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Pancreatic Cancer- The Silent Killer World Pancreatic day
The diagnosis of cancer of the pancreas is difficult and often late. The symptoms are not terribly specific and this is why the diagnosis is often at an advanced stage. Symptoms include jaundice (yellowing of skin and whites of the eyes), light-colored stools, dark urine, pain in the upper or middle abdomen and or back, unexplained weight loss, feeling tired, and poor appetite. With the exception of jaundice and color of stools and urine, none of these symptoms and signs are specific indicators that something is wrong, and even these are often late signs of disease (meaning by the time they occur the cancer is Stage I or greater.) There is one brand new, promising blood marker (GPC1) that may be helpful for detection. The definitive diagnosis requires confirmation by radiologic studies and or tissue biopsy of cancerous tissue. Sometimes a gastroenterologist will discover the disease with endoscopic techniques. Pancreatic cancer has a very high mortality and the later it is diagnosed (more advanced the stage) the poorer the survival.
About the Speaker
DR. VIJAY KUMAR KONTHAM
Consultant Radiation Oncologist and Pain and Palliative Care Physician, Yashoda Hospitals
Upcoming CME Events
Biosimilars and Cancer Supportive Care
Biosimilars are biological products that are highly similar to and have no clinically meaningful differences from an existing approved reference biologic drug. In cancer supportive care, biosimilars have become increasingly important for managing various aspects of cancer treatment, including supportive therapies. One significant application of biosimilars in cancer supportive care is in the management of chemotherapy-induced neutropenia. Neutropenia, characterized by low levels of neutrophils (a type of white blood cell), is a common side effect of chemotherapy that can increase the risk of infections. Biosimilar versions of granulocyte colony-stimulating factors (G-CSFs), such as filgrastim and pegfilgrastim, are used to stimulate the production of neutrophils and reduce the duration and severity of neutropenia.
Medical management of GI Neuroendocrine tumor
The medical management of gastrointestinal neuroendocrine tumors (NETs) involves a tailored approach based on the tumor's grade, stage, and specific hormonal secretion patterns. Somatostatin analogs, such as octreotide and lanreotide, are commonly used to control symptoms related to hormone hypersecretion and to stabilize tumor growth. For well-differentiated NETs with advanced disease, targeted therapies like everolimus and sunitinib may be considered to inhibit mTOR and tyrosine kinase pathways, respectively. Peptide receptor radionuclide therapy (PRRT) with agents like lutetium-177 DOTATATE has shown efficacy in certain cases. Systemic chemotherapy, often with streptozocin-based regimens, may be employed for poorly differentiated or aggressive tumors. Close monitoring through imaging studies, biomarker assessments, and multidisciplinary collaboration between oncologists, endocrinologists, and surgeons is essential for an integrated and individualized approach to the medical management of GI neuroendocrine tumors. Additionally, patient education and support are crucial components to address the chronic nature of this condition and optimize the patient's overall well-being.
Management of Malignant Biliary Strictures
The management of malignant biliary strictures involves a multidisciplinary approach aimed at relieving obstruction, improving quality of life, and potentially extending survival. Endoscopic retrograde cholangiopancreatography (ERCP) with stent placement is a common intervention to alleviate biliary obstruction. Metal stents are preferred over plastic stents for their durability and longer patency. In cases where ERCP is not feasible, percutaneous transhepatic biliary drainage may be employed. Systemic chemotherapy or radiation therapy may be considered as part of a comprehensive treatment plan, particularly in cases where the malignancy is unresectable. Surgical resection remains the curative option when feasible. Palliative care plays a crucial role in managing symptoms and enhancing the overall quality of life for patients with advanced disease. Close collaboration among gastroenterologists, oncologists, interventional radiologists, and surgeons is essential for the optimal management of malignant biliary strictures.