Pancreatic cancer treatment in Austria

Pancreatic cancer treatment is offered 10 specialized centers and departments, which are concentrated in Vienna, Linz, Innsbruck, Salzburg and Graz.

Pancreatic cancer is the result of pathological changes in the cells of the pancreas.

The consequence of these changes is uncontrolled cell growth.

Symptoms of the disease are usually non-specific; pain and discomfort usually occur in the advanced stages of cancer.

Most often, pancreatic cancer is diagnosed in men older than 40 years.

The pancreas is an approximately 15 cm long, pear-shaped organ that lies behind the stomach, inside a loop formed by a part of the small intestine. The wider right part of the pancreas is called the "head", the middle part – the "body" and the narrow left part – the "tail".

The exocrine part of the pancreas produces the digestive juices and the endocrine part forms hormones, like insulin.

95% of all pancreatic carcinomas arise from cells of the exocrine part, mainly from the ductal system. Pancreatic cancer, along with colon and stomach cancer are the most common tumors of the digestive tract.

Origin and risk factors

Malignant tumors of the pancreas make up only about 2% of all cancers.

The incidence of pancreatic cancer increases with age. About 80% of patients are people aged 50 to 80 years. In young patients, as well as in children and adolescents, this disease is rare.

Despite intensive research, Austrian doctors are aware of only a few causes and risk factors.

In smokers, pancreatic cancer occurs 2-3 times more often than in non-smokers. At present, the link of this disease with smoking, alcohol consumption, and coffee is known. Different dietary factors also play a role in the development of this form of cancer.

Symptoms

Pancreatic cancer causes complaints only at a very late stage.

Usually, general, non-specific symptoms are not taken seriously by patients.

The most common symptoms include:

• Weight loss for an unknown reason (83% of all patients)
• Painless jaundice is often the first and only symptom of pancreatic head tumors (85%)
• Pain in the upper abdomen or back, often radiating like a belt (70%)
• Nausea and vomiting (21%)
• Food aversion (44%)
• Diarrhea (38%)

Pancreatic cancer diagnosis

After a detailed discussion with your doctor, the first examinations begin.

The first step in the diagnosis of pancreatic cancer is usually laboratory tests to check the function of the pancreas and determine the so-called tumor markers.

Tumor markers are substances that are produced by a tumor. Cancer antigen 19-9 (CA 19-9) plays a role in pancreatic cancer, although it does not increase in every patient.

Therefore, the next step is an ultrasound examination of the abdomen. Using ultrasound, the pancreas and neighboring organs can be checked for the presence of pathological changes.

Ultrasound examination is performed in the supine position when the doctor moves the ultrasound probe through the abdomen. This diagnostic test is absolutely painless and safe.

In the case of suspicious changes in the pancreas in the ultrasound, an endoscopic ultrasound examination (endosonography) is performed as the next step. This is one of the most meaningful diagnostic methods for diseases of the pancreas. Similar to a gastroscopy, a thin tube is inserted through the mouth to the stomach and further into the duodenum.

At the end of the tube there is a small ultrasound head that takes pictures of the pancreas and surrounding tissues. In addition, the doctor can take a tissue sample (biopsy), which is sent for histological examination to the laboratory. A biopsy helps confirm the diagnosis.

Austrian doctors perform endosonography using anesthesia or tranquilizers to relieve stress and pain.

The cost of such an examination with biopsy and laboratory tests is up to $ 3,000.

After confirmation of pancreatic cancer, further research is needed to determine the stage of the disease.

To do this, it is important to know how big the tumor is, how far it has spread in the abdominal cavity and whether other organs are affected.

These steps are summarized in medicine under the term staging. It is important for choosing the best treatment for pancreatic cancer.

Computed tomography (CT), magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) are used to determine the stage of cancer.

During these diagnostic tests, the computer creates virtual slices that show pathological changes in individual organs. MRCP provides optimal results when examining the pancreas and bile ducts.

All of the above diagnostic tests are painless, safe, and usually take 20-40 minutes.

The cost of MRI in private clinics in Austria is up to $ 1,500. CT is usually a bit cheaper.

One of the innovative diagnostic methods is positron emission tomography (PET), which detects the accelerated metabolism of radioactive sugar in cancer cells.

Soon after administration, radioactive glucose accumulates in the tumor cells, and then these areas can be visualized using modern computer technology. Thus, PET shows any metastases (secondary tumors), even if they are far from the pancreas. PET does not cause discomfort and takes about an hour.

The cost of PET in Austria ranges from $ 1,500 to $ 4,000.

When all of these tests are completed, your doctor will tell you the stage of the disease and suggest the best methods of treatment. Further actions depend on your decision.

What do pancreatic cancer stages mean?

In determining the stage of the disease, the size of the tumor, involvement of lymph nodes and adjacent tissues, and the presence of metastases are taken into account.

• Stage I: the tumor is confined to the pancreas, and other organs are not affected.
• Stage II: the pancreas and adjacent tissues are affected by the tumor.
• Stage III: the tumor invades adjacent tissues and regional lymph nodes, but there are no metastases.
• Stage IV: the tumor has spread to distant organs through the blood or lymphatic system, giving rise to secondary tumors.

