Hello Dr. Hadley,
Thank you for reading my discussion post. Pancreatic cancer is the fourth foremost trigger of cancer demise in the United States, the American Cancer Society projected that approximately 46,420 novel case of pancreatic cancer with about 39,590 demises in the United States (Reynolds and Folloder, 2014). According to Reynolds and Folloder (2014); Wolfgang et al., (2013), the lone treatment modality for pancreatic cancer with restorative potential is resection of the encompassed fraction of the pancreas, thus with the regrettably 80 percent of diagnosed patients with pancreatic cancer came with metastatic or locoregional illness at the early diagnosis which is indeed a prohibition criteria for surgical therapy. The exclusion
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This exploration is executed exclusively with pancreatic modus operation bestows important specific on the anatomic correlation of the tumor to neighboring blood vessels and organs. Also, a CT scan with use of contrast can appropriately envisage resectability with about 80 to 90 percent exactness, likewise bestows data on extrapancreatic lesions fishy for metastatic illness (Hidalgo, 2010). The use of PET scan, Endoscopic like that of EUS with fine needle aspiration, ERCP and widely utilized for pancreatic cancer valuation while EGD with EUS is beneficial in differentiating tumor specifics and procurement of tissue diagnosis, beneficial in recognizing a cancerous tumor not obviously recognized on CT scan since it possesses healthier sensitivity for littler pancreatic scratches (Hidalgo, 2010). A pancreatic cancer diagnosis is challenging and when necessitated the advanced nurse practitioner should utilize a multidisciplinary approach for patient’s quality and safe care and to assist prompt diagnosis and treatment …show more content…
(2010). Pancreatic cancer. The New England journal of medicine. 362(17),1605–1617. doi:10.1056/NEJMra0901557
Lee, E. S., & Lee, J. M. (2014). Imaging diagnosis of pancreatic cancer: A state-of-the-art review. World journal of gastroenterology, 20(24), 7864–7877. doi: 10.3748/wjg.v20.i24.7864
Reynolds, R. B., & Folloder, J. (2014). Clinical Management of Pancreatic Cancer. Journal of the Advanced Practitioner in Oncology, 5(5), 356–364. Retrieved July 9, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457174/
Wolfgang, C. L., Herman, J. M., Laheru, D. A., Klein, A. P., Erdek, M. A., Fishman, E. K., & Hruban, R. H. (2013). Recent Progress in Pancreatic Cancer. CA: A Cancer Journal for Clinicians, 63(5), 318–348.
A 14 year old female with no known history of pancreatitis, alcoholism, diabetes, or biliary disease presented for an abdominal sonogram. Her only symptom was generalized upper abdominal pain with no history of nausea, vomiting, weight loss, or appetite changes. Ultrasound images showed a well circumscribed, round, hypoechoic 14-mm lesion within the head of the pancreas and another lesion in the body. Color Doppler analysis showed no internal or peripheral vascularity associated with the lesions. The main pancreatic duct was dilated, measuring at 4 mm. The ultrasound examination was followed by an MRI which demonstrated a 12 mm mass in the pancreatic body that correlated to the
There are not many defined risk factors known for pancreatic cancer. Some risk factors are “family history of the disease, smoking, age, and diabetes (Mayoclinic).” Ideally, pancreatic cancer cells can be detected early and the patient can be treated surgically, but once the cancer has spread, it is usually incurable. A popular clinical tool used to detect pancreatic cancer “is a tumor marker called sialylated Lewis blood group antigen CA19–9, which can act as a sensitive tumor marker, value diminishes when used to detect small, resectable tumors (Maitra,
There is another classification of pancreatic tumor help in decision making of management. This classification depends on the possibility of surgical removal of the tumor: in this way, tumors are judged to be "resectable", "borderline resectable" or "unresectable" (American Cancer Society, 2014).
According to Professor John Neoptolemos, "There are approximately 7,000 new cases each year - but it is one of the most lethal cancers." The main reason for the low survival rate from pancreatic cancer is due to its difficulty in finding this cancer early. By the time a person has symptoms, the cancer has often reached a large size and spread to other organs. Because the pancreas is deep inside the body, the doctor cannot see or feel tumors during a routine physical exam. There are currently no blood tests or other tests that can easily find this cancer early in people without symptoms. Tests for certain genes in people with a family history of the disease can help tell if they are at higher risk for cancer. There are some new tests for finding pancreatic cancer early in people with a strong family history of the disease, but these tests are complicated and expensive. Some symptoms of pancreatic cancer include jaundice, a yellow color of the eyes and skin caused by a substance buildup in the liver, pain in the belly area or in the middle of the back, significant weight loss over a number of months, loss of appetite, digestive problems including nausea, vomiting, pain that tends to be worse after eating, a swollen gallbladder that is enlarged, blood clots that form in the veins or cause problems with fatty tissue under the skin, and diabetes. If the doctor has any reason to suspect pancreatic cancer, certain tests will be done to see if the disease is really
Mayo Clinic PRT (Moertel, Lancet 1969; PMID: 4186452) randomized 64 patients with locally advanced unresectable pancreatic ACA to RT alone vs. chemoRT (35 to 40 Gy +/- concurrent 5-FU). Survival was significantly improved with chemoRT (10.4 vs. 6.3 months). A subsequent Gastrointestinal Tumor Study Group Trial 9273 also demonstrated benefit with chemoRT (Moertel, Cancer 1981; PMID: 7284971). Patients (194) were randomized to RT alone (60 Gy) vs. chemoRT to 40 Gy vs. chemoRT to 60 Gy. RT was given as a split course with 2 weeks between each 20 Gy. Chemo was 5-FU 500 mg/m2/d on d1-3 of each 20 Gy course and then maintenance 5-FU for 2 years. Concurrent chemoRT improved MS compared to RT alone, and there was a trend toward better survival
Although this has refined the areas of research when looking for treatments, many different possibilities still remain. This is why I’ve chosen to focus on possible treatments for acute pancreatitis during my project. Several studies have already suggested targeting the PMCA, MPTP and increasing intracellular ATP levels. At this time I believe the most beneficial treatment would involve blockage or inactivation of the MPTP as it would prevent global Ca2+
However, unlike in other cancers, this has not resulted in a similar increase in effective targeted treatment options that are available in the clinic. In fact, the mainstay of pancreatic cancer remains largely conventional and includes surgery for the minority of patients who are diagnosed with resectable disease, and cytotoxic therapy (3-5).
