tumors– Tumours originating in the exocrine gland are termed as adenocarcinomas. The formation of this cancer takes place in the pancreas ducts and are hence targeted depending on their growth.

•    Ductal Adenocarcinoma – 75 percent of all pancreatic cancers diagnosed are adenocarcinomas and hence originate from the cells that line the ducts which are digestive juices carriers. These cancer pathogens are predominately found in the head of the pancreas.

•    Acinar Cell Carcinoma – A sporadic type, it accounts for 1 percent of pancreatic cancers and begins in the acinar cells that manufactures digestive enzymes. However, these tumours have been associated with secreting extreme amounts of the digestive enzymes which lead to unusual skin rashes, itchiness and pain in the joints.

•    Adenosquamous Carcinoma – Imitate the characteristics of adenocarcinomas, but one distinct feature is that the cells flatten as they mature.

•    Intraductal Papillary Mucinous Neoplasm/Tumours – Such type begins in the pancreatic duct or its side branches.  These have been liked with secreting an excessive amount of mucus which results in dilation of the duct. 3 percent of all pancreatic cancer cases are those of IPMN. 

•    Mucinous Cystadenocarcinoma – A malignant cyst cancer type filled with mucin, predominantly occurs among middle-aged women. If the size of the cyst grows up to 20 cm, then it leads to obstructive jaundice.

•    Pancreatoblastoma – Children below ten years of age are afflicted with this type of pancreatic cancer. However, it seldom occurs among adults. These cancerous pathogens comprise of acinar cells, and some are made up of ductal elements or endocrine cells.

•    Serous Cystadenocarcinoma – A tumour with a cyst filled with thin watery fluid. This tumour doesn’t spread to other parts and exhibit symptoms such as jaundice.

•    Solid and Pseudopapillary Tumors – A low-grade malignant tumours common among girls and young women. They originate in the foot of the pancreas and are cystic.

•    Endocrine Tumors:  A rare type which stems from an endocrine tumor (cystadenocarcinoma) and hampers the production of various hormones.

•    Gastrinomas– Also known as Zollinger-Ellison Syndrome, such a type of pancreatic cancer secretes excess gastrin, which causes peptic ulcers in the stomach or duodenum, thereby causing pain, diarrhoea, black tarry stools and bleeding. 

•    Glucagonomas – This type secret excess hormone called glucagon which causes a particular type of skin rash (redness, ulceration and scabbing), anaemia, mouth ulcers and diarrhoea.

•    Insulinomas – A benign type of a tumour which causes excessive production of insulin and takes a toll on the patient, resulting in fatigueness, low on energy, dizziness and drowsiness. This is the most frequently-occurring cancer, classified under islet cell tumor of the pancreas.

•    PPomas – Extremely malignant that emerge to be cancerous.

•    Somatostatinomas – Unrestricted production of somatostatin which causes stones in the gallbladder, diabetes, diarrhoea and steatorrhoea.

•    VIPomas – An extremely malignant type, they excessively secret hormone known as VIP which may result in diarrhoea, elevated blood pressure and flushed face.

Pancreatic Cancer Treatment in India

The type of the treatment one undergoes, depends on the type, extent and grade of pancreatic cancer. The various treatment options are as follows:

Surgery

1.    Curative Surgery – This surgery is performed for treating benign tumours which have not spread to other parts of the body. At times this surgery removes removal of the pancreas. 

Some of the procedures performed under curative surgery are as follows:

  • Whipple’s Operation – This surgery involves removing the head of the pancreas, the lower end of the stomach, and maximum part of the duodenum, the common bile duct, gallbladder and the adjacent lymph nodes. The remaining part of the stomach, bile duct and pancreas are then reattached to the small intestines.
  • Pylorus-preserving Pancreatoduodenectomy: This procedure holds potential in preserving the stomach valve (the pylorus) that enters the small intestines.
  • Distal Pancreatectomy – Termed as left pancreatectomy, this procedure is performed on the tail end of the pancreas.
  • Total Pancreatectomy – This surgery involves removing the whole pancreas for treating massive cystic or an endocrine tumour.

