Best Pancreatic Cancer Treatment Hospital In India

Pancreatic cancer is a deadly form of cancer that grows in the tissues of pancreas when pancreatic cells begin to grow uncontrollably. Pancreatic cancer may also spread (metastasize) to lymph nodes and other organs such as lungs and liver.

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Before we proceed let us learn something more about the pancreas. The pancreas is a 6-inch long gland situated behind the stomach. It secretes the hormone insulin (which controls blood sugar) and enzymes that help digest your food. The pancreas is divided into three parts viz head (widest part near the liver ducts and small intestine), body (middle portion of the pancreas), and tail (thin tip of the pancreas close to the spleen). Most pancreatic cancers (approximately 90%) develop in the head of the pancreas.

The pancreas has two main components exocrine (secretes enzymes required for digestion) and endocrine (secretes insulin required for blood sugar control). Hence pancreatic cancer is classified on the basis of whether the cancer develops in the exocrine or endocrine component.

Exocrine Tumors – They constitute to about 95% of pancreatic cancers and begin in exocrine cells.  They most common exocrine tumors begin in the cells that line the pancreatic duct (which carries digestive juices into the intestine) and are called ‘adenocarcinoma’. The other rare exocrine tumors include acinar cell carcinoma, lymphoma, cystic tumors, intraductal papillary-mucinous neoplasm (IPMN).

Endocrine cancer – Also known as pancreatic neuroendocrine tumors (PNETs) or islet cell tumors, these are less common than exocrine tumors. They involve abnormal growth of endocrine cells in the pancreas and can be further divided into functional tumors and non-functional tumors. Functional tumors are those that produce hormones for e.g. PPomas, insulinoma, VIPomas, gastrinoma, glucagonoma, somatostatinoma. Nonfunctional tumors do not produce any hormones and are mostly malignant.

The exact cause of pancreatic cancer is not known but smoking, obesity, long standing pancreatitis increase the risk of developing pancreatic cancer. 

Pancreatic cancer presents in four stages as follows –

Stage I – In this early stage, cancer present only in pancreas and has not spread anywhere.

Stage II – In this stage, the cancer spreads to nearby structures such as bile duct, duodenum, tissues near the pancreas or nearby lymph nodes.

Stage III – This stage is known as ‘locally-advanced cancer’, wherein cancer cells spread to blood vessels close to the pancreas, stomach, large bowel or spleen and lymph nodes.

Stage IV – In this ‘advanced or metastatic cancer’ stage, cancer cells spread to other organs such as liver, lungs, brain etc. 

Known for its aggressive nature, pancreatic cancer progresses rapidly from stage I (localized within the pancreas) to stage IV (metastatic disease) in an average of 1.3 years.

The symptoms generally do not show up until the cancer has reached an advanced stage. Some common symptoms include loss of appetite, enlarged lymph nodes in the neck extreme weight loss, belly or low back pain, jaundice (yellowing of eyes and skin), nausea, pale-colored stools, diarrhea, etc.    

Detecting cancer as early as possible can increase the chances of survival.  A number of imaging studies are used to detect pancreatic cancer are as follows –

Positron Emission Tomography (PET): In this test, radioactive glucose (that is absorbed by the cancer cells) is injected into the patient’s veins, to determine how far the cancer has spread.

Computer Tomography (CT): As a CT scan takes cross-sectional (slice) images of your body, it helps to observe the pancreas clearly and determine if the cancer has spread to nearby organs, lymph nodes or distant organs and also if surgery might be a good treatment option.

Ultrasound: It creates images of organs like pancreas by means of sound waves that are reflected from the organs.

Magnetic Resonance Imaging (MRI): It uses magnetic radio waves to create detailed images of parts of your body.

If the above imaging tests show presence of a mass in the pancreas, a biopsy is done to confirm pancreatic cancer. Biopsy can be done using several different methods such as laparoscopy, percutaneous needle biopsy, endoscopic ultrasound, or Endoscopic Retrograde Cholangiopancreatography (ERCP).

Once a diagnosis of pancreatic cancer is confirmed, treatment is undertaken based on the stage of disease, either to destroy cancer cells or prevent further spread of the disease. It may include one or more of the following –

Surgery: Surgery is generally recommended when the tumor is in the head and neck of the pancreas, and has not spread beyond. It involves removal of head and approximately 20% of the body of the pancreas. In some cases, even a part of the stomach is removed.

Radiation therapy: Ionizing radiation is used to destroy pancreatic cancer cells and to prevent their further growth.

Chemotherapy: Anti-cancer drugs (injected into a muscle or vein, or given by mouth) are given in alternating cycles of treatments and rest periods to destroy pancreatic cancer cells.

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