Approximately 20% of pancreatic cancer is found to be operable or resectable. The complete resection of the primary lesion is best treatment for patients with localized pancreatic cancer. However the risk of both local and distal recurrence is high in following resection. In early stage pancreatic cancer the complete resection are associated with considerable morbidity in 40–60% of patients and mortality in less than 3% of patients (Sohn et al., 2000; Winter et al., 2006). Moreover, it takes 2–3 months for complete recovery to a normal quality of life. Although the 5-year survival rate of resected pancreatic cancer is approximately 20% and the median overall survival time is 17–27 months (Winter et al., 2006).
In August 2009 M.W. a 56 year old female, was diagnosed with a stage II-B adenocarcinoma of the pancreatic head, ductal type, with perinueral invasion, with two of nine lymph nodes involved by direct extension and positive margin. Shortly after diagnosis, she received the Whipple procedure followed by treatment with gemcitabine and 5FU chemoradiation. She was diagnosed later with a regional cancer recurrence in the retro portal space nestled between the portal vein, the inferior vena cava, the superior mesenteric artery, and the left renal vein. It is possible this recurrence was nodal in origin rather than in the autonomic neural sheath surrounding the artery which is the typical region of recurrence. Subsequently, she was treated with six cycles of Folifirinox with 5FU adjuvant followed by an additional four cycles ending in May of 2012. Following this treatment, a CT scan showed improvement of her disease. A few months later she received a partial cycle of Abraxane with Gemcitabine. In the first few months of 2014, she was enrolled in a
Pancreatic cancer is an extremely aggressive tumor and its management remains an intricate challenge in oncology. Despite significant improvements in the field of cancer-related mortality, the progress in pancreatic cancer remains largely dismal. With one of the highest mortality-to-incidence rate ratios, it is the third most common gastrointestinal malignancy and the fourth leading cause of cancer-related death in the western world. Early and frequent metastatic dissemination at diagnosis (40-50%) coupled with resistance to systemic therapies and ineffective local control explains the high mortality rate associated with the disease. Currently, margin-negative surgical resection offers the only means of cure but unfortunately, only 10% to 15%
When spreading through the body there are certain stages the cancer has to go through to expand. Stage 0. There is no spread.The cancer is limited to only one cell in the pancreas. Stage I: The cancer is only limited to the pancreas cell, but has moved at least two centimeters. Not yet visible in screening tests. Stage II: The cancer has grown outside the pancreas and may have spread to the lymph nodes. Stage III: The tumor has spread drastically making it now possible for the tests to detect the tumor,increasing the possibility for it expand into the blood vessels or nerves. Stage IV: The cancer has spread to different organs of the body.("Pancreatic Cancer Treatments by Stage") The first place to attack after spreading would be the stomach, then it would expand to the liver. After the cancer reaches these points, it travels to other places in the body. ("Treating Pancreatic Cancer, Based on Extent of the Cancer").
Many diseases had been appearing from a long time. Sometimes, our body fails to make any response against that disease. Pancreatic cancer is a type of cancer that appears in the pancreas, it is generally detected after a period of time and until it becomes hard to treat or remove.
Pancreatic cancer is when cancer cells form around the the tissue in the pancreas. It is located in your stomach in front of your spine. What the pancreas does for you is it makes the liquid and the hormones that help make your blood sugar normal. For the most part the start of pancreatic cancers start in the exocrine cells. Pancreatic cancer has a poor judgement that might happen in the future. It spreads very fast and not seen in the earlier stages. That is one reason this is one of the major cancers that leads to a lot of people's
Pancreatic cancer is the cancer of the pancreas. The pancreas is an organ between the spine and the stomach, and is about 6 inches long. The pancreas is also made up of two major components named the exocrine and the endocrine. A person has to have a pancreas to survive and this cancer can cause a rapid decline in health and eventually death. To prevent this cancer, a person needs to stop smoking, maintain a healthy weight, and check up with your sugar.
Pancreatic cancer has been studied many times. Pancreatic Ductal Adenocarcinoma(PDAC) is a pancreatic cancer and it is the third most leading cause of death by cancer in the world. Many studies and experiments have been done to improve the poor long-time survival rate of this disease. These studies show that a mutation in KRAS show up in many cases of pancreatic cancer. KRAS is what regulates proliferation, differentiation, metabolism, and survival. Being that KRAS has been confirmed in studies of animals that it is an initiation in cancer cells, it is a great therapeutic target. But these attempts to create something to affect the initiation of pancreatic cancer have been hindered in many ways. Scientists have been looking into how greatly