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Laparoscopic Surgeon Dr. Yardesh Singh speak with his patient Roddy Tikasingh who recovered from surgery to remove a tumor from the tail of his pancreas six years ago at his office in Southern Medical Clinic in San Fernando, yesterday.

KEVON FELMINE

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Pancreatic cancer is one of the deadliest cancers. Once diagnosed with it, there is a nine per cent chance of survival. But as the world commemorates World Pancreatic Cancer today, 76-year-old survivor Roddy Tikasingh wants those afflicted with the disease and their families to hold onto hope.

“As long as you are alive and breathing, you cannot give up hope,” Tikasingh said.

Speaking to Guardian Media at the Caribbean Minimally Invasive Surgery Clinic at the Southern Medical Clinic in San Fernando yesterday, Tikasingh urged cancer patients to put their faith in God and their doctors. Back in 2014, the retired Fyzabad Presbyterian Primary School principal would walk three miles on mornings. But as age often brings ailments, discomfort in his abdomen was the first sign of a scary journey.

A visit to the San Fernando General Hospital revealed swelling in his pancreas and kidney. After draining fluid from the organs, laboratory tests showed malignancy in the pancreas. An ultrasound confirmed there was a tumour growing in the tail of his pancreas.

“There was a discomfort around the midsection, and after visiting doctors, I was sent by one who drained the kidney and pancreas. A good bit of fluid came out, and they sent it for testing. The pancreas fluid came back suspiciously malignant.”

On learning of their brother’s illness, Tikasingh’s siblings abroad began getting their travel documents in order. They believed he was on the verge of death.

“My eldest sister contacted the others and told them to get their passport ready. Through whatever research she did, she thought that was the end of it all.”

After a consultation, doctors found that they could save his life by removing his tumour laparoscopically. Advanced laparoscopic surgeon and consultant Dr Yardesh Singh explained that Tikasingh’s tumour affected his spleen, colon and his adrenal gland. On September 19, 2014, Singh excised parts of Tikasingh’s pancreas, spleen, adrenal gland, colon and spleen, giving him more years with his family.

“He is very fortunate. It is six years now, and he is alive, no tumour recurrence, no cancer coming back and all his scans are good, and I suppose he is happy,” Singh said.

He continued: “I think this patient offers hope for patients with pancreatic cancer. We all know that the five-year mortality rate for pancreatic cancer is very high, so it is 9 per cent survival in five years. This patient, for me, offers hope. I hope this can offer hope to other patients, not only pancreatic cancer but colon, breast, etc.”

The pancreas is an organ in the gastrointestinal system that helps in the digestion of food. It also helps in the management of glucose by producing insulin. Singh said men are more likely to develop pancreatic cancer, especially those over age 50. Other risk factors include smoking tobacco, a diet high in unhealthy fats and obesity.

It is a non-discriminating disease, taking the rich, poor, famous and infamous. Just 11 days ago, Pancreatic cancer claimed the life of Alex Trebek, the popular host of the American game show, Jeopardy. Locally, businessman John Sabga, then 56, died in 2017 after a 10-month battle with the disease.

Why is Pancreatic cancer so deadly? Singh explains that by the time patients visit their doctors, the cancer is already advanced.

“There is no effective screening mechanism to detect pancreatic cancer early. The patient would present with pain, and by that time, the tumour would already be of an increased size. It may have left the pancreas and gone to another site like the liver or lung, and that is what is called Stage 4 cancer.”

He hopes that as medical technology continues to advance, there will be some form of screening tool to detect pancreatic cancer.”I have a personal vested interest in pancreatic cancer. I have two family members that actually died from pancreatic cancer at about the age of 60 years old. One recently in 2018.”Singh advises that maintaining a healthy lifestyle and not waiting too long to visit their doctors after experiencing symptoms could save their lives.

T&T now first in the Caribbean to perform laparoscopic Whipple

Before 2019, patients requesting laparoscopic Whipple procedure had to spend a lot of money for a trip, stay and surgery in the United States or the United Kingdom. Now, the global medical fraternity is again acknowledging T&T’s advancement in medicine. Last March, the international medical journal Cureus published a paper on the Caribbean’s first pancreatic Whipple done fully laparoscopically, authored by Singh, along with Prof Shamir Cawich, Dr Sidiyq Mohammed Dr Thivy Kuruvilla and Prof Vijay Naraynsingh.Surgeons perform the Whipple procedure on patients whose tumour is in the head of the pancreas. These patients would present with weight loss and jaundice because the tumour blocks the pancreatic and bile ducts. Other symptoms include abdominal and back pain, nausea, loss of appetite and anorexia.According to the paper, oncologic surgery in the Caribbean has evolved over the past decade, with increasing reports of advanced minimally invasive operations. However, surgeons previously did not use the minimally invasive approach for peri-ampullary lesions. “This is because a laparoscopic Whipple operation is technically demanding and time-consuming,” the paper states.Singh performed the surgery in 2019 on a 65-year-old man at the Caribbean Minimally Invasive Surgery Clinic. According to the paper, the patient had no comorbidities, presented with a four-week history of progressive jaundice and un-quantified weight loss. The surgery took just over eight hours, with only 200 ml recorded blood loss and no reported complications. Singh explained that the procedure is lengthy and complicated as before removing the tumour from the head of the pancreas, the surgeon must remove the surrounding structures, including the duodenum and gallbladder and resect the bile duct. After removing the tumour, the surgeon must reconstruct the organs.Doctors discharged the patient from the High Dependency Unit within 24 hours of the operation, and he left the hospital on Day 5.Singh said the patient continues to do well today.Using the classical open surgery, the surgeon would make a 30 cm cut on the abdominal wall and use a retractor to access the tumour. It causes more blood loss, a longer recovery time and leaves a large scar.