1.1 Pancreatic cancer
Pancreatic cancer is a highly lethal disease that is ranked fourth among cancer-related deaths in Norway. 31 Yearly 600-650 new cases are detected, corresponding to 7 per 100 000 inhabitant. The survival rate five years after diagnosis is very low, at only 5 %. 19 Approximately 90 % of patients diagnosed with advanced pancreatic cancer survive less than one year, with a median survival of 5-6 months. The high mortality rate is connected to late diagnosis, early metastasis and poor response to chemo- and radiotherapy. 34 Pancreatic cancer can be inherited, but 90 % of cases are considered sporadic. 19 The major histological type of pancreatic cancer is ductal pancreatic adenocarcinoma which account for 80 % of the
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Evidence shows that some families have increased risk of pancreatic cancer, implying a genetic contribution. 28 The genetic base for this increased risk has not been identified yet, but mutations in BRCA2 and PALB2, among others, are associated with greater risk of disease 37. Only 5-10 % of patients have a family history of the disease. 19 It has been shown that in families with four or more cases of pancreatic cancer the risk of disease is 57 times higher than in families with no history of disease. 19
1.1.2 Stage and diagnostics
Pancreatic cancer tumors are staged according to tumor-node-metastasis (TNM) classifications of the American Joint Committee on Cancer (AJCC). The staging of tumors is based on tumor size and localization, and connected to resectability. 19 Further staging reflect whether lymph node metastasis (N stage) or distant metastasis (M stage) are present. Tumor stage, nodal stage and distant metastasis are combined into stages which tell about the overall disease. See Table 1 for complete overview of this staging strategy. 19
Table 1 Explanation of TNM classification of the AJCC for pancreatic cancer
Stage Tumor stage Node metastasis Distant metastasis Characteristics
IA T1 N0 M0 The tumor is limited to the pancreas, with a size smaller than 2 cm.
IB T2 N0 M0 The tumor is limited to the pancreas, with a size larger than 2 cm.
IIA T3 N0 M0 The
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
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").
The doctor may also take a blood test to determine if the jaundice is due to pancreatic cancer or liver disease. (Panno) Once the patient is diagnosed with pancreatic cancer, they can choose from different treatment plans. When determining the person’s treatment plan, they take consider their age and expected lifespan, other serious health conditions, the stage of the cancer, if surgery can remove cancer, likelihood of curing the cancer, and how the person feels about side effects. For many patients, the part that most important is the controlling of pain. Some treatments for the cancer include surgery, radiation therapy, chemotherapy and other drugs. (Treating) Treating pancreatic cancer is very difficult due to the dense outer shell around the pancreatic tumor and nearly impossible to penetrate with cancer-killing drugs. “Wall is so tough that clinical trials with medications that are experimental designed to breach barrier had to be abandoned mainstream, drug so harsh they sicken already ailing patients,” said Doctor Abram Handly-Santana, a researcher who specializes in pancreatic cancer. (Ricks) Even though treating pancreatic cancer is difficult, some doctor decide to perform surgery to determine if the tumor is removeable and to determine the staging of the cancer to prescribe the best treatment. (Panno) The best
I would tell my younger self just be yourself—that who you are is good enough.". ( ) When I think about age, I think about growth. Using a brief questionnaire, I was able to identify The age I was projected to live. The results stated that I was projected to live to 100 years old and I’d have 75 more years to live. We still approach aging with fear, resignation, and sadness even though life expectancy, health status, and financial status have improved for the elderly ( ) . The information given by the questionnaire allowed me to appreciate life and the decisions that I am making. Recently my Uncle Horace passed away with pancreatic cancer from tobacco and alcohol consumption for about 17 or more years. With his condition,
ImagePain in the PancreasDiabetic Danger ZoneCoordinationBlackouts Shifty Eyes Dependence Stomach Distress Gotta Go Fighting Fatigue Infertility Skinny Skeleton The Liver Takes the Brunt Slurred Speech Shrinking Frontal Lobes Strange Sensations Hallucinations Major Mouth Problems Malnutrition Hard on the Heart Sexual Dysfunction Birth Defects Muscle Cramps Check Out That Cough
The first discovery of pancreatic cancer was thought to be during the 18th century, but the first cases were reported in the 1800s. As more cancers were discovered throughout the body, more research was done on it. It has been a problem for hundreds of years, but there was and still isn’t a real cure. Within the last 10 years more light has been shed upon the subject and more research is being done. Pancreatic cancer, like all other cancers has no “cure”, but there are ways to treat it. This type of cancer is one of the most deadly kinds, especially if it is not caught early on. According to Pancreatic Cancer Action, the risks of people ages 45-84 is about 84.6% and when people get diagnosed they are usually under the age of 65 (“Causes
Ms. BH is a 70 year old female with a history of recently diagnosed pancreatic adenocarcinoma with hepatic lesions, multifocal PEs s/p IVC filter placement on lovenox, and HTN who presents with persistent nausea and vomiting.
