Pancreatic Cancer Treatment in India: The pancreas is the tenth most common site of new cancers, but pancreatic cancer is the fourth leading cause of cancer deaths among men and women, being responsible for 6% of all cancer-related deaths.

Pancreatic cancer is notoriously difficult to diagnose in its early stages. At the time of diagnosis, 52% of all patients have distant disease and 26% have regional spread. The relative 1-year survival rate for pancreatic cancer is only 24%, and the overall 5-year survival is 5%.

What is Pancreatic Cancer and Treatment in India

What is Pancreatic Cancer?

Pancreatic cancer begins in the tissues of your pancreas — an organ in your abdomen that lies horizontally behind the lower part of your stomach. Your pancreas secretes enzymes that aid digestion and hormones that help regulate the metabolism of sugars.

Pancreatic cancer often has a poor prognosis, even when diagnosed early. Pancreatic cancer typically spreads rapidly and is seldom detected in its early stages, which is a major reason why it’s a leading cause of cancer death. Signs and symptoms may not appear until pancreatic cancer is quite advanced and surgical removal isn’t possible.

Cancer is an uncontrolled growth of abnormal cells that form tumors, damage normal tissue, and that may eventually spread (metastasize). Most (95%) pancreatic cancers develop in the pancreatic ducts and sometimes develop in the enzyme-producing cells of the exocrine pancreas. Endocrine pancreatic tumors are usually less aggressive than exocrine tumors and are rarer. They may be benign tumors that do not metastasize, such as insulinomas, or malignant, including a group of cancers called islet cell cancers. They often are detected earlier than exocrine cancers because they tend to produce excessive amounts of the hormones insulin and glucagon.

Causes of Pancreatic Cancer:

Scientists still do not know exactly what causes most cases of pancreatic cancer, but they have found several risk factors that can make a person more likely to get this disease. Recent research has shown that some of these risk factors affect the DNA of cells in the pancreas, which can result in abnormal cell growth and may cause tumors to form.

The cause of Pancreatic cancer has still not be officially declared but it is believed that continuous torture to the body with the food we intake and improper lifestyle plays a great role. Here are some of the causes – 

  • Smoking
  • Alcohol consumption
  • Advanced age
  • Chronic Indigestion 
  • Diabetes
  • Hereditary

Pancreatic Cancer Symptoms:  

Diagnosis of pancreatic cancer at an early stage is quite difficult and rare too. The symptoms of the early stages of pancreatic cancer are subtle and nonspecific.  Below you will find some of the most common pancreatic cancer symptoms:

  • Yellowing of the Skin and Eyes– Jaundice, a condition marked by the yellowing of the skin and eyes commonly occurs in people pancreatic cancer. It occurs when an increased level of bilirubin is in the blood. This can occur when a tumor completely or partially blocks bile ducts, slowing the flow of bile. 
  • Abdominal Pain– Abdominal pain is common symptom of pancreatic cancer. It usually occurs on the upper abdomen and may even radiate to the back. Abdominal pain may worsen when lying down or 3 to 4 hours after eating. 
  • Unintended Weight Loss- While losing weight without trying may welcomed by many, but it can indicate something is wrong. Again, unintended weight loss is a common symptom of pancreatic cancer and one that is usually one of the first symptom experienced along with abdominal pain. Weight loss is common in many types of cancer and other benign conditions.
  • Nausea/Vomiting– Again, another vague symptom of pancreatic cancer that is common among many other conditions. Non-specific symptoms, like nausea, often result in a delay in a pancreatic cancer diagnosis. 
  • Loss of Appetite- Appetite loss is a symptom of hundreds of diseases and conditions, including pancreatic cancer. It can signal something severe or even be related to something as small as a stomach virus. When symptoms are vague like this, medical tests are necessary to make an accurate diagnosis. 
  • Itchy Skin– Itchy skin is a less common symptom of pancreatic cancer. Again, a vague symptom, but when coupled with another symptom like abdominal pain or jaundice, it can be significant in making a more accurate, timely diagnosis. Unfortunately, when someone with undiagnosed pancreatic cancer is experiencing itchy skin, it is often misdiagnosed as a dermatological condition.
  • Unexpected Onset of Diabetes– In some cases, pancreatic cancer may impede the pancreas’ ability to produce insulin, resulting in diabetes. It is important note that most people develop diabetes because of reasons unrelated to pancreatic cancer. 
  • Changes in Stool and Urine Color– Urine may become much darker, while stools loser their brown color, becoming a pale, clay color. This is often due to the bile duct being blocked. Stools can also have a odd, strong smell. Unsure of what your symptoms may be? Try the Symptom Checker to see what your symptoms could mean.

