Where is the pancreas Between the stomach and spine Lies partially behind the stomach and rests in the curve of the small intestine http wwwwebmdcom digestivedisorderspictureofthepancreas ID: 1040921
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1. Pancreatic cancerBy Linda Sircy
2. Where is the pancreas?Between the stomach and spineLies partially behind the stomach and rests in the curve of the small intestinehttp://www.webmd.com/digestive-disorders/picture-of-the-pancreas
3. StatisticsThe ACS estimates:About 45,220 people (22,740 men and 22,480 women) will be diagnosed with pancreatic cancerAbout 38,460 people (19,480 men and 18,980 women) will die of pancreatic cancerRates of pancreatic cancer have been slowly increasing over the past 10 yearsThe lifetime risk of developing pancreatic cancer is about 1 in 78.
4. Exocrine tumorsMost common typeBenign cysts and benign tumors (cystadenomas) can occur, but most are malignant.About 95% are adenocarcinomasLess common types include:Adenosquamous carcinomasSquamous cell carcinomasSignet ring cell carcinomasUndifferentiated carcinomasUndifferentiated carcinomas with giant cellsSolid pseudopapillary neoplasms of the pancreasAmpullary cancer (or carcinoma of the ampulla of Vater)
5. Endocrine tumorsKnown as pancreatic neuroendocrine tumors (NETs),or islet cell tumorsSubtypes include:Insulinomas**Gastrinomas**GlucagonomasSomatostatinomasVIPomas (Vasoactive Intestinal Peptide)Ppomas (Pancreatic Polypeptide)Carcinoid tumors
6. Risk factorsAgeGenderRaceTobacco useObesityDiabetesChronic pancreatitisCirrhosis of the liverOccupational exposureStomach problemsDietCoffeeAlcohol
7. Risk factorsFamily history/Genetic syndromesInherited gene mutations may cause as many as 10% of pancreatic cancers:Hereditary breast and ovarian cancer syndromeFamilial melanomaFamilial pancreatitisHereditary non-polyposis colorectal cancer (HNPCC), also known as Lynch syndrome.Peutz-Jeghers syndrome (PJS), also linked with polyps in the digestive tract and several other cancersVon Hippel-Lindau syndromePancreatic neuroendocrine tumors and cancers can also be caused by a genetic syndrome, such as: Neurofibromatosis type 1 and Multiple endocrine neoplasia type 1
8. Signs and symptomsExocrine tumorsJaundiceDarkening urineAbdominal or back painWeight loss and poor appetiteDigestive problemsGallbladder enlargementBlood cots or fatty tissue abnormalitiesDiabetesEndocrine tumorsStomach ulcers, abdominal pain, nauseaDecreased appetite, weight loss, malnutrition, digestion problemsDiabetesDiarrhea, gallbladder issues, jaundice, dark urineFainting, coma, seizuresRapid heart rate, weakness, shortness of breath, confusion, sweating
9. Signs and symptomsBecause of the pancreas' deep location, tumors are rarely palpable through the abdomen.Many symptoms of pancreatic cancer often do not appear until the tumor grows large enough to interfere with the function of nearby structures:StomachDuodenumLiverGallbladder
10. Diagnostic testsCT scanCT-guided needle biopsyMRISomatostatin receptor scintigraphyUsed for diagnosing NETsPositron emission tomography (PET) scanUsed to look at spread from exocrine tumorsUltrasonographyEndoscopic ultrasoundLaparoscopyX-rayEndoscopic retrograde cholangiopancreatography (ERCP)Percutaneous transhepatic cholangiography (PTC)AngiographyBlood testsUsed for diagnosing NETsBiopsy
11. GradingPancreatic cancer does not use a specific grading system, so it follows the general system:GX: Undetermined gradeG1: Well differentiated or low gradeG2: Moderately differentiated or intermediate gradeG3: Poorly differentiated or high gradeG4: Undifferentiated or high grade
12. StagingStage 0Stage IIAIBStage IIIIAIIBStage IIIStage IV
13. Stage I
14. Stage II
15. Stage III
16. Stage IV
17. Other terms:Another factor in staging pancreatic cancers is the extent of resection:From R0, where all visible and microscopic tumor was removed…To R2, where some visible tumor could not be removedSome doctors use a simpler staging system, dividing cancers into groups based on likelihood of surgical removal:ResectableLocally advanced (or unresectable)Metastatic
18. Treatment optionsSurgeryPalliative surgeryRadiationChemotherapyBiologic therapyAblative techniques
19. Referenceshttp://pathology.jhu.edu/pc/BasicOverview1.phphttp://www.cancer.org/cancer/pancreaticcancer/indexhttp://www.cancer.gov/cancertopics/types/pancreatichttp://www.mayoclinic.com/health/pancreatic-cancer/DS00357http://www.cancer.gov/cancertopics/factsheet/detection/tumor-gradehttp://www.cancer.gov/cancertopics/pdq/treatment/pancreatic/Patient/page2http://www.upmccancercenter.com/pdq_xml/cancer.cfm?id=105