Pancreatic Cancer - Which Type Of Surgery Should You Opt For?
Often referred to as silent cancer, pancreatic cancer has little or vague symptoms in the early stages. Unexplained and significant weight loss is a classic symptom during the initial stages along with symptoms such as yellow skin/eyes, itching, dark urine, and abdominal discomfort or pain. Treatment usually involves evaluation of what stage the cancer is in, the complications that are involved and identifying the right surgical method.
The two major types of surgery include potentially curative surgery and palliative surgery.
Curative Surgery
- Studies have revealed that partially removing the affected parts of the pancreas and surrounding areas does not increase lifespan by a substantial amount. Hence, potentially curative surgery is recommended by surgeons only if it is ascertained that the whole cancer can be removed. It is a very complex surgery and the recovery time is substantial. The possible benefits and risks need to be evaluated very carefully before going ahead with this form of treatment.
- Curative surgery is typically preferred to treat cancer that is located in the head of the pancreas since sometimes it can be found early enough to be removed, but the downside is that the method is used only if the entire cancerous growth can be removed.
Palliative Surgery
- If the surgeon finds that curative surgery might not be of help, especially if the cancer has spread too far to be completely removed, the next best option would be palliative surgery. As the name implies, the surgeon would opt for smaller operations aimed at relieving some of the symptoms, this would not cure the cancer as such but would help manage the symptoms.
- Whipple procedure (pancreaticoduodenectomy) is the most common form of surgery adopted to treat cancer located in the exocrine pancreas or pancreatic NETs. The Whipple procedure involves the removal of the head of the pancreas and sometimes even the body as well. The nearby structures including the gallbladder, bile duct, small intestine, lymph nodes and sometimes parts of the stomach may be removed too. Then, they are re-attached to the small intestine to allow the bile and digestive enzymes to pass through the small intestine and finally, the small intestine pieces are re-attached to allow the food to travel through the digestive tract.
- The procedure is highly time-consuming and can take several hours to complete. It requires sufficient surgical experience and skill. The area around the pancreas differs from person to person, making it difficult to perform surgery through the various blood vessels and duct arrangements in the body. If treated at major medical facilities the death rate is under 1%, while in smaller hospitals or if performed by inexperienced surgeons the death rate may be significantly higher.
Hence, when diagnosed with pancreatic cancer, it is generally recommended to go for surgeons who perform many such surgeries each year to get the best possible treatment.
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