- decodeMR Team
Pancreatic Cancer - A Basic Understanding
This interview was originally published in www.oncofocus.com on 20th November 2019.
As mentioned in our earlier post, November is also for raising awareness about Pancreatic Cancer. Here is the transcript of our interview with Dr. Sujit Chakraborty, Clinical Oncologist from Hospital Lam Was Ee, Malaysia.
Dr. Sujit Chakraborty is a specialist in Cancer Treatment, mainly in Medical Oncology and Radiotherapy. He has 27 years of experience in treating and managing cancer patients, both surgically and via radiotherapy. He has been actively involved in various Cancer Awareness programs.
Dr. Sujit Chakraborty
Clinical Oncologist, Hospital Lam Wah Ee, Malaysia
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We understand that most cancers are manageable if they are identified at an early stage. So, for someone to get an early diagnosis, what are the early signs and symptoms to look for pancreatic cancer?
Dr. Sujit: Most of the cancers are asymptomatic in their early stages. Diagnosis is made during routine screening or is found incidentally while performing a complete physical examination. Pancreatic cancer often doesn’t cause any signs and symptoms in the initial stages and is hard to diagnose early.
Jaundice is the early sign of pancreatic cancer and can occur when the tumor blocks the bile duct connecting the pancreas to the liver. Depending upon the segment of the pancreas affected, the symptoms will vary. There might be also pain in the upper abdomen as the tumor pushes against the nerves.
What are your suggestions to increase the early diagnosis of pancreatic cancer?
Dr. Sujit: Actually, there is no known precaution. Most pancreatic cancers occur de novo which means without a known risk factor. However, people who drink excessive alcohol have a higher chance of developing pancreatic cancer. Excessive alcohol intake can lead to chronic pancreatitis – a major risk factor for pancreatic cancer.
To diagnose pancreatic cancer, a doctor may advise the patient to undergo imaging tests such as CT scans, endoscopic ultrasound, and blood tests. A biopsy may even be performed. There is no established screening procedure for pancreatic cancer.
In general, who are at risk of developing pancreatic cancer? Is there any specific population that is at risk?
Dr. Sujit: A person is at an increased risk of developing pancreatic cancer if he is a smoker, alcoholic, overweight, diabetic, or has a family history of pancreatitis (inflammation of the pancreas) or pancreatic cancer. There is no known case of pancreatic cancer related to a particular ethnicity.
What are the major types of pancreatic cancer?
Dr. Sujit: The gland pancreas has three main parts: the head, the body, and the tail.
Pancreatic cancer usually occurs in the ducts; some of them in the body of the pancreas. Cancer that affects the body and tail of the pancreas exhibit late symptoms whereas cancer that affects the head of the pancreas exhibit early symptoms as it is close to the duct and can cause obstructive symptoms such as jaundice and abdominal pain.
Pancreatic Neuroendocrine Tumors (PNET) are the most common type of pancreatic cancer that starts in the pancreas. These tumors are curable and have a better prognosis. Adenocarcinoma is the other common cancer of the pancreas.
What is the prognosis? What are the common treatment options (expected development of a disease, signs, and symptoms will improve or worsen (and how quickly) or remain stable over time)?
Dr. Sujit: Surgery is the standard treatment for patients with pancreatic cancer. Whipple's procedure (pancreaticoduodenectomy) is the surgical treatment performed to remove pancreatic tumors and is associated with a better long-term survival rate.
Removing part (partial pancreatectomy) or the entire (total pancreatectomy) pancreas is the only treatment and an effective way to prevent the spread of pancreatic cancer to other parts of the body. Pancreatectomy requires a skilled surgeon and this procedure is associated with several complications. The goal is to restore the function of the GI tract, absolute water-tight anastomosis, and no leakage.
The consequences of pancreas surgery include – patients may require life-long insulin therapy and pancreatic enzyme supplements. Usually, the two-year survival is very low, about 20%-25%.
Other modes of treatment include radiotherapy, chemotherapy, targeted therapy, and supportive care. These treatments have proved to be effective in the early stages of the disease.
Do you foresee any interesting trends in pancreatic cancer?
Dr. Sujit: Monoclonal antibodies are a new mode of treatment for pancreatic cancer. A monoclonal antibody is a laboratory-produced molecule that is carefully engineered to attach to specific defects in cancer cells.
In Malaysia, Tarceva is prescribed for patients with advanced stages of pancreatic cancer.
Thank you for sharing your experience with us! Have a great day ahead.
Dr. Sujit: It is my pleasure