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Pancreatic cancer is a complex, rapidly progressive disease. This disease may not manifest itself until the last stages. Despite the fact that pancreatic cancer is only 10th in the world in terms of its spread yet many more people die from it than from many other types of cancers. According to statistics, pancreatic cancer ranks 4th among all oncological diseases in terms of its mortality rate. So how effective is the fight against it?
READ IN ARTICLE:
Surgical treatment of pancreatic cancer
Chemotherapy and radiotherapy for pancreatic cancer
Non-surgical methods of pancreatic cancer treatment: Nano-Knife
Types of operations for pancreatic cancer
MAIN METHODS OF TREATING PANCREATIC CANCER
SURGICAL TREATMENT OF PANCREAS CANCER
The gold standard of cancer surgery for the head of the pancreas is surgery by the Whipple technique. During which surgical removal of the part of pancreas along with the part of stomach, duodenum and gallbladder is performed.
Cancerous process can affect the nearby lymph nodes, so these are also subject to resection. Whipple operation is possible with operable type cancer of the head of the pancreas for 1, 2, rarely 3 stages.
If malignant neoplasm is localized in the tail of the gland, distal pancreatectomy is performed. The operation consists of resecting the body and tail of the organ. If the cancer has affected the spleen, then it should also be resected. In addition, resection of the kidney, adrenal gland, diaphragm and other organs can be performed if affected by oncoprocess.
HOW THE METHOD OF TREATMENT IS CHOSEN?
The choice of a method for curing pancreatic cancer will depend on whether the tumor is operable or not. As a rule, surgical removal of the neoplasm is possible in 1, 2 stages, less often in 3 stages (if large vessels and nerves are not affected). However, everything is determined strictly by the results of the diagnostic, which provides information about the localization of the tumor and its effect on other organs.
CHEMOTHERAPY AND RADIOTHERAPY IN PANCREATIC CANCER
An effective method of therapy for pancreatic cancer is recognized as chemotherapy. It is prescribed before surgery to reduce the size of the tumor, and after – to remove residual cancer cells and reduce the risk of recurrence. Chemotherapy can also be the main method of treatment in the case if the tumor can not be surgically removed. In addition, chemotherapy is used to enhance the effect of radiation therapy. When combining radiotherapy and chemotherapy drugs, the dosage of the later is significantly reduced, thereby reducing the number of side effects.
Radiotherapy for pancreatic cancer can be performed both, before surgery (to reduce the size of the tumor) and after (to reduce the risk of relapse). Radiation therapy is also prescribed for locally advanced pancreatic cancer. To carry out this type of therapy, external exposure devices are used, for example, Cyber Knife. The Cyber Knife is available in all leading medical institutions in Germany, Israel, Turkey.
NON-SURGICAL TREATMENT OF PANCREATIC CANCER
Modern medicine knows non-surgical methods of treating pancreatic cancer. In the top clinics of Germany and Israel, with inoperable pancreatic cancer (due to the proximity of the neoplasm to the blood vessels), and in advanced stages of the disease, the tumor is removed with the help of Nano-Knife.
In order to perform treatment with this device, the doctor must have a special certificate. Until now, only few doctors in the world have mastered the technique, namely 3 surgeons in Israel, 2 in Germany and another in Switzerland.
The certified surgeon with Nano Knife is the leading surgeon of the Sheba clinic – Yuri Goldis, the doctors of the Assuta clinic – Riad Haddad and Dr. Marat Khaikin, the German specialist of the Helios Hospital-Matthias Birt, and the Swiss doctor of the Hospital Hirslanden -Hani Oveira.
Innovative technology involves the use of short pulsations of high-voltage electric current on cancer cells. Due to this, perforation of their membrane occurs, and the tumor is destroyed.
The feature of this method lies in the fact that healthy tissues remain safe. In this case, the impact is possible even on those tumors that are located in hard-to-reach places or close to important organs of the digestive tract. Removing the tumor with Nano Knife can also be possible in case of its contact with the portal vein (leads the blood from the intestine to the liver).
Nano-Knife brought real change in treatment for pancreatic cancer in stage 4. Thanks to such therapy, the percentage of five-year survival of patients with pancreatic cancer stage 4 is increased to 16% (from 1%). Today, doctors are able to prolong the patient’s life and significantly improve its quality, thanks to the use of this technology in the therapy of pancreatic cancer with metastases to the liver. Nano-Knife has opened up radically new possibilities of therapy in the last stages.
OPERATION IN PANCREAS CANCER
Pancreatic cancer at the operative stage, according to statistics, is diagnosed in 15-17% of patients. These are the people who managed to detect the tumor, when it is still located within the body, does not affect important veins and arteries and also did NOT metastasize. If the neoplasm is in the head of the pancreas,which on an average is for about 60% of the cases then it can be possible to perform Whipple’s operation.
This procedure is classified as complex, during surgery it is important to remove not only the head of the pancreas but also the duodenum, part of the stomach, as well as the gallbladder, surrounding lymph nodes and the bile duct. Further the surgeon needs to restore as much as possible GIT and bilious ways. The operation can be performed by the classical method of open surgery or laparoscopically. Often during laparoscopic surgery, the surgeon decides whether to continue laparoscopically or witch to an open surgery. Complete recovery of the patient after an open surgery occurs no earlier than few months.
It is very important that an experienced surgeon operates as the results directly depends on his qualification. Some of the best specialists with many years of experience in this field work in Israel and Germany. In the Israeli clinic Ichilov, a physician with more than 40 years of experience is practicing – Professor Joseph Klausner. In the German hospitals Helios and Nordwest, Professor Matthias Birt and Professor Thomas Kraus, respectively, are working, who are the best specialists in Europe in visceral surgery.
It is important to understand that surgical treatment alone is effective only by 25%. The risk of recurrence is high after the surgical intervention, therefore, chemotherapy and / or radiation therapy are usually performed additionally. Combination therapy increases the percentage of five-year survival in the І-ІІ stages to 61% and 52%, respectively.
Another operation for pancreas cancer is pancreatectomy. There are two types of pancreatectomy – distal and total. Total pancreatectomy is rare. Distal pancreatectomy is prescribed for those 40% of patients whose malignant neoplasm is localized in the tail and body of the pancreas. The operation involves their removal. When the cancer spreads to the spleen, then it is also removed, if the tumor has invaded the stomach, kidney or diaphragm then those might be resected as well. In order to reduce the size of the neoplasm, chemotherapy or radiation therapy before the intervention is usually prescribed.
Pancreatectomy refers to the category of complex operations, so it is extremely important to contact a qualified specialist. One of the best visceral surgeons, specializing in the surgical treatment of pancreatic cancer is Professor Wolfgang Schwenk practicing in the City Hospital of Solingen. Among the leading surgeons of the clinic is also worth mentioning Professor Martin Krusevski.
For detailed information on modern methods of treating pancreatic cancer, leave a query on the site and the MediGlobus specialist will answer all your questions.
