Pancreatic Cancer Treatment In India For Highest Success Rate
Do you know advanced pancreatic cancer treatment in India can help you enjoy your life to the fullest and fight it successfully?
Though the detection of pancreas cancer itself is a matter of concern, with the right treatment, and the right doctor by your side you can beat pancreatic cancer.
That’s why early detection is important to cure the cancer as the tumor is generally operable in the early stages.
Let’s understand pancreas cancer in detail and how early detection impacts the success rate.
What is the pancreas?
It is an anatomical structure with two roles of secreting digestive enzymes and hormones regulating blood glucose levels.
Digestion – It facilitates the digestion of proteins and carbohydrates by releasing digestion enzymes in the body.
Hormones Secretion – It is known to secrete the insulin hormone which is responsible for reducing the blood sugar level of the body and the glucagon hormone which prevents low blood sugar.
The pancreas consists of exocrine and endocrine cells. Let us know the function and properties of these cells.
- The exocrine function involves the digestion of foods in the intestine.
- The endocrine function of the pancreas helps in blood glucose regulation by secreting the hormone insulin.
What are the different types of pancreatic cancer?
There are different types of Pancreatic cancer depending on the cell type and the area where the cancer originated.
There are three forms of pancreatic cancer:
1. Adenocarcinoma
Ductal carcinoma is the other name for the pancreatic cancer that develops in the pancreatic duct. This is by far the most common of all the pancreatic cancers.
Additionally, this cancer may arise from the cells that are the source of pancreatic enzymes. Generally, this type is called Acinar cell carcinoma, which results in about 1 percent to 2 percent of cancer originating in the exocrine glands.
2. Squamous Cell Carcinoma
The tumour is of a very rare kind, established in the ducts and made purely of squamous cells (flat cells that look like fish scale under a microscope). It is a nonendocrine cancer of the pancreas. Only 0.5% of all ductal pancreatic cancers are of this type.
3. Adenosquamous Carcinoma
These are exceptionally rare adenocarcinomas of the pancreas that are categorized as 1 to 4 percent of exocrine pancreatic cancers. Adenosquamous cancer is a very aggressive type of tumour which is associated with a poorer prognosis compared to adenocarcinoma. What is known is that they are presented with the signs of both ductal adenocarcinoma and squamous cell carcinoma.
Now that you know about various types, let’s know the signs of pancreas cancer.
What are the signs and symptoms of pancreatic cancer?
Symptoms may vary as per the location of the cancer and in which stage the cancer is.
These are common symptoms found in pancreas cancer:
- Unjustified weight loss and loss of appetite
- Itching skin
- Dark Urine
- Jaundice symptoms include yellowish skin and eyes
- Pain in the abdomen that radiates to the back
- Uncontrolled diabetes
- Blood clots
- Nausea and fatigue without any reason
If symptoms remain persistent for long, you should go for a screening.
What are the causes and risk factors in pancreatic cancer cases?
Several risks tied to pancreatic cancer can be called factors.
Factors are listed below:
- DNA level mutation in pancreatic cells.
- Diabetes
- Smoking
- Obesity
- Family history of pancreatic cancer
- Older age. The majority of pancreas cancer occurs after 65
- Frequent inflammation of the pancreas
Tests used to diagnose pancreatic cancer
Diagnostic tests employed in pancreatic cancer include the following:
Endoscopic ultrasound, also referred to as EUS, refers to the diagnosis of the digestive system through the use of imaging studies. The thin structure of a tube tipped with a camera is called an endoscope. An ultrasound next to the endoscope transmits ultrasound waves and is capable of generating images of nearby tissues. Also, the ultrasound can visualize images of the pancreas.
It is the procedure that is meant to take a small specimen of tissue for microscopic examination in the laboratory. In the majority of cases, the doctor requests the sample from the patient during an endoscopic ultrasound examination.
During the procedure of EUS, tissue from the pancreas is taken. Less frequently, a sample of pancreas tissue is taken from the human body by inserting a needle into the body via the skin and reaching the pancreas. It is carried out by using a thin needle to remove the suspicious materials.
The sample is sent to the lab to get tested to know the answer as to whether it is malignant or not. In addition, expert tests of the genes can reveal what DNA changes are involved in cancer. With the help of results, they come up with your treatment plan involved.
Blood tests of pancreatic cancer patients may identify proteins called tumour markers as they are produced by the pancreatic cancerous cells. CA19-9 just stands for one pancreatic cancer tumour marker test.
Doctors use, to a lesser extent, this exam when you are undergoing or completing treatment to determine your reaction to the cancer. Certain cases of pancreatic cancers don’t create extra CA19-9, which implies that this test is not useful for everyone, although it is beneficial for many of the cases.
You can talk to your healthcare team about the importance of genetic testing. The genetics of cancer risk is identified through blood or saliva sampling for genetic testing.
Staging of cancer can be done post-diagnostic procedure. Let’s understand the stages of pancreatic cancer.
What are the different stages of pancreatic cancer?
We can see that a system (TNM) categorizes stages of pancreatic cancer: T- T refers to the size of the tumour; N- it means that it has spread to the lymph nodes; M- it signifies that it has spread to other parts of the body.
There are different types of lesions on the walls of abnormal pancreas. The changing cells may become cancerous and find a way for infiltration into surrounding healthy tissue. Such type of stage is also known as (T0; N0; M0)
Stage I is differentiated into Stage IA and Stage IB.
Stage IA: There are no cancerous cells in any of the lymph nodes, and there are no cancerous cells found in any part of the body other than the primary tumour (T1; N0; M0).
Stage IB: Tumor size: >2 cm (T2); regional lymph nodes and distant metastases are not observed.
