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Pancreatic Cancer

“The cancer that grows inside the pancreas is known as pancreatic cancer. Pancreas is the gland that is about 6 inches long that makes hormones including the enzymes responsible for controlling blood sugar and also helps in digesting food. The development of pancreatic cancer starts when the cells inside the pancreas grow out of control. This cancer may metastasize or spread top surrounding organs and lymph nodes such as lungs and liver.

Types of Pancreatic Cancer

Pancreatic cancer can be categorized into different types that depend on whether or not the cancer began in the endocrine or exocrine component. Pancreatic cancer types include –

Endocrine Tumors : Endocrine tumors also referred to as pancreatic neuroendocrine tumors (PNETs) or islet cell tumors are not so common as compared to exocrine tumors. A pancreatic neuroendocrine tumor could be non-functioning that means it does not make any hormones or it could also be functioning that means it can make hormones. The base of a functioning neuroendocrine tumor is on the hormone that cells usually make –

PPomas
Insulinoma
VIPomas
Gastrinoma
Glucagonoma
Somatostatinoma
Exocrine Tumors: They are considered as the most common type of pancreatic cancer. Adenocarcinoma that begins in gland cells is mostly seen in around 95% people who are suffering from pancreatic cancer. Ductal Adenocarcinoma is the ducts of the pancreas from where the tumor typically begins. Rarely when tumor starts in the acini then it is termed as acinar Adenocarcinoma.

Some of the other rare tumors of the pancreas are –

Lymphoma
Acinar Cell Carcinomas
Cystic Tumors
Neuroendocrine tumors
Diagnosis of pancreatic cancer:

Computed tomography (CT) scans
CT Scanner produces clear and sharp images throughout the body with 33 percent greater detail than traditional scans. The improved imaging helps to diagnose disease earlier and with greater accuracy. More importantly, scan radiation can be reduced up to 50 percent, a critical benefit for cancer patients.

Magnetic resonance cholangiopancreatography (MRCP)
Magnetic Resonance Colangio Pancreatography (MRCP), uses magnetic fields and radio waves to produce detailed images of the pancreas, liver and bile ducts. This noninvasive test is especially helpful for diagnosing bile duct obstructions and for detecting pancreatic cysts (fluid-filled pockets) that can develop on or within the pancreas. Most cysts are benign, but some may become cancerous over time and are followed by our oncologist.

Endoscopic ultrasound (EUS)
During the test, a tiny ultrasound probe is placed in the stomach through an endoscope. The probe produces sound waves that create extremely detailed images of the pancreas, which lies next to the stomach.

Digital analysis of these images can help distinguish cancer from chronic pancreatitis – an ongoing inflammation of the pancreas. During EUS, the oncologist may also do FNAC or remove a small samples of pancreatic tissue (core biopsy). The biopsies can help distinguish autoimmune pancreatitis from pancreatic cancer. Oncologists can also collect pancreatic juices or fluid from precancerous cysts for laboratory analysis. EUS can be technically demanding and produces the best results.

Endoscopic retrograde cholangiopancreatography (ERCP)
ERCP is used to evaluate and treat problems in the bile ducts. During a traditional ERCP, Gastroenterologist injects a dye into the biliary tract through an endoscope before taking a series of X-rays.

Treatment of pancreatic cancer in India:

SURGERY

Surgery is the best option for people whose cancer can be safely and effectively removed. This usually means that the tumor hasn’t grown into any of the major blood vessels located near the pancreas or spread to the liver, abdominal cavity or lungs.

Unfortunately, only about 20 percent of pancreatic cancer patients have tumors that can be surgically removed (resected). And although improvements in diagnosis, staging, surgical techniques and postoperative care have led to much better outcomes after surgery, pancreatic resection is still one of the most difficult and demanding operations for both surgeons and patients.

Pancreatic surgeries

Whipple procedure – This is the most common type of surgery, also known as pancreatoduodenectomy (Whipple procedure) and is potentially curative. The surgery involves removing the “”head”” of the pancreas along with the duodenum, the gallbladder and the lower end of the bile duct. The bile duct, pancreatic duct and intestine are reconstructed. This is a technically demanding procedure, which surgeons perform routinely, within acceptable rate of morbidty.
Other surgical procedures – Other options for pancreatic cancer, include total pancreatectomy, which removes the entire pancreas, along with the gallbladder, part of the stomach and small intestine, the bile duct, spleen, and nearby lymph nodes; and distal pancreatectomy, in which the body and tail of the pancreas are removed.


RADIATION THERAPY AND MULTI-MODALITY THERAPIES


Radiation can be delivered during surgery using intra-operative radiation electron therapy. Intra-operative radiation electron therapy allows doctors to treat tumors with high doses of radiation – the equivalent, in some cases, of 10 to 20 daily radiation treatments – without harming nearby organs.

