More than 1,300 patients die every day in India due to cancer. More than 70 per cent of these cancers are diagnosed in the population of age groups between 30 to 70 years. Two new cancer cases are detected every two minutes at some part of India. Pancreatic cancer is a disease of elderly, usual age of diagnosis of majority of cases is around 60 years. The incidence of pancreatic cancer in India is 0.5 to 2.4 per 1 lakh men and 0.2-1.8 per 1lakh women. Lots of research is going on and revolutionary drugs were discovered every day across the globe. But slight change was seen in survival rates of pancreatic cancer over time since 1970.
Diagnosis
Majority of pancreatic cancer cases are diagnosed in very advanced stage because patients don’t tend to show any symptom specific to disease until much later, by the time of which the disease has already spread to other organs in the body.
There aren’t any noticeable signs or symptoms in the early stages of pancreatic cancer. Patients usually seek medical attention in advanced stage with some nonspecific symptoms like jaundice, light-coloured stools, dark urine, pain in the upper or middle abdomen and back, weight loss for no known reason, loss of appetite and feeling very tired. The diagnosis of pancreatic cancer requires CT scan, MRI, tumour markers, endoscopy and biopsy which are done at physician's discretion after detailed clinical examination.
Treatment
If the cancer is at an early stage, which is confined within the pancreas and has not spread to the lymph nodes or other areas of the body, then surgery is the treatment of choice. Chemotherapy is a treatment of cancer by using anti-cancer medicines which kill cancer cells or stop them from multiplying. When chemotherapy is used in addition to surgery, it is known as adjuvant chemotherapy. This aims to kill any cancer cells which may have spread away from the primary tumour. However, in advanced stage, surgery will not be possible and chemotherapy with the intent of symptom relief and maintaining quality of life is the only option.
Symptoms
Pancreatic cancer often causes weight loss and weakness from poor nutrition. These symptoms might be caused by treatment or by the cancer itself. So meticulous diet plan with nutritional supplements, as prescribed by doctor, is a must. Exercising, stopping smoking might lower the risk of the cancer growing or coming back, but not proven. Support from friends and family, religious groups, support groups, professional counsellors may be required at some part of the treatment and follow up to cope up with the stress of the patient.
There has been an increase in awareness and better medical facilities, but still there is a wide gap between survival rates for cancer patients between India and most countries. One plausible reason is that cancer in India is diagnosed in later stages resulting in the treatment being complex and the probability of beating cancer at the root level also goes down. This could be due to lack of awareness, sufficient information and socio-economic factors. Genetic constitution of an individual can’t be altered. What can be altered, improved upon is health education. A healthy lifestyle includes active physical activity, keeping body weight in control. Eating more of natural foods, not indulging in smoking, alcohol and drugs are some modifiable risk factors.
The writer is Dr Vineet Talwar Co- Director, medical oncology at Rajiv Gandhi Cancer Institute & Research Centre, Delhi