In order to begin the initial diagnosis process, an image of the pancreas, and a blood test is performed. The reasoning behind the blood test and imaging, is to verify the intensity of the cancerous cells, and the allow the doctors to determine how many organs have been affected. The Helix “Spiral” CT Scan, one of the most overall efficient diagnosis tools. According to Hirshberg Foundation for Pancreatic Cancer Research, this scan is used to accurately pinpoint the exact location and nature of the tumor. If the results from this CT scan appear to be inconclusive, then further procedures will be set into place. The Larascopy, mainly used for further examination, would be the next major step to take. A small camera, that displays an image of the pancreas on a T.V like screen, is inserted through a small surgical incision inside the pancreatic wall. This allows easier access for the doctors to take a closer look at the cancer. Lastly, a biopsy would be performed to officially confirm the diagnosis. This procedure involves doctors entering the pancreas, and removing a small area of tissue from inside the infected organ. After the diagnosis has been confirmed, treatment
As per the United States Census Bureau , around 73% of the US population are white ,12% are African-American and 5% are Asian (United States Census Bureau ,2016) , which is close to pancreatic cancer incidence distribution per race. The assumption that white race is a relevant risk factor for pancreatic cancer prediction conflicts with previous studies outcome. Yadav, D., & Lowenfels, A. B. (2013) assumes that pancreatic disorders including pancreatitis and pancreatic cancer “affect Blacks more than any other race” (Yadav & Lowenfels ,2013).
Context: Surgical resection remains the primary and the only potentially-curative treatment for pancreatic carcinoma. However, aggressive multi-visceral surgical option in the presence of locally-advanced disease is controversial.
The type of cancer that I have is pancreatic cancer, Pancreatic cancer is a disease in which cancerous cells form in the tissues of the pancreas. The pancreas produces digestive juices and hormones that regulate blood sugar. Cells called exocrine pancreas cells produce the digestive juices, while cells called endocrine pancreas cells produce the
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 known as one of the most aggressive cancer in the current time period. In the United States around 40 000 to 50 000 individuals are diagnosed with pancreatic cancer annually. It is one of the most deadly types of cancer with the 4th highest mortality amongst all cancers. According to (Han Hsi Wong, 2010)an average 5 year survival rate of about 6%. The life span of pancreatic cancer is poor as well with an average life span of around 6months. Reasons as to why this cancer is so deadly is due to the rapid proliferation, late diagnosis and lack of effective treatment options. Current treatment of pancreatic cancer includes whipple procedure or total pancreatectomy which cause many problems as the pancreas is removed. Chemotherapeutic agents include
Methods In the retrospective study, advanced pancreatic cancer patients were treated as the GS regimen (gemcitabine 1000mg/m2 I.V for 30min on days 1, 8, and S-1 80mg/m2 per day orally for 14 consecutive days, followed by a 7 days rest period, repeated every 21 days). The cycle was repeated until disease progression or unacceptable toxicity.
Currently, the clinical avail of CTCs analysis remains debatable in the PC. To date, numerous analysts have attempted to identify CTCs in patients with PC and have shown its potential clinical utility utilizing different methodologies and with varying results (Table 1) [84, 180-190]. Notably, some studies showed that CellSearch™ has a lower CTCs detection rate for PC patients with the sensitivity and specificity of 55.5 % and 100 %, respectively. Additionally, these studies also revealed that CTCs could only be found in malignant pancreatic tumor and CTCs positive patients have a significantly shorter overall survival. However, CTCs detected in these studies failed to correspond with tumor stage [84, 180, 182, 190]. Interestingly, in a