India witnessing rise in pancreatic cancer: Doctors

New Delhi: Death of Apple co-founder Steve Jobs due to pancreatic cancer has brought into focus this rare and aggressive form of cancer, which is causing concern in India following a rise in incidences of the disease, especially in Mizoram.

Jobs, who led a mobile-computing revolution with wildly popular devices such as the iPhone, died Wednesday in California, US, after battling cancer for years.

According to medical experts, pancreatic cancer, with a negligible survival rate, is ranked fourth in cancer-related deaths in the US. The cancer form has seen a rise in India.

The global prevalence rate of pancreatic cancer is 1 per 100,000 people per year against the 80 per 100,000 people per year cases of breast cancer - one of the most prevalent cancers among women.

According to global figures, of the 232,000 people diagnosed with pancreatic cancer in 2002, 227,000 died by 2010.

Shyam Aggarwal, Chairman Department of Medical Oncology, Sir Gangaram Hospital, says that pancreatic cancer is an aggressive, fast growing disease which kills its victims within five years after diagnosis.

"There are two known types of pancreatic cancer - adenocarcinoma and neuroendocrine tumour. Jobs was affected by the latter, an extremely rare form reported in just five percent of people diagnosed with pancreatic cancer," Aggarwal said.

The tumours are usually located on the head of the pancreas - an organ that helps break down food so it can be absorbed into the body - where they can block the bile duct and cause jaundice.

"Pancreatic cancer is less common in India compared to western countries but now incidences of pancreatic cancer are increasing, and since the last two-three years we get one-two cases every month," P.K. Julka, clinical oncologist, All India Institute of Medical Sciences (AIIMS), said.

Julka says that most of the cases that come to them are in an advanced stage and chances of survival are nil. It is generally seen in old people.

Standard treatment for pancreatic cancer includes surgery, chemotherapy, radiation and, most recently, targeted anticancer drugs that may slightly extend patients` lives.

"Pancreatic cancer is diagnosed at a later stage in 89-90 percent cases and in such cases we provide chemotherapy, targeted therapy and few other procedures. But patient can survive only 18-24 months," said Julka.

Although there are no specific studies about causes of pancreatic cancer, doctors blame it on sedentary lifestyle, smoking and high alcohol intake. People suffering from diabetes and chronic pancreatic inflammation are also at risk.

There is also a lack of oncologists specialised in treating pancreatic cancer in India and the cost of treatment is very high.

According to Delhi Cancer registry, Mizoram in India has the highest prevalence of pancreatic cancer. "In Aizawl, Mizoram, prevalence rate is 2.3 per 100,000 people per year against the global rate of 1 per 100,000 people per year. Majority of cases in Mizoram are reported in women," he said.

Aggarwal, who is also a member of Pancreatic Cancer India, a group working to spread awareness about the less-known disease, says that this year`s Nobel Prize winner in medicine Ralph Steinman died of pancreatic cancer in September this year.


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