Pancreatic Cancer

Pancreatic Cancer

  • Pancreatic Cancer is a disease in which cancerous cell growth occurs in the tissues of the Pancreas.
  • The Exocrine Cells and Endocrine Cells of the pancreas have different type of function and it produces two different types of tumors.
  • Exocrine Pancreas cells produce digestive juices and endocrine pancreatic cells produce the hormones.
  • Pancreatic Cancer ranks 13th and comprises 2.5% of the total cancer patients annually.
  • The death rate in pancreatic cancer stands at around 4.9% as per Globocan 2018.
  • American Cancer Society study suggests, for all stages of pancreatic cancer, the one-year relative survival rate is 20%, and the five-year rate is 7%.
  • Pancreatic cancer has poor prognosis and recently its increasing incidence in India is alarming.

Causes

Signs and Symptoms

  • Symptoms of Progressive obstructive Jaundice –  Tumors of the head of pancreas will cause dark urine, pale stools, skin itching.
  • Obstruction of common bile duct –  It will cause dilatation of the gall bladder.
  • Purpura or Bleeding – Prolonged bile duct obstruction may cause abnormalities of coagulation, due to inadequate vitamin K–dependent clotting factors.
  • Steatorrhoea or Malabsorption  –(Steatorrhoea is the presence of excess fat in feces. Stools may also float due to excess gas, have an oily appearance and can be especially foul-smelling) If the tumour causes extensive replacement of the pancreas, it may cause pancreatic insufficiency with, malabsorption and steatorrhoea and Diabetic Mellitus.
  • Pain in Abdomen – Local invasion of tumor arising in body and tail of pancreas may give rise to severe pain.
  • Palpable Mass – Tumor may be palpable as an epigastric mass due to local extension of tumor.
  • Weight loss and Cachexia etc.

Investigations / Screening

  • Physical Examination and Investigation
  • Biopsy – For confirmation of cancer and type of cells.
  • PET Scan / MRI / CT Scan / Ultra sound – May demonstrate dilated bile ducts or pancreatic mass and guide fine needle aspiration cytology.
  • CA 19-9 Tumor marker – The protein CA 19-9 is secreted by malignant cell from gastrointestinal tumors but very high levels are strongly suggestive of Pancreatic cancer.
  • ERCP – Definitive diagnosis of carcinoma head of pancreas can be obtained by ERCP.
  • Percutaneous transhepatic Cholangiography – It may demonstrate dilated bile ducts.
  • Chest X-ray – to detect metastasis.
  • Blood investigation reports. As per requirement

Treatment

  1. To plan personalised treatment for each individual patient as every individual is different even if they have the same type of cancer.
  2. To improve health related quality of life (QOL) in all types and stages of cancer patients.
  3. To plan for partial or total regression of tumour depending on the nature of tumors.
  4. To increase overall survival (OS) of patients.
  5. To increase disease free survival (DFS) where complete resection of tumour is achieved.
  6. To provide a treatment option to patients who are refractory to conventional treatments like chemotherapy / radiotherapy / immunotherapy etc.
  7. To reduce the rate of growth of the tumor in recurrent and advanced staged cases.
  8. To increase progression free survival in advance cases.
  9. To reduce impact of symptoms related to progression of disease.
  10. To improve confidence of patients.
  11. To provide palliative support in end-of- life cancer cases.
  12. To add happiness and extension of life to cancer patients.
  13. To compliment other therapies like chemotherapy, radiotherapy in a synergistic way.
  14. To reduce severity or adverse effects of other conventional treatment. This reduces incidence and frequency of hospitalization.
  1. It is pertinent to note that Rasayu Cancer Clinic does not claim or blame anything while communicating any aspect to cancer patients.
  2. Rasayu Cancer Clinic focuses on Ayurveda fundamental based therapies.
  3. Rasayu Cancer Clinic believes in continuous improvement in service and science.
  4. Rasayu Cancer Clinic always advocates patient centric approach which leads to long and happy life of cancer patients.
  5. Every patient has a right to choose the therapy.
  6. Rasayu Cancer Clinic never imposes Rasayana therapy on patients but helps them to take the right decision, hence making patients/ relatives well aware about the disease and possible outcomes along with its risk benefit and cost benefit ratios.
  7. Rasayu Cancer Clinic is well connected with global updates in cancer care and therapies, through advisors and collaborations with national and international institutes.

Surgery

  1. Radical Surgery
    After staging and investigations only 10% of patients will be considered suitable for definitive radical surgery called whipple surgery or pancreaticoduodenectomy.
  2. Biliary Bypass
    Operation / Hepaticojejunostomy
    If the tumor is found to be inoperable at laparotomy, the surgeon can perform a biliary bypass operation to relieve the obstructive jaundice. This will typically involve joining the hepatic duct to the jejunum.
  3. Gastroenterostomy
    If there is duodenal obstruction due to large periampullary mass, then gastroenterostomy may performed.
  4. What are the side effects of pancreatic cancer surgery?
    – Click Here

Chemotherapy

  1. Chemotherapy treatment uses medicine to weaken and destroy cancer cells at the original cancer site and any cancer cells that may have spread to other parts of the body.
  2. While destroying cancer cells, it destroys fast dividing normal cells, which further creates multiple side effects. It may have palliative role in this type of cancer.

Radiation Therapy

  1. It is a treatment with high energy rays or particle that kills cancer cells also termed as External beam radiation (Radiation given by machine from outside of body). It may involve External beam radiation or Brachytherapy.
  2. Possible Side EffectsClick Here

Immunotherapy

  1. Efficacy of the treatment is still not clear as per the National Library of Medicine, since there is a need for improved biomarkers.
  2. Cost of this treatment is high and many times does not fit into cost benefit ratio.
  3. Side Effects – Click Here
  4. Risk and Benefits of Immunotherapy – Click Here
  5. Side Effects of Immunotherapy – Click Here
  6. Pancreatic enzyme supplements – It will help in malabsorption.
  7. Vitamin K supplement – It is useful in treating coagulation disorders.
  8. Flurouracil and Gemcitabin – These have been licensed for this situation. However benefit is limited.

Rasayu Cancer Clinic Rasayan Treatment Protocol – To know more please click here

Rasayu Therapy is recommended for those :

  1. Who voluntarily opted for this treatment as their first choice?
  2. Who are disenchanted with the past treatments?
  3. Who do not see any other options of treatments?
  4. Who are looking for personalized treatment plan?
  5. Who desire a convenient home-based oral therapy which is easy to consume?
  6. Who are susceptible to acquire hospital borne infections/ complications, hence not willing to be hospitalised?
  7. Who are looking for favourable risk benefit ratio?
  8. Who desire to improve Quality Of Life benchmarks based on global standards and monitored regularly?
  9. Who are involved in decision making for choice of treatment?
  10. Who are willing to be involved in monitoring the efficacy of Rasayana Therapy?
  11. Who believe in the transparency of the process by conducting regular investigations by biochemical parameters/ hi tech imaging techniques like PET scan etc?
  12. Who are equally sensitive to the patient, the care givers and the family?
  13. Which can be taken with other treatments including Chemotherapy / Radiotherapy?

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