Pancreatic cancer has attracted media attention as many celebrities have been victim to this dreaded disease. Steve Jobs, Nargis Dutt, Patrick Swayze and late Goan CM Manohar Parrikar have all died of this cancer. Despite the attention there has not been much awareness about it. Pancreas is a deep-seated abdominal organ. Functionally, it is a mixture of endocrine and exocrine glands, secreting insulin and digestive juices, respectively. In fact, a common medical emergency, acute pancreatitis is a life-threatening disease, wherein pancreatic secretions leak and digest the organ itself as well as surrounding structures.Cancer of the pancreas is a rare but an aggressive disease. This is eleventh most common cancer in the world. Despite growing medical and technical advancement, pancreatic cancer is difficult to diagnose because of pancreas being seated deep in the abdomen and silent nature of the disease in the beginning. As pancreas is surrounded by important complex internal structures, its cancer is difficult to be surgically resectable, making the treatment more difficult. Diagnosis is difficult in the early stages because biopsy is tedious due to pancreas’ location in the stomach plus it is a sensitive, delicate and vital organ. Even after detecting and confirming the diagnosis, it is a very resistant disease with very poor response to available modalities. According to global statistics, this cancer is almost always fatal, being the fifth biggest cancer killer. More importantly, as its occurrence rates are increasing worldwide, death rates are also rising in parallel. It is in contradiction to most other cancers, where better treatment modalities have improved the survival rates. Nevertheless, early detection definitely offers better chances of cure and survival.
Like every other cancer, it is an abnormal unwanted growth of defective cells, which cause local damage by pressure effect and to the rest of the body by distant spread and release of harmful substances.
Diagnosis
Imaging scans to see the extent of the disease and needle sampling (biopsy) to confirm the type of cancer. There are other supportive blood tests to see fitness for treatment and disease complications.
Management
A multipronged approach is implemented to treat any cancer. Surgery, radiotherapy, chemotherapy and immunotherapy are the basic oncological modalities utilised as per the stage of the disease and physical fitness of the patient. In very few cases, patient is eligible for curative treatment, as most cases present at an advanced stage. Other supportive care modalities include pain control, nutritional support, enzyme supplementation and management of co-existing illnesses.
Chances of survival
There are four stages of pancreatic cancer. Stage I, II, III and IV constitute approximately 20 per cent, 60 per cent, 10 per cent and 10 per cent, respectively. The respective median lifespan for these stages is two years, one year, 10 months and five months, approximately. Pancreatic cancer is a rare, dreaded disease. It can only be prevented, and not cured. However, early detection is the next best possible thing for someone, who has already developed the disease. Awareness about it is vital. Regular or annual medica check-ups, coupled with the availability of high-quality diagnostic infrastructure for common public can lead to timely consultation with a qualified medical oncologist. This in turn can definitely reduce the chances of someone reaching advanced stages of this cancer, which is incurable and hence, fatal. Hence prevention is always better.
Symptoms
These may vary in early stages depending upon whether the cancer initiates from the head or body of the pancreas:
Pain in the stomach, which may be severe, agonising and refractory to oral pain-killers.
Decreased appetite and involuntary weight loss.
Sticky, frothy, greasy, frequent, foul smelling stools.
Yellowness of skin and eyes, if cancer involves head of the pancreas.
Role of screening
It is a rare disease. Universal screening will not be cost effective. It may be required in high-risk familial or hereditary cases.
Prevention
Do not smoke.
Avoid excessive alcohol and coffee consumption.
Say no to western or other unhealthy dietary habits, fast foods.
It is best to follow a traditional Indian diet in which whole grains, millets, pulses, green vegetables, etc. are staple.