How is Pancreatic Cancer Diagnosed?

In order to diagnose pancreatic cancer, physicians will request a complete physical exam as well as personal and family medical histories. The way in which the cancer presents itself will differ depending on whether the tumor is in the head or the tail of the pancreas. Tail tumors present with pain and weight loss while head tumors present with steatorrhea, weight loss, and jaundice. Doctors also look for recent onset of atypical diabetes mellitus, Trousseau’s sign, and recent pancreatitis.

Several imaging techniques are employed in order to see if cancer exists and to find out how far it has spread. Common imaging tests include:

  • Ultrasound – to visualize tumor
  • Endoscopic ultrasound (EUS) – thin tube with a camera and light on one end
  • Abdominal computerized tomography (CT) scans – to visualize tumor
  • Endoscopic retrograde cholangiopancreatography (ERCP) – to x-ray the common bile duct
  • Angiogram – to x-ray blood vessels
  • Barium swallows to x-ray the upper gastrointestinal tract
  • Magnetic resonance imaging (MRI) – to visualize tumor
  • Positron emission tomography (PET) scans – useful to detect if disease has spread

The only absolute way to make a cancer diagnosis is to remove a small sample of the tumor and look at it under the microscope in a procedure called a biopsy. A fine needle aspiration (FNA) biopsy is the most commonly used method. A thin needle is inserted into the pancreas through the skin, and the pathologist uses CT scan or ultrasound images as a guide. Another type is the brush biopsy performed during ERCP to gather cells. A laparotomy is sometimes ordered to determine the stage, or extent, of the disease because it provides access to a large part of the abdominal cavity.

Treatment for Pancreatic Cancer:

Treatment of pancreatic adenocarcinoma depends on the stage of the tumor. All patients should be evaluated for surgical removal of the tumor since this provides the best option for long term survival. The determination of respectability of the cancer is made after a complete workup of the extent of the tumor. Doctors do not biopsy the tumor prior to the surgery since pathology of biopsy specimens can be erroneous in up to 20% of patients due to sampling errors.

f the doctor finds pancreatic cancer, the patient will have more tests to find out if the cancer has spread from the pancreas to the tissues around it or to other parts of the body. This process of testing is called staging, and it helps the doctor plan the patient’s treatment. The following stages are used to describe exocrine cancer of the pancreas:

  • Stage I: Cancer is found only in the pancreas itself and not in other organs.
  • Stage II: Cancer has spread to nearby organs, such as the duodenum or bile duct, but has not entered the lymph nodes.
  • Stage III: Cancer has spread to lymph nodes near the pancreas. The cancer may or may not have spread to nearby organs.
  • Stage IVA: Cancer has spread to organs, such as the stomach, spleen, and colon that are near the pancreas but it has not spread to distant organs, such as the liver or lungs.
  • Stage IVB: Cancer has spread to organs, such as the stomach, spleen, or colon that are near the pancreas or to places far away from the pancreas, such as the liver or lungs.
  • Recurrent: The cancer has come back (recurred) after it has been treated. It may come back in the pancreas or in another part of the body.

Islet cell cancers of the pancreas are usually grouped into three stages: those occurring in one site within the pancreas; those occurring in several sites within the pancreas; and those that have spread to lymph nodes near the pancreas or to distant sites.