CHEMOTHERAPY

Inoperable pancreatic cancers require the use of chemotherapy / radiation therapy to shrink / control the tumour growth. Pancreatic cancers with metastatic require chemotherapy. Selection of chemotherapeutic drugs, dosages and schedule depend on the physical condition of the patient and performance status. Patient not fit for injetable chemotherapy may also be offered targeted therapy.

PALLIATIVE CARE

When cancer is so advanced that treatment options are limited, an experienced, integrated team of palliative care providers serves the social, psychological and spiritual needs of patients and their families. The team may include physicians from a number of fields as well as dietitians, medical social workers, psychologists, pharmacists and pain management specialists.”

How it works?

1.

Request for medicine

Patient who has serious problem request for medicine

 

2.

Drug Verify

Internal processing of drug verifications at GM Global

 

3.

Prescription

Recognizing best source for the specific prescription

 

4.

GDP Instruction

Import medicine under the GDP instruction

 

5.

QA check

Supply drugs to concerned healthcare provider after QA check

 

5.

QA check

Supply drugs to concerned healthcare provider after QA check

 

FAQ

A NPP provides access to post-approval drugs that are approved and commercially available in one or more country, other than the patient’s home country.

 

No. Companies are not required to provide their products through a formal NPP.

 

  • Dealing with unsolicited patient request for drug in an ethical and regulatory controlled manner
  • Providing exposure to, and experience with, company products to physicians in additional countries and build a larger KOL network and future advocates
  • Providing new products to patients who would move to commercial drug when it becomes available in these countries
  • Generating additional revenues in countries that allow you to charge for drugs supplied on a named patient basis

Companies can provide drug to patients in any country in which they have not yet received marketing approval. This includes countries in which a company plans to seek marketing approval, as well as those countries in which a company does not plan to seek marketing approval.

 
 

INFORMATION FOR PATIENTS

As a named patient medicines you may find yourself in the frightening position that you have a serious condition or illness and the treatment you need is not available in your home country. It is possible that the medicines are available outside your country and if your physician decides that these drugs would be suitable for the treatment of your illness, they then face the challenge of obtaining them for you. We help physicians across the world access medicines which are not approved or licensed in their country, but may be required to meet the special needs of an individual patient. The service we provide not only locates and supplies the required medicines but ensures that the physician has all the quality assurance and supporting clinical information they will need to safely prescribe it to you. If you are confronted with a situation where a drug is not available to you, talk to your physician or healthcare professional about Named Patient Program and ask them to contact us. We will then work directly with your physician to help them in patient access program and understand what options are available.

 

 

Drugs We Provide Under NPS

Drug Directory

Orphan Drugs

1.

Request for medicine

Patient who has serious problem request for medicine

 

2.

Drug Verify

Internal processing of drug verifications at GM Global

 

3.

Prescription

Recognizing best source for the specific prescription

 

4.

GDP Instruction

Import medicine under the GDP instruction

 

5.

QA check

Supply drugs to concerned healthcare provider after QA check

 

5.

QA check

Supply drugs to concerned healthcare provider after QA check

 

FAQ

A NPP provides access to post-approval drugs that are approved and commercially available in one or more country, other than the patient’s home country.

 

No. Companies are not required to provide their products through a formal NPP.

 

  • Dealing with unsolicited patient request for drug in an ethical and regulatory controlled manner
  • Providing exposure to, and experience with, company products to physicians in additional countries and build a larger KOL network and future advocates
  • Providing new products to patients who would move to commercial drug when it becomes available in these countries
  • Generating additional revenues in countries that allow you to charge for drugs supplied on a named patient basis

Companies can provide drug to patients in any country in which they have not yet received marketing approval. This includes countries in which a company plans to seek marketing approval, as well as those countries in which a company does not plan to seek marketing approval.

 
 

INFORMATION FOR PATIENTS

As a named patient medicines you may find yourself in the frightening position that you have a serious condition or illness and the treatment you need is not available in your home country. It is possible that the medicines are available outside your country and if your physician decides that these drugs would be suitable for the treatment of your illness, they then face the challenge of obtaining them for you. We help physicians across the world access medicines which are not approved or licensed in their country, but may be required to meet the special needs of an individual patient. The service we provide not only locates and supplies the required medicines but ensures that the physician has all the quality assurance and supporting clinical information they will need to safely prescribe it to you. If you are confronted with a situation where a drug is not available to you, talk to your physician or healthcare professional about Named Patient Program and ask them to contact us. We will then work directly with your physician to help them in patient access program and understand what options are available.