1. Why Turkish clinics?

• Foreign doctors were able to make an accurate diagnosis.

Pancreatic cancer is one of the most difficult to diagnose. Most of the organ is covered by the stomach and colon, so it is not visible during a standard examination such as an ultrasound or CT scan. In foreign clinics, doctors use special techniques that allow them to detect a tumor in any part of the pancreas, accurately determine the stage of the disease, and select an effective treatment based on gene mutations in cancer cells.

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• Abroad, doctors specialize in low-trauma operations.

To reduce the tumor before the intervention and to preserve the organ as much as possible, they use modern chemotherapy drugs and precise radiation therapy.

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• For effective treatment in the later stages abroad, immuno- and targeted therapy is used.

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The main difference between such treatment in the CIS countries and abroad is the number of drugs used. For example, in clinics in Europe or Israel, doctors have 70 immunotherapy drugs available, in Russia - 18, in Ukraine - 12. This increases the chances of choosing a treatment for each patient that is most effective in his case, and not the only one available.

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2. How is pancreatic cancer treated in Turkey?

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For the treatment of pancreatic cancer in foreign clinics, the following methods are available:

• laparoscopic and open surgery;

• chemotherapy;

• radiation therapy;

• targeted therapy;

• immunotherapy;

• irreversible electroporation (Nano-knife).

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How to treat pancreatic cancer in a particular patient can only be determined by a qualified doctor based on the results of a comprehensive diagnosis.

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Pancreatic cancer surgery

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Doctors perform an operation for pancreatic cancer if the tumor does not affect the arteries and veins of the organ, so it can be removed without risking the patient's life. Moreover, the intervention is considered one of the most difficult in surgery. By  international medical standards , the surgeon must agree on the course of the operation at a consultation with a team of doctors who perform at least 15 such interventions annually.

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The type of surgery depends on the location of the tumor and its size.

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Foreign surgeons carry out 3 types of operations:

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1. Operation Whipple (pancreatoduodenectomy)

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This type of intervention is used to treat cancer of the head of the pancreas. The surgeon removes the head of the pancreas, part of the bile duct and gallbladder, duodenum, part of the stomach. This is the only way he can remove all tissues that have come into contact with the tumor. This prevents the spread of cancer cells to neighboring organs.

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Depending on the qualifications of the surgeon, the operation is performed laparoscopically - through 4-5 thin punctures up to 1 cm in size or open - through one incision up to 20 cm in the abdomen.

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Whipple's operation is considered one of the most difficult in abdominal surgery. The efficiency of the performed procedure and the duration of postoperative rehabilitation depend on the experience and qualifications of the operating surgeon.

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2. Distal pancreatic resection (pancreatectomy)

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The operation is used for cancer of the tail of the pancreas. During the intervention, the surgeon removes it and the spleen. The main difficulty is that the tumor in this area quickly affects the adjacent tissues, so it is important to remove it as much as possible.

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The operation is performed by an open or laparoscopic method. In some clinics, such interventions are performed using a Da Vinci robot. It is equipped with a computer that processes the doctor's movements and translates them into smooth manipulations of the robot, eliminating hand shake. This allows the operation to be carried out as accurately and accurately as possible.

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3. Total pancreatectomy

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The operation is indicated for cancer of the body and neck of the pancreas, multiple tumors.

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• Is the pancreas removed completely?

During the operation, the surgeon removes not only the organ itself, but also a portion of the small intestine, part of the stomach, bile duct and gallbladder, spleen, and neighboring lymph nodes. Thus, he excises the maximum number of affected tissues, therefore, stops the progression of the disease.

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Chemotherapy for pancreatic cancer

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Chemotherapy for pancreatic cancer is prescribed at any stage of the disease. It is done before surgery to shrink the swelling, or afterwards to reduce the risk of recurrence.

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The number of courses is determined by the oncologist after a comprehensive examination.

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It's important to know! In Turkish clinics, doctors use more than 200 different chemotherapy drugs - this increases the ability to choose the most effective drug for a particular patient. For comparison, there are about 40 registered in Ukraine and Russia.

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Radiation therapy

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For pancreatic cancer, the patient undergoes SBRT (stereotactic radiation therapy). During irradiation, the doctor uses a special computer and a linear accelerator (TrueBeam, Novalis). The radiologist enters the parameters of the tumor into the computer, sets the plan and radiation power. After that, the system itself regulates the direction and accuracy of the exposure using high-energy X-rays. Under their influence, malignant cells are destroyed.

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It's important to know! Pay attention to the year of manufacture of the radiation therapy unit. The equipment produced in the period from 2013 to 2019 is equipped with a special computer system that increases the accuracy of the impact to 0.5 mm. This allows you to act only on the tumor and preserve healthy tissue around it.

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Targeted and immunotherapy for pancreatic cancer

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Targeted therapy drugs target the neoplasm specifically. They interact with the receptors of tumor cells and stop their division. Education stops growing and spreading throughout the body.

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Immunotherapy drugs activate the patient's immune system, “teach” it to recognize and attack the neoplasm.

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Some of these drugs are used in the CIS countries. However, no more than 20 of them are available here. For comparison, in Europe, doctors use up to 70 drugs for immunotherapy alone.

