Treatment of Pancreatic Cancer

Pancreatic cancer (ICD C25) affects the organ itself or its ducts.

According to statistics, only a small percentage of patients with pancreatic cancer have a 5-year survival rate. The disease is further complicated by the fact that malignant neoplasm is rarely detected at an early stage.

Content

1. What are the symptoms of pancreatic cancer?
2. Pancreatic cancer types
3. Treatment options
4. Whipple surgery for pancreatic cancer
5. Treatment of pancreatic cancer with metastases
6. Stage 4
7. Pancreatic cancer: can it be cured?
8. How to choose the best hospital for treatment abroad?
9. Prices
10. Treatment abroad with Booking Health

What are the symptoms of pancreatic cancer?

Well, the main symptoms of pancreatic cancer can be divided into three groups: obstruction, compression, and intoxication.

Obstruction (blockage) happens when the tumor increases in size, which blocks the pancreatic duct, common bile duct, duodenum and compresses the splenic vein. This is what causes the development of biliary hypertension and, as a consequence of obstructive jaundice, renal and hepatic failure. Compression develops due to nerve suppression that the tumor causes. And intoxication occurs due to "waste products" of cancer cells activity in the tissues and blood.

In this regard, the main symptoms of pancreatic cancer are:

• Pain
• Obstructive jaundice
• Itchy skin (manifests itself based on jaundice due to irritation of skin receptors with bile acids)
• Weight loss (belongs both to intoxication symptoms and symptoms of digestion disorders)
• Inability to eat normally, due to nausea, heartburn, and possible bowel dysfunctions
• The development of diabetes, an enlarged spleen, an enlarged gallbladder

Pancreatic cancer is insidious: often the first symptoms appear only in the late stages when the tumor suppresses the neighboring organs.

Pancreatic cancer types

Specialists identify several pancreatic cancer types. About 90% of all pancreatic cancer types originate in exocrine cells (neoplasms of the mucus-secreting gland).

There are such pancreatic cancer types as neuroendocrine tumors, manifesting as bronchial spasms, intestinal ulcers, and fibrosis. These types of pancreatic cancer are also referred to as islet cell cancers. About 5% of all types of cancer of the pancreas are considered neuroendocrine tumors.

Treatment options

Pancreatic cancer treatment is carried out in a combined course, using several methods at once.

The pancreatic cancer treatments are:

• Surgery implies not only the resection of affected part of the organ itself but also the lymph nodes adjacent to it, a duodenum section, and stomach affected by the process. Surgery isn’t indicated for pancreatic cancer with metastases.
• None-radical surgery. Typically, these are endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, and the anastomosis.
• Chemotherapy. Chemotherapy is applied both as an independent method and as an additional method before and after surgery. In the case of preoperative chemotherapy, the main goal is to reduce the size of the tumor; postoperative chemotherapy helps to get rid of the remaining cancer cells to prevent the tumor from spreading.
• Radiation therapy. It is also indicated in the postoperative period to prevent the development of new foci of cancer. Unlike chemotherapy, which also affects healthy cells, radiation treatment is directed more locally, which avoids damage to other organs and cells.
• Hormone therapy. The use of hormonal correction drugs gives a good result since the tumor cells are sensitive to certain hormones.
• Pancreatic cancer vaccines. They are used to increase life expectancy and reduce the risk of disease recurrence.

Radiotherapy and chemotherapy serve as palliative treatments to relieve symptoms and pain.

Unfortunately, very often, pancreatic cancer is detected at a later stage of development, but even then, there are ways to prolong life and advance its quality.

Whipple surgery for pancreatic cancer

At the onset of pancreatic cancer surgery is leading method of therapy. Doctors turn to certain options of it:

• PDR (pancreatoduodenal resection, Whipple surgery)
• Total pancreatectomy

These interventions are performed in the form of open access surgery or with minimally invasive surgery. 

Whipple surgery is traditionally indicated for pancreatic oncology. During the intervention, the head of the gland, the gallbladder, sometimes with certain and intestinal parts are excised. Then doctors connect the remaining ends of the intestine and suture pancreas to them. Whipple surgery is performed under general (often endotracheal) anesthesia and takes 4 – 5 hours.

Whipple surgery for pancreatic cancer is very difficult to perform. To perform it successfully, the surgeon must operate on 15 – 20 such patients annually. But even in this case, due to complex nature of the surgery, 5% of people die. If the surgeon doesn’t have enough experience, the mortality rate is 15%.

In the extended Whipple surgery for pancreatic cancer of part of the stomach is possibly to be removed as well.

Treatment of pancreatic cancer with metastases

So, which symptoms are indicative to pancreatic cancer with metastases?

The symptoms of pancreatic cancer with metastases can be varied. Common symptoms of pancreatic cancer with metastases are lack of energy, ascites, nausea and subsequent weight loss. Very often, patients notice discomfort in the lower back, which is similar to sciatica.

Pancreatic cancer with metastases in the lungs can spread to pericardium, and bronchi. Then the main symptoms will be coughing, hemoptysis, and chest pain.

The pancreatic cancer treatment will be based on the morphological type of the neoplasm, and the degree of its differentiation.

