Pancreatic Cancer

The pancreas, an organ in the abdomen behind the stomach, produces both digestive enzymes and insulin. Pancreatic cancer, in spite of arising as a thirteenth cancer worldwide, is the fourth most common cause of death due to cancer. The occurrence and mortality rates of PC have been increasing year by year worldwide, says the best pancreatic cancer doctor in Kolkata. Most pancreatic tumors are exocrine tumors, including acinar cell carcinoma, ductal adenocarcinoma, cystadenocarcinoma, adenosquamous carcinoma, hepatoid carcinoma, signet ring cell carcinoma, undifferentiated carcinoma, colloid carcinoma, pancreatoblastoma, and pancreatic mucinous cystic neoplasm. However, the most common form is the ductal adenocarcinoma that involves moderately to poorly differentiated glandular structures.

Risk factors:

The possible risk factors for PC include gender, age, smoking, alcohol abuse, obesity, physical activities, diabetes, chronic pancreatitis, vitamin D, genetic alterations, dietary, and reproductive factors.

 Diagnosis and Staging:

Early and accurate diagnosis of PC, which often can be challenging, is important because it helps doctors choose the effective and timely treatment option for patients. It is usually based on a combination of imaging techniques such as computer tomography (CT) and endoscopic ultrasonography (EUS), tumor markers such as carbohydrate antigen 19-9 (CA19-9), clinical presentations, and the “gold standard” diagnosis-biopsy.

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Clinical Presentation

Lack of symptoms is the main reason for delayed diagnosis and therapy. Appearance of clinical presentations typically indicates an advanced stage, while the most frequent presentations are anorexia, progressive weight loss, abdominal pain, and sometimes jaundice. These non-specific symptoms of PC are varied in different parts of the pancreas. The tumor located on the head of the pancreas (75%) produces symptoms such as weight loss, nausea, vomiting, and painless jaundice. If cancer is found at the body or tail of the pancreas, people usually present with pain in the abdomen that usually radiates to the sides or the back.

Imaging

Imaging techniques, such as CT, positron emission tomography- (PET-) CT, transabdominal ultrasound (US), magnetic resonance imaging (MRI), and endoscopic retrograde cholangiopancreatography (ERCP), play a crucial role in PC detection and staging.

Chronic Pancreatitis Treatment in Kolkata

The only possibility for curing PC is surgery, though there are only 20% of the patients who have operable PC. The choice of an operative procedure is based on factors such as the size, location, and staging of tumour. The classic Whipple procedure involves removal of the pancreatic head, as well as the gallbladder, curve of the duodenum, and common bile duct. It is the most common operation for cancers of the neck or head of pancreas. When cancer occurs at the body and tail, distal/subtotal pancreatectomy is recommended. Although laparoscopic treatment for pancreatic cancer, laparoscopy in diagnosis and staging of PC is known to be critical, safe, and reliable.

Chemotherapy

For unresectable PC, chemotherapy is now extensively used, including GEM-E, FOLFIRINOX, GemCap, Gem/NabP, and XELOX. PC, however, is characterized by a dense desmoplastic reaction that promotes resistance to chemotherapy.

Radiotherapy

For unresectable PC, little evidence exists to support the efficiency of radiotherapy. It can kill the cancer cells, and keep them from growing and recurring. Data evaluating the use of adjuvant chemotherapy for CC are limited, and for the most part, combine patients with intrahepatic and extrahepatic CC, gallbladder cancer, and ampullary and pancreatic cancer.

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