Treatment Options:  

Surgery: Surgery to remove the tumor offers the best chance for long term control of all types of advanced pancreatic cancer.

Pancreatic Cancer Surgery Before After
Pancreatic Cancer Surgery Before After

In general, a tumor can be removed with surgery if it has not spread (metastasized) beyond the pancreas and does not involve major blood vessels. About 15% or about 1 out of 7 of advanced pancreatic cancers can be surgically removed at the time of diagnosis. This can be done if the tumor is small and has not spread to other areas of your body.

Radiation: Uses X-ray beams to shrink the tumor. Radiation may destroy cancer cells remaining after surgery. Radiation may be given alone or with chemotherapy or other treatments. The chemotherapy drugs most commonly used with radiation therapy are fluorouracil (5-FU) and gemcitabine.

Chemotherapy: Drugs used to destroy or slow the growth of cancer cells.

Targeted Therapy: Designed to affect only certain cancer cell activities. Helps slow the tumor growth and destroy cancer cells.

Follow up & Recovery:  

Follow up care after pancreatic cancer treatment is an important part of the overall treatment plan. Patients should not hesitate to discuss followup with their doctor. Regular checkups ensure that any changes in health are noticed. Any problem that develops can be found and treated. Checkups may include a physical exam, laboratory tests, and imaging procedures.

Pancreatic cancer patients and their families may need to work with an occupational therapist to overcome any difficulty in eating, dressing, bathing, using the toilet, or other activities. Physical therapy may be needed to regain strength in muscles and to prevent stiffness and swelling. Physical therapy may also be necessary if an arm or leg is weak or paralyzed, or if a patient has trouble with balance.

Between scheduled appointments, people who have had cancer should report any health problems to their doctor as soon as they appear.

COUNTRY
COST
India
$ 4,500
Singapore
$ 6,500
USA $ 15,000

Cost of Pancreatic cancer treatment Surgery in India

The cost of getting the Pancreatic cancer treatment surgery done in countries like USA and UK is very expensive whereas in India, this can be done at less than half the cost and the patient gets the best possible treatment available. Significantly low cost of pancreatic cancer surgery in India is one of the main reasons why this destination is growing popular. Cost of medical care is a fraction of the cost in the US, Canada or Europe (60 to 80 percent less).

Cost of Pancreatic cancer treatment Surgery in India

Pancreatic Cancer Treatment in India

Pancreatic cancer Surgery in India is used to remove all or part of the pancreas. If a cancer has not metastasized, it is possible to completely cure a patient by surgically removing the cancer from the body. After the disease has spread, however, it is nearly impossible to remove all of the cancer cells. There are three main surgical procedures that are used when it seems possible to remove all of the cancer:

  • Whipple procedure: the pancreas head, and sometimes the entire organ, is removed along with a portion of the stomach, duodenum, lymph nodes, and other tissue.
  • Distal pancreatectomy: the pancreas tail is removed, and sometimes part of the body, along with the spleen. This procedure is usually used to treat islet cell or neuroendocrine tumors.
  • Total pancreatectomy: The entire pancreas and spleen are removed. Although you can live without a pancreas, diabetes often results because your body no longer produces insulin cells.
  • Palliative surgery is also an option when the cancer in the pancreas cannot be removed.

Why India? Indian corporate hospitals are at par with the best hospitals in Thailand, Singapore, etc so India is becoming a preferred medical destination for the treatment of Pancreatic cancer therapy. In addition to the increasingly top class medical care, a big draw for foreign patients is also because of the very minimal or hardly any waitlist to follow for the treatment as is a common case in European or American hospitals. Many doctors in India have gained their training from abroad and these surgeons are attached to some of the best hospitals that are at par with those in the west and are attracting many international patients to India for their treatment. The Indian health and medical industry is large and boasts some well developed infrastructure, particularly in big cities such as Chennai, which support the wealthy classes.

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