In this stage, the cancer spreads to adjacent tissue and tissues near the pancreas or lymph nodes where it is present.
Stage II is divided into the following stages based on where the cancer has spread:
Stage IIA: Cancer doesn’t extend beyond the organ in which it was found, and the nearby tissue, organs, and lymph nodes are also not involved in it at this stage. (T3; N0; M0).
Stage IIB: The tumour was found to be confined to the primary site with the involvement of some lymph nodes or surrounding tissues or organs (T1, T2, or T3; N1) but no known metastasis to distant regional lymph nodes, major blood vessels, or nerves (M0).
There is an enlargement of the adjacent blood vessels in the vicinity of the pancreas that may have reached the surrounding lymph nodes. (T1, T2, T3 or T4, N2, or M0).
The cancer may be the size of an orange and it may have reached the various organs in the body, such as the liver, lungs, and peritoneal cavities. Adenocarcinoma cells are capable of Invading lymph nodes and lymphatic vessels or adjacent pancreas and organs (T; any N; M1).
Pancreatic cancer treatment in India
Pancreatic cancer therapy options include surgery, chemotherapy, radiotherapy, and targeted therapy. This means that depending on the cancer type and stage, the doctor will prescribe certain treatments that can be applied.
Advanced cancer needs to be resected along with the adjacent blood vessels and lymph nodes.
1. Surgery for malignancies of the pancreatic head.
When a cancerous tumour presents in the head part of the pancreas, Whipple surgery is the choice of the surgeon.
Whipple’s procedure is a surgical process in which the head of the pancreas, gallbladder, first section of the small intestine, and surrounding lymph nodes are all removed.
The surgeon once again reconnects the detached parts of the pancreas, stomach, and intestine.
2. Endoscopic surgery for pancreatic tumours in the tail or body.
The surgeon removes the left side of the tail and body of the pancreas. The spleen is removed too if it is required.
3. Treatment of cancerous blood vessels just next to the pancreas
They remove and reconstruct blood vessels if the condition affects other blood vessels in the area.
Thereafter you are likely to vomit if you have challenging cases of digestion and emptying of your stomach.
Surgery is a lengthy process with recovery lasting for a long time. Several days of staying in the hospital after surgery and up to multiple weeks of post-operative care might be important.
Chemotherapy is used to eliminate cancer cells. It is used in advanced stages of cancer or after surgery to eliminate the growth of cancerous cells.
In chemotherapy, drugs are used to kill cancerous cells. It is either given orally or in a vein.
Pancreatic Arterial Infusion (PAI) chemotherapy at the same time can give more drugs to the pancreas without combining with other organs and has lower drug side effects than systemic infusion.
This is already the therapeutic approach tested in different types of tumors for example primary and metastatic liver cancers with some promise. Considering PAI in advanced pancreatic cancer, some trials in humans have shown good safety and preliminary effectiveness of PAI.
In radiation therapy, a high-energy beam is used to eliminate the growth of cancer cells. It is often used before or after surgery to reduce cancer growth.
High radiation beams like X-rays and protons are used for treatment.
Nowadays protons are used to eliminate cancer cells. Proton beams cause lower side effects than traditional X-ray beams.
Radiofrequency energy usage for the control of solid organ malignancies is in practice. Specifically, Radiofrequency Ablation (RFA) has been used more frequently due to its ability to offer a palliative intervention for patients with unresectable pancreatic cancer. RFA has tumor-killing effects via various mechanisms including denaturing of proteins and enhancing anticancer immunity.
Palliative care is often used as a form of treatment that aims at easing the distress that the patients may be experiencing. It assists in enhancing the health of the patient by making them feel comfortable at any given time. It is also used together with other treatments to make the patients feel better and should be used to increase the lifespan of the patients.
Supportive care can reduce the side effects of chemotherapy. It can also significantly improve the mental and physical health condition of the patient by making the patients do regular exercise.
Targeted therapy specifically targets a particular protein in the cancer cell which is helping the cancer cell to divide and grow. Destruction of pancreatic cancer cells by targeted therapy can be used as a maintenance therapy (ongoing cancer treatment after sessions of chemo and radiotherapy) or in combination with radiotherapy or chemotherapy.
Latest advancements in pancreatic cancer treatment options in India
There are certain advanced techniques which can successfully treat tumours, which are inoperable by conventional surgical techniques. These latest advancements require the skillfulness of surgeons or need clinical testing on a large number of patients. The surgical procedures are performed or inclinical interventions are done when there are few choices left for treating the case.
In this technique, the tumour is first frozen and then thawed using cryoprobes. The procedure is done along with an ultrasound or CT guidance and the inoperable tumors are destroyed. The temperature for freezing the tumours is generally reduced to a temperature as low as -160 degrees.
In CyberKnife treatment, high-dose radiation is provided with a robotic system. Another advantage of this treatment is that the number of sessions is much less as compared to conventional radiotherapy.
This treatment is based on irreversible electroporation of cell membrane ( cancer cell membrane is irreversibly damaged by making pores on it).
This is also a minimally invasive treatment carried out by robotics. This treatment has received some degree of success in renal cancer, prostate cancer, and pancreatic cancer patients.
Stage-wise pancreatic cancer treatment in India
Pancreatic cancer can be managed depending on the phase it has reached. The first two or three stages can be surgically managed while the rest cannot. In addition, some stage-IV pancreatic cancer cases are identified to be incapable of being operated upon.
At this stage, many tumours are either localized or locally advanced and most are still technically removable by surgical resection. Pancreaticoduodenectomy or Whipple operation is the type of pancreatic surgery that is done in this stage.
Preoperative treatment is sometimes offered to patients with pancreatic cancer who have b