The Problem Of Pancreas Adenocarcinoma With Complete Encasement Of The Superior Mesenteric Artery And Vein

1238 Words Apr 3rd, 2015 5 Pages
Problem
Pancreas adenocarcinoma with complete encasement of the superior mesenteric artery and vein. AJCC stage III, T4 Nx M0.
Definition
• Fourth most common cancer mortality cause in USA.1
• Contributes to 3% estimated new cancer each year in USA, contributing to 44, 030 new diagnosis and 37, 660 expected deaths in 2013.1
• Most aggressive cancer with less than 2% 5 years survival.1
• Clinical staging o Stage I or II – surgically resectable.2 o Stage III – localy advanced, unresectable.2 o Stage IV – metastatic.2
Sign and symptoms
• Abdominal pain.2
• Weight loss.2
• Asthenia.2
• Anorexia.2
• Jaundice.2
Diagnostics
• Best initial diagnostic test using tri-phasic pancreatic-protocol CT.3
• Endoscopic ultrasound.2, 3
• MRI.3
• Monitor tumour markers carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9). Both has no specificity or sensitivity to be used in screening but can be useful for monitoring patient with known pancreatic cancer.2
Risk factors
• Genetic/family history.2, 3
• Smoking.2, 3
• Long-standing diabetes mellitus.2, 3
• Nonhereditary or hereditary chronic pancreatitis.2
• Obesity.2, 3
• Non-O blood group.2
• Occupational exposures.3
• High fat diet.3
Complication
• Poor survival rate upon diagnosis. 90% patient pass away within 1 year being diagnosed.4
• Physiological impact, may cause depression,4 anxiety5.
• Affect quality of life (QOL).4
• Metastasis and invasion to another parts of the body.2

Options
Pharmaceutical regimen
• FOLFIRINOX
o…
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