Pancreas Cancer Research and Referral Clinic

In Chennai, we have many CT scan centers. It is common for our patients to come and see us with CT scan reports of scans done outside. Sometimes, we are unable to look at the CT films and give a genuine opinion. So we end up asking for a second imaging to the dismay of our patients. Imaging standards for pancreatic tumour imaging has been standardized by many radiologic societies and only a standardized evaluation will give us appropriate decision making. Using the wrong scans to decide will lead us into confusion. So what are the established standards for CT scan of the pancreas? Here we go. Before we deal with pancreatic CT, I will explain what constitutes a normal CT scan protocol.  Normal CT scans are done in different formats. Plain CT scan refers to CT scan done without giving contrast agents. Plain scan will not show the blood vessels and cannot accurately define the relationship of the lesion or even clearly define the lesion. It is useful to pick up very large lesions, cal...

CA 19.9 is an essential part of the evaluation of pancreatic cancer. CA stands for Carbohydrate antigen. This CA19.9 is normally produced in two sources in the human body - pancreatic parenchymal cells and the biliary epithelial cells. We still don't know the connection points between the tissue production of CA19.9 and the blood levels. This protein was discovered in the research for large intestinal cancers, but we have found that it is very useful in pancreatic malignancies. A level of > 1000 has a very high chance (around 99%) of pancreatic cancer. The normal level is around 37 U/L and usually the other cutoffs that pancreatic surgeons remember is 100 U/l and 500 u/L, to assess cancer diagnosis and features of advancing disease. It is important to check your CA 19.9 levels after the jaundice is relieved by ERCP and stenting. High levels in the presence of jaundice or cholangitis (infection of the bile ducts) is not useful to assess advanced disease. At PCRRC, we keep 500 u/L...

 NCCN stands for National Comprehensive Cancer Network. In this blog, you will find a lot of reference to NCCN guidelines. This is a resource that we, as cancer surgeons have come to respect and depend on for providing state of the art cancer management. NCCN is a non profit organisation. It is conglomerate of 30 cancer hospitals in the United States. This group consists of experts who treat cancers in high volume dedicated research centers. We, at PCRRC have been using NCCN guidelines to provide care for our patients since 2007. Though as clinicians, we find that leading research journals like Journal of gastrointestinal Surgery, Surgical Oncology Clinics and many such expert resources also provide information on cutting edge technologies, NCCn guidelines for cancer provide the appropriate bedside tool for the management of patients. Though we develop expertise, by using self developed tools, NCCN gives a good framework with which we can take the patient through the entire treatme...