2.    Palliative Surgery Another surgical procedure performed for treating malignant pancreatic cancer.

  • Inserting a stent – This procedure involves sedating the patient and inserting a stent (plastic or metal tube) endoscopically.
  • Biliary Bypass – Choledocho-Jejunostomy – When the option of inserting a stent is closed, this procedure acts as a saviour which enables the bile to drain away via bypassing the blockage.
  • Gastric Bypass – This surgery is used to treat a blockage in the duodenum, thereby enabling smooth passage of food and restoring healthy bowel movement.
  • Coeliac Plexus Nerve Block -This procedure involves administering a unique chemical into the nerves from the pancreas which accumulate behind the Coeliac Plexus. Coeliac Plexus Nerve Block surgery holds potential in relieving pain.

Therapy

•    Targeted Therapy for Pancreatic Cancer

•    Radiation Therapy for Pancreatic Cancer

•    Chemotherapy for treating Pancreatic Cancer

Patients Resistance to Chemotherapy for Pancreatic Cancer Treatment Decoded

When we talk about ‘Pancreatic Cancer’, military word-classifications like war, combat, battlefield, victims and survivors strike our mind. But theories and sayings have been backed by plausible reasons that those who succumbed to some cancer may not have had the valour to keep fighting. Well, it’s not always advisable to go by sayings, it is about knowing your cancer which is comfortably marinated amidst your pancreas so that its roots can be cut. However, researchers across the world have engaged in ground-breaking and innovative research to improvise the treatment of pancreatic cancer. The novel insight spotted by these researchers has potentially shed light on the role of vitamin D receptors, which makes the patient resistant to the chemotherapy treatment.

If theory to inactivate the vitamin D receptor in pancreatic cancer cells is supported with a plausible clinical implication, then this may open avenues to effectively treating cancer.

Best Hospitals and Oncologists for Pancreatic Cancer Treatment in India

•    Fortis Memorial Research Institute, Gurugram- Dr Vinod Raina

•    Fortis Memorial Research Institute, Gurugram – Dr Rahul Bhargava

•    Max Smart Super Speciality Hospital, Saket – Dr Rahul Naithani

•    BLK Super Speciality Hospital, New Delhi- Dr Amit Agarwal

•    BLK Super Speciality Hospital, New Delhi- Dr Dharma Choudhary

Some Pancreas specialist and surgeons are as follows:

•    Institute of Liver and Pancreas Transplantation and Regenerative Medicine Medanta, Gurugram- Dr Arvinder Singh Soin

•    Max Healthcare, Saket- Dr Subash Gupta

•     BLK Super Speciality Hospital, New Delhi- Dr. (Prof.) Sanjay Singh Negi, GI Surgery and Liver Transplant

•    Pushpawati Singhania Research Institute- Dr K R Vasudevan

•    Jaypee Hospital- Dr Abhideep Chaudhary

•    Artemis Hospital, Gurugram- Dr Ramdip Ray

•    Fortis, Noida- Dr VivekVij

Pancreatic Cancer Treatment Cost in India

Pancreatic Cancer treatment can be availed at a minimal cost in India. The cost of removing pancreatic cancer via surgery is close to USD 7000-8000, and the cost of chemotherapy per cycle is USD 500. Radiation therapy amounts to approximately USD 5000. The cost of  Whipple’s Operation is USD 9,500, which is deemed to be cost-effective.

The total cost incurred on the treatment depends on various other factors such as:

•    Treatment centre

•    Choice of the oncologist

•    Type, extent and aggressiveness of pancreatic cancer

•    Post-operative care expenses

Why should one choose India for Pancreatic Cancer treatment?

Indian healthcare facilities boast of a renowned panel of oncologists, who have a knack for performing procedures with meticulousness. The hospitals in India work with seamless coordination and integrated management, thereby dispensing top-notch care and services to their patients. Patients from various parts of the countries are guided by medical health platforms in India like MedMonks who have tie-ups with leading hospitals in India and surgeons. Team MedMonks helps patients walk through the entire procedure and does not charge a single penny. Led by healthcare professionals, who have an accumulated experience of 40 years in the field of health and medicine, MedMonks sticks to its algorithm of dispensing gold standard of care to the patients and helps you avail treatment at a minimal cost.