Pancreatic cancer centers in Austria

There are more than a dozen specialized centers, departments and clinics in Austria that provide local residents and medical tourists with first-class services in the field of diagnosis and treatment of pancreatic cancer. Most of them are located in Vienna and the largest cities of the country:

Vienna

• Comprehensive Cancer Center Vienna – AKH Vienna
• Social Medical Center South – Kaiser Franz Josef Hospital
• Sisters of Mercy Hospital Vienna

Lower Austria

• Landesklinikum St. Pölten
• Landesklinikum Wiener Neustadt

Upper Austria

• Ordensklinik Linz – Sisters of Mercy, Internal Department I
• Klinikum Wels-Grieskirchen, Department of Internal Medicine IV
• Ordensklinik Linz – Elisabethinen, Surgical Department

Salzburg

• LKH-Salzburg PMU, Surgical Department
• LKH-Salzburg PMU, Oncology Department

Tirol

• Innsbruck Medical University, Surgical Department
• Innsbruck Medical University, Oncology Department

Styria

• Medical University Graz, Surgery
• Medical University Graz, Oncology

In the capital of Austria there are excellent private clinics that offer conservative treatment and a comfortable stay for demanding patients. This is the world-famous Wiener Privatklinik and Dobling Private Hospital.

Pancreatic cancer treatment in Austria: modern options

Once you know that you have pancreatic cancer, your doctor will tell you about each treatment option.



Surgical removal of the tumor, chemotherapy, and sometimes radiation therapy are considered as the basis of treatment. Under certain circumstances, modern molecular-biological therapies can be used (the so-called “targeted therapy”).

Surgery (up to $ 35,000)

To get the best chance of recovery, you should remove all tumor tissue as soon as possible. Therefore, surgery is especially useful if the tumor is detected at an early stage.

Depending on the part of the pancreas in which the tumor is located, various surgical procedures are used.

When the tumor is located in the head of the pancreas, a very extensive surgical procedure is usually chosen to ensure that no cancer cells remain – even those that are already scattered but not yet visible.

The tumor is removed together with part of the pancreas, the stomach, the duodenum, the gallbladder and bile duct. This procedure is called Whipple surgery.

After this very extensive surgical procedure, the digestive system is restored using reconstructive measures.

Sometimes the whole pancreas has to be removed (total pancreatectomy).

If the tumor is located in the tail of the pancreas, the procedure is less extensive. In these cases, except for the tumor, usually only the spleen is removed. Reconstructive measures are not required.

The possibility of surgical removal depends, among other things, on the age and condition of the patient.

Recovery time and complications depend on the extent of the surgical procedure. After removal of a significant part of the pancreas, diabetes can develop. Often the digestive enzymes produced by the pancreas have to be replaced with drugs.

The doctor will help you evaluate the benefits and risks of a particular procedure.

Chemotherapy (up to $ 11,000)

Chemotherapy is used by Austrian oncologists at all stages of pancreatic cancer.

It can be used as a single therapeutic measure, as well as before or after surgery. Chemotherapy often makes a significant contribution to increasing the chances of recovery and improving the quality of life.

The goal of systemic chemotherapy is to kill tumor cells throughout the body, regardless of location.

The drugs used (called cytostatic drugs) inhibit the growth of cancer cells and damage them directly.

Cancer cells differ from healthy cells because they divide faster and therefore grow faster. Cytostatic agents specifically attack those cells in the division phase. That is why tumor tissue is damaged more severely by chemotherapy than healthy tissue.

However, chemotherapy damages rapidly dividing normal cells, which often causes unwanted side effects. Ask your doctor about possible side effects of therapy, and discuss ways to relieve these symptoms.

Radiation therapy (up to $ 18,000)

Some patients also receive radiation therapy. Radiotherapy cannot cure cancer, but this method helps control the symptoms caused by rapidly growing tumors. Thus, radiation therapy can make a significant contribution to improving the quality of life. Radiotherapy can slow the spread of the tumor.

High-energy (ionizing) radiation affects the cell nucleus of tumor cells, preventing them from dividing and causing cell death. Procedures are carried out for a certain period of time in several sessions, and individual procedures take only a few minutes. Your doctor will tell you about side effects.

Targeted therapy

New targeted therapies use substances that target key molecular processes in cancer cells. These modern substances can also be used in pancreatic cancer. Many of the targeted agents are directed against targets that are often found in certain tumor cells. For their effective use, laboratory tests are needed.

Targeted therapy differs from classical cancer treatments such as chemotherapy and radiotherapy in that it selectively attacks cancer cells.

Talk to your doctor if this type of therapy is right for you. He will also inform you about the respective benefits and possible side effects.

As a rule, several doctors from different fields of medicine (for example, a gastroenterologist, a surgeon, an oncologist and a radiation therapist, as well as a radiologist) are involved in planning a treatment strategy.

This collaboration of experts in Austrian medicine is called the "tumor shield." A team approach ensures that all important factors are taken into account and the best treatment options are found.

© Analytical reviews and oncology news by K. Mokanov: clinical pharmacist and professional medical translator