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Irreversible Electroporation (Nano Knife, IRE)

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It is an innovative treatment for pancreatic cancer that has proven itself in several clinical trials.

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In irreversible electroporation, the destruction of cancer cells occurs due to the action of a pulsating electric current. This does not damage the surrounding tissues, blood vessels and bile ducts.

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The technique is used as the only treatment, in combination with chemotherapy or during surgery, to destroy cancer cells after removing the tumor itself.

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3. What modern methods of diagnosing pancreatic cancer are used abroad?

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The pancreas is one of the most difficult to access organs for diagnosis. It is partially hidden by the organs of the digestive system, therefore it is almost invisible on ultrasound. To detect a malignant tumor, foreign oncologists prescribe endoscopic ultrasound (EUS), which transmits information in digital format. This allows you to get a clearer and more informative image of the organ and tumor.

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Other methods of diagnosing pancreatic cancer, which are used by doctors abroad:

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• a complete analysis of urine and blood to assess the general condition of the body and the work of organs, to identify inflammation and infections;

• a blood test for tumor markers - special proteins, the level of which in the blood increases with the development of a tumor in the pancreas;

• CT according to the protocol for diagnosing pancreatic cancer is a study that allows you to determine the state of the pancreas, surrounding tissues and organs;

• magnetic resonance cholangiopancreatography - a type of MRI that creates a very accurate image of the pancreas and bile ducts;

• endoscopic retrograde cholangiopancreatography - the technique combines endoscopy and radiography and allows you to identify pathologies in the bile duct and pancreatic duct;

• fine-needle aspiration biopsy to obtain tumor tissue for analysis (the procedure is performed during endoscopic ultrasound, percutaneously under the control of CT and ultrasound);

• studies of the obtained tissue sample (immunohistochemistry, histology), which make it possible to determine the type of tumor, the possibility of using targeted therapy, the effectiveness of radiation and chemotherapy;

• FoundationOne CDx - analysis of tumor cells for genetic mutations to select an effective drug for immuno- or targeted therapy;

• genetic testing of blood or saliva to identify mutations (BRCA1, BRCA2, PALB2) and choose the right immunotherapy regimen;

• PET-CT to detect metastases in other organs.

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4. How is rehabilitation after pancreatic cancer treatment going?

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Rehabilitation includes:

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• special diet;

• taking medications to improve the general condition of the patient.

After treatment for pancreatic cancer, you must undergo regular medical examinations. The frequency and its program is made by the attending oncologist. This will allow you to detect a relapse of the disease in time.

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Patients who have partially or completely removed the pancreas are given insulin. The doctor also prescribes drugs to relieve postoperative pain, disturbances in the work of the gastrointestinal tract, and gives recommendations for proper nutrition.

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5. How long does the treatment for pancreatic cancer take?

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The duration of the examination for pancreatic cancer depends on the clinic chosen for the treatment:

• in Turkey - 3-5 days;

The duration of hospitalization after surgery is 10 to 14 days.

The doctor determines the number and duration of courses of radiation or chemotherapy individually for each patient.

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6. Stages of pancreatic cancer treatment

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Day 1. First consultation

Arrival at the clinic and meeting with the attending physician.

Day 2-5. Survey

Depending on the patient's condition, it takes place in a hospital or on an outpatient basis.

Day 6. Repeated consultation

The attending oncologist reviews the examination results and draws up a treatment plan.

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7. What determines the cost of treatment?

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The final price for pancreatic cancer treatment abroad depends on:

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• The scope of diagnostic procedures

The examination program in a foreign clinic may include studies that the patient has already undergone at home (CT, MRI, biopsy, PET-CT). Take their results with you. If the doctor considers them sufficiently informative, the procedure will not have to be repeated. This will reduce costs.

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• Stages of the disease

The treatment plan is drawn up on the basis of data on the prevalence of the tumor, the possibility of surgical intervention.

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• Selected for the treatment of the clinic

Prices in different hospitals of the same state differ in different types of medical institutions (private / public).

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8. How to go to Turkey for treatment?

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To travel to Turkey for pancreatic cancer treatment, leave a request on the Medikal & Estetik Group website. You will be contacted by a coordinator doctor who will answer all questions regarding the choice of the clinic, the organization of treatment and the cost of the procedures.

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Test results and other medical documents must be sent to the medical coordinator of Medikal & Estetik Group. He will give them to a specialist at the selected medical center. According to them, the doctor will clarify the diagnosis, determine the treatment options and its cost.

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Consultation with a foreign oncologist

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You can get a second opinion from a foreign oncologist. The doctor will analyze the extracts, the diagnosis made earlier and draw up his conclusion. The consultation takes place online.

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Organization of the trip

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If the treatment program suits you, the coordinator will make an appointment with the doctor and the necessary procedures. It takes 3-5 days.

Patient escort

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A local coordinator will accompany you at the hospital. We stay in touch with you during treatment and after returning home.

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Medikal & Estetik Group is an independent medical platform. We do not represent the interests of specific clinics. Our partner hospitals pay for our services, not patients.

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Help is needed?

Doctors-coordinators will advise you and help you with the choice. Medikal & Estetik Group services are free of charge for you and do not affect your clinic bill.

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Medikal & Estetik Group coordinator will help find the best solution for pancreatic cancer treatment

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