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Pancreatic Cancer Surgery in India FAQ's
Pancreatic Cancer Surgery in India FAQ's

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Pancreatic Cancer Surgery in India FAQ's

Pancreatic Cancer Surgery in India FAQ's

Pancreatic Cancer Surgery in India FAQ's

Pancreatic Cancer Surgery in India FAQ's

Pancreatic Cancer Surgery in India FAQ's


Pancreatic Cancer Surgery in India FAQ's




Common Question about Pancreatic Cancer

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1.What are the symptoms of Pancreatic Cancer?

Pancreatic cancer usually does not cause symptoms early on. The cancer may grow for some time before it causes pressure in the abdomen, pain or other problems. In many cases, the cancer has spread outside the pancreas by the time it is found. When symptoms appear, they depend on the location and size of the tumor.

If the tumor blocks the common bile duct so that bile cannot pass into the intestines, the skin and whites of the eyes may become yellow, and urine may become dark. This condition is called jaundice. Pain often develops in the upper abdomen and sometimes spreads to the back. Cancer of the pancreas can also cause nausea, loss of appetite, depression, weight loss, and weakness. These symptoms may be caused by cancer or by other, less serious problems. Only a doctor can correctly diagnose the cause of the symptoms. 



2.What diagnostic tests are used to determine the presence of pancreatic cancer?

 There are several different tests that can be used to diagnose pancreatic cancer:
Ultrasonography
This method uses high-frequency sound waves that are above the human audible range. An instrument sends sound waves into the patient’s abdomen, and the echoes that the sound waves produce as they bounce off internal organs creates a picture called a sonogram. Healthy tissues and tumors produce different echoes.
CT scanning Computed Tomography)
This method of testing involves the use of an x-ray machine which is linked to a computer. The patient lies on a bed that passes through a hole, and the machine moves along the patient’s body, simultaneously taking multiple x-rays. The computer then pieces the x-rays together to produce detailed pictures.
ERCP (Endoscopic retrograde cholangiopancretography)
A method for taking x-rays of the common bile duct and the pancreatic ducts. The doctor passes a long, flexible tube called an endoscope down the throat, through the stomach, and into the small intestine. The doctor then injects dye into the ducts and takes x-rays.
EUS (Endoscopic Ultrasound)
This is a test that combines ultrasound(sound waves) with an endoscope. The doctor places the tube (endoscope) into the stomach and the ultrasound machine (which is on the endoscope) is used to direct sound waves to the pancreas. This test is especially useful for detecting small tumors of the pancreas.
MRI (Magnetic Resonance Imaging)
This method of testing involves the use of an x-ray machine which is linked to a computer. The patient lies on a bed that passes through a hole, and the machine moves along the patient’s body, simultaneously taking multiple x-rays. The computer then pieces the x-rays together to produce detailed pictures.
PTC (Cholangiogram, Percutaneous Transhepatic)
A thin needle is put into the liver through the skin on the right side of the abdomen. Dye is injected in to the bile ducts in the liver so that blockages in the ducts can be seen on x-rays.



3.What else can be done to diagnose Pancreatic Cancer?

Pictures of the pancreas and nearby organs provide important clues as to whether a person has cancer. However, doing a biopsy is the only sure way for a doctor to determine whether pancreatic cancer is present. In a biopsy, the doctor removes a small tissue sample. A pathologist examines the tissue under a microscope to check for cancer cells. Biopsies can be done by several different methods: CT scan guided, ultrasound guided, ERCP guided, or EUS guided.

4.What can be done for the pain that is associated with Pancreatic Cancer?

There are several ways to control pain. In most cases, the doctor prescribes medication to control the pain. However, in some cases pain medication is not enough. The doctor may use other treatments that effect the nerves in the abdomen. The doctor may inject alcohol in to the area around certain nerves to block the feeling of pain. This procedure rarely causes problems and usually provides pain relief. Sometimes, the doctor cuts nerves in the abdomen during surgery to block the feeling of pain. In addition, radiation therapy can help relieve pain by shrinking the tumor.



5.How is Pancreatic Cancer treated?

Carcinoma of the pancreas can be treated in several different ways. If possible, the doctor will recommend surgery to remove the tumor. In most cases, the type of operation performed is known as a Whipple Operation. This surgery removes a large part of the pancreas, the duodenum and a portion of the bile duct. The patient may develop diabetes mellitus and need to take insulin. Often patients will need to take pancreatic enzyme supplements to prevent fat and protein malabsorbtion which leads to diarrhea, steillarrhea and weight loss.
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6.What can be done if surgery is not possible?

In patients who have cancer that is unresectible (unable to operate on), other options are pursued to relieve the symptoms of the cancer. If the bile duct is obstructed by the cancer, jaundice will develop. The jaundice and obstruction may lead to intense itching, poor appetite, diarrhea, weight loss and fever. It is important to alleviate this jaundice. ERCP with stent placement is the most common method. This involves the use of a flexible tube (endoscope) inserted into the intestine. The doctor then places a stent into the bile duct to allow the flow of bile into the intestine. This stent may be made of plastic or stainless steel. Jaundice may also be relieved by puncturing the liver via an incision within the skin on the right side of the abdomen. A tube (stent) can then be inserted. Surgery may be used to bypass the obstruction of the bile duct in some instances.



7.What about chemotherapy?

In the past, chemotherapy has not been effective in the treatment of pancreatic cancer. Recently, a new agent called gemcitabine has been approved by the FDA to help shrink the tumor in pancreatic cancer. As with all chemotherapy there are side effects which include nausea, vomiting, and decreased white blood cell counts.
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