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Dr Harsh Shah is the leading pancreas cancer surgeon in India. He has treated hundreds of patients with pancreatic cancers. He has more than 15 years of experience in treating pancreatic cancers. He specialises in whipple’s procedure & distal pancreatosplenectomy.Â
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Pancreatic cancer happens when normal cells within the pancreas turn into abnormal cells and grow out of control. The pancreas is an organ (6 inch long) that is situated behind the stomach that makes hormones (such as insulin) and juices that help the body break down food. Pancreas is anatomically divided in three parts - Head, Body & tail. Cancer can occur in any part of pancreas.
Pancreas cancer are of various types such as adenocarcinoma, neuroendocrine tumours, cystic neoplasms etc. Out of which adenocarcinoma are the commonest.
Symptoms of pancreatic cancer include pain in upper abdomen which may radiate to the back, reduced appetite & weight loss. Tumour may compress bile duct which can result in jaundice. Sometimes the tumour may block the small intestine, which results in vomiting.
Pancreatic cancer is diagnosed based upon the CT Scan finding of mass in head region or periampullary region of pancreas. EUS(Endoscopic Ultrasound) guided biopsy can confirm the nature of the disease. ERCP(Endoscopic Retrograde Cholangio Pancreatography) is used to place a stent in bile duct if there is a need to reduce the jaundice.
Pancreas cancer is staged with the help of CECT Abdomen. The surgeon may ask for a CT Angiography to look for vascular involvement. In certain clinical scenarios, the surgeon may choose for PET-CT Scan which will scan entire body for tumour evidence. Blood CA 19-9 levels is a helpful marker in a non-jaundiced patient
Pancreas Cancer is staged from stage 1 to stage 4. Stage 1 will have a better survival as compared to stage 4.
Resected pancreatic cancer means operable tumour. The tumour when present in head of pancreas is treated by a surgical procedure called ‘Whipple’s Pancreaticoduodenectomy’. The structures removed are: Head of pancreas along with duodenum, lower bile duct & Gall bladder.
The surgical procedure to remove tumour in tail of pancreas is called distal pancreatectomy or distal pancreatosplenectomy. Spleen is usually removed during the procedure.
Most of the pancreatic cancers are idiopathic (No identifiable cause). Few known causes are smoking, tobacco chewing & alcohol consumption. Sometimes the cancer runs in family.
When the tumour is not surgically operable due to involvement of nearby major vascular structures, the doctor will advise for chemotherapy. After 3-4 cycles of chemotherapy, the tumour will be reassessed with help of CT Scan & decision regarding operation can be taken of postponed.
Metastatic pancreatic cancer means stage 4 cancer. Here, the tumour has spread beyond the pancreas via blood stream. The tumour cells may have been detected in liver, lung or bone.
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