Cancer in itself is a terrifying diagnosis and out of the various abdominal cancers, Pancreatic cancer is one of the most aggressive cancer. Pancreatic cancer is the 12th most common and the 4th leading cause of cancer-related deaths in the world. In India, the incidence rates of pancreatic cancer are low compared to western countries. In India, the incidence of pancreatic cancer is 0.5-2.4/100,000 persons per year in women – 0.2-1.8/100,000 persons per year in men. However, irrespective of the incidence of the disease, survival in patients with pancreatic cancer is generally very low with the 1-year and 5-year survival rates for all stages being 29% and 7%, respectively. The cause for such poor long-term outcomes is possibly related to the fact that the disease is largely asymptomatic in the early stages and by the time symptoms do develop, the disease is very advanced or has spread to other organs like liver. Only 10-20% of patients have early pancreatic cancer, one that can be removed by surgery.
Risk Factors
The risk factors associated with pancreatic cancer can be both genetic as well acquired. Pancreatic cancer has a familial component in about 10% of cases. The risk increases with the number of first degree relatives involved. Acquired risk factors for pancreatic cancer include cigarette smoking (20% of pancreatic cancer are caused by smoking ), obesity, and diabetes (both type 1 and type 2), Recent and sudden onset of diabetes is an alarming ( increases the risk by 7 folds) feature and should not be ignored. Another factor for pancreatic cancer and one of the most important risk factor for pancreatic cancer in our country is chronic pancreatitis, which should be considered as a pre-malignant condition. Some other important risk factors are heavy alcohol consumption, physical inactivity, high red meat consumption and daily habit of soft drinks
According to Dr Abhimanyu Kapoor, who is a senior Gastro-Intestinal Cancer Surgeon, heading the department of Surgical Gastroenterology at Regency hospital, Kanpur, their is a rising trend in the occurrence of pancreatic cancer in the population. This can be due to the changed life styles habits with above explained risk factors , but the primary cause of concern is to diagnose the disease as early as possible which can reduce the risk and can increase the survival of the patient. The patient with pancreatic cancer usually present with the jaundice, which is often painless and associated with generalised itching all over the body. Other important symptoms include weight loss, abdominal pain, reduced appetite, and recent onset of jaundice. Usually the patients present late to the specialised OPD like GI surgery unit after taking multiple advices, and this can delay the treatment and lead to progression of the disease. For the patients who can be diagnosed early, surgical removal of the pancreatic cancer can lead to complete cure. Dr Abhimanyu Kapoor and Dr Sneha Jha (also a G.I Cancer surgeon) along with their team of doctors at Regency hospital Kanpur is already treating many such cancer patients, the surgery for Cancer of Head of Pancreas is known as Pancreaticoduodenectomy (Whipple’s) procedure. Therefore for the early diagnosis the first and foremost requirement is coming to the good hospital setup where all the investigations (CT scans , PETCT scans, MRI, EUS, ERCP, interventional radiology assessment), treatment and good post operative care as well as intensive care can be given under one roof , as the treatment depends upon multiple factors , including the stage of the condition and spread of the disease. Treating doctor may recommend for the surgery and can also advise for other treatment choices like chemotherapy and radiotherapy. This multi-disciplinary approach in the management of pancreatic cancer can provide good results in this cancer.