Surgery belongs to radical cancer treatments and, therefore, it might not always be prescribed. Although, sometimes, palliative surgery is conducted to alleviate the general condition and prolong life if possible.

During radiation therapy with the help of high-precision equipment, the neoplasm and metastases are irradiated. Radiotherapy treatments do not require anesthesia and subsequent recovery period, are carried out on an outpatient basis, that is, there is no need for a stay in hospitals, and are considered painless treatments.

Stage 4

In stage 4 pancreatic cancer, many body structures are affected. This stage 4 lung cancer manifests itself as:

• Pain sensation in the lower back or abdomen
• The patient losing weight dramatically
• Jaundice
• Vomiting

Sometimes stage 4 pancreatic cancer provokes an excessive production of insulin accompanied by tremors and general weakness.

When doctors prescribe stage 4 pancreatic cancer treatments, they usually don’t count on the neoplasm to be gone. Surgical treatment for pancreatic cancer is impossible most of the time. Even if only one metastasis is found, there’s a probability that there are already many of other undetected ones.

Thus, chemotherapy is one of the leading stage 4 pancreatic cancer treatments.

In some stage 4 pancreatic cancer treatments or regimens, radiation therapy is prescribed along with chemotherapy. It’s more effective, but fraught with more pronounced side effects.

Coping with undesirable clinical signs and complications is another area that should be managed.

Palliative cancer treatments for stage 4 pancreatic cancer may include the following procedures:

• Pain management with non-narcotic or narcotic analgesics.
• Supportive therapy that helps to cope with side effects and better reschedule chemotherapy.
• Fight against exhaustion. The doctor evaluates the patient's nutritional status and prescribes an optimal diet.
• Restoring the patency of the stomach by creating an anastomosis: a section of the intestine is sutured to the wall of the stomach and a hole is formed between them.
• Fight against ascites.

Pancreatic cancer: can it be cured?

Well, the answer is yes, but there are a lot of "ifs":

• Yes, if experienced surgeons are involved in cancer treatments.
• Yes, if hospitals can provide adequate chemotherapy and radiation therapy.
• Yes, if the disease is detected early. The prognosis for stage 3 is worse, but even with it, a cure is possible.

The prognosis is significantly improved with highly differentiated cancer. Palliative cancer treatments are also important for patients, they can significantly alleviate the condition, reduce excruciating pain and slow the progression of the disease.

How to choose the best hospital for treatment abroad?

Choosing the right hospital for treatment abroad is vital.

Medical statistics show the following relationship between the flow of patients and outcomes of treatments: the threshold of safe performance of the pancreatic removal is 22 operations per year. That is a surgeon, which, at least twice a month, conducts such treatments, reaches a sufficient level of testing of surgery techniques to change statistical trends.

Hospitals for cancer treatment abroad are difficult to choose. Many hospitals declare that they are the best in the area. With that in mind, hospitals for pancreatic cancer treatment abroad should meet the following criteria:

• Experience and qualifications of doctors
• Equipment and specific treatments available in hospitals
• Type of hospitals
• Specialization of hospitals
• Certificates and awards of hospitals

Feel welcome to visit a page on the Booking Health webpage, dedicated to the hospitals, to learn more about the services they provide.

Prices

Each country has its own pricing policy for treatments, so an estimate for alike services in different countries may differ. Besides, a large, well-established clinic, as a rule, has a price list with higher prices than an average hospital. In some countries it is customary to accept payment in advance; in other countries, payment is either partial, or its calculation is made already upon receipt of medical services. The approximate prices are:

• The cost of chemotherapy for pancreatic cancer is between 7,380 EUR and 12,100 EUR.
• The cost of chemotherapy and radiotherapy for pancreatic cancer is between 30,300 EUR and 45,800 EUR.
• The cost of the Whipple procedure for pancreatic cancer is between 26,400 EUR and 55,600 EUR.
• The cost of segmental pancreas resection for pancreatic cancer is between 26,500 EUR and 55,800 EUR.

The average price of oncological rehabilitation after pancreatic cancer treatment is 1,190 EUR per day, the minimum price is 1,041 EUR per day, and the maximum price is 1,553 EUR per day.

Treatment abroad with Booking Health

Booking Health values health and life above all else, knowing how valuable the time is, therefore we offer only proven hospitals for you to choose from.

Booking Health offers:

• Low prices in comparison with other similar offers, because we work directly with the best medical centers in the world.
• Individual approach. The selection of clinics and specialists is carried out in accordance with the medical requirements and wishes of the clients.
• For the period of stay in the country, we provide full support.

By entrusting Booking Health you will not only save your time, but you’ll also be protected from unprofessionalism, unscrupulous intermediaries, overpayments, and disappointments. You’ll be able to focus on the most important thing – your recovery. Booking Health takes upon itself all the nuances of organizing treatment abroad.

The employees of our company, having extensive experience in organizing medical tourism, and will organize your treatment abroad in such a way that upon returning home you feel truly healthy and at full of strength.

Fill in the request form on Booking Health, and a medical advisor will contact you.

Authors: 

The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

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Sources:

National Cancer Institute

Cancer Support Community

Healthline