Pancreatic cancer is considered one of the fatal diseases for which the survival rates have not substantially improved over the last forty years. According to a recent fact sheet provided by the Pancreatic Cancer Action Network in the U.S, pancreatic cancer is the 11th and 8th common type of cancer diagnosed in men and women, respectively. The improvement made in the management of pancreatic cancer are mainly related to better quality of life with improved chemotherapy drugs and endoscopic treatment, and safer surgeries by surgeons specialized in pancreatic surgery.
The signs and symptoms of pancreas cancer can be very subtle, often with unexplained loss of appetite or unexplained loss of weight. In the majority of cases, pancreas cancer is detected in the later stages where treatment may not be curative. That’s why pancreas cancer is named the ‘silent cancer
The pancreas performs certain important functions such as secretion of insulin and glucagon hormones (for blood sugar control) along with essential enzymes that help in the digestion and absorption of foods in the intestine.
Four symptoms that are usually noticed in the patients affected with pancreas cancer include:
A CT scan of the patient’s abdomen is done to detect the presence of pancreatic mass
Magnetic Resonance Imaging or MRI Scan:
The test provides a visual depiction of the pancreas as well as pancreatic ducts. MRI scans prove to be particularly useful while planning a surgery.
Endoscopic Retrograde Cholangiopancreatography or ERCP:
In this test, a fiberoptic scope is used to take a look of the stomach as well as the small intestine. Subsequently, an X-ray dye is injected into the pancreatic ducts to take X-rays of the pancreas and check for the irregularities of the pancreatic ducts
In this procedure, small pieces of the tissue are biopsied to establish the nature of the tumour
The treatment of pancreatic cancer may vary depending on which part is affected as well as the stage of the disease. However, surgery is usually considered in early stages of pancreas cancer. The pancreas itself is divided into 3 parts – the head, the body and tail of pancreas. Pancreas cancer surgery may be intended for both preventing and relieving the symptoms. To date, surgical resection remains the only potentially curative option for pancreas cancer.
Typically 2 main types of surgery are used for treating pancreatic cancer, namely:
Whipples procedure, which is also known as Pancreaticoduodenectomy, is performed for tumours in the head of pancreas. The head of the pancreas is removed by a pancreatic cancer surgeon along with the gallbladder, small intestine, stomach, bile duct, and nearby lymph nodes. It is usually considered as a complex operation, which is best performed by an experienced pancreatic cancer surgeon in a hospital.
Distal Pancreatectomy & Splenectomy:
In distal pancreatectomy and splenectomy surgery, the surgeon removes the body of the pancreas and the tail along with the spleen.
Other surgical options may include palliative surgery (bypass surgery). This surgery may be discussed if tests indicate that the tumor is locally advanced and cannot be removed completely. The intent of palliative surgery is to relieve or prevent certain conditions, such as bile duct or intestine blockage by the cancer. Laparoscopic staging of pancreas cancer may occasionally be necessary. In laparoscopy, small cuts are made in the abdomen using a video camera to visualize the extent of pancreas cancer dissemination to adjacent areas as well as other abdominal organs.
Other treatment options may include radiotherapy to relieve pain and chemotherapy as a radiosensitiser to relieve pain in patients with advanced stage of pancreatic cancer.
Pancreatic cancer surgery may result in following complications:
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