Understanding the “Silent” Disease: Pancreatic Cancer

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Understanding the
“Silent” Disease:
Pancreatic Cancer

Tara Woodard


Statistics in the
US


Function of the Pancreas


Types of Pancreatic
Cancer


An Overview of Pancreatic Cancer


Who’s at Risk


Signs/Symptoms


Tests


Staging


Prognosis


Diets


Treatments


Future of Pancreatic
Cancer


References


Content of Pancreatic
Cancer Tutorial:

www.medscape.com


Statistics in the
US


Function of the Pancreas


Types of Pancreatic
Cancer


An Overview of Pancreatic Cancer


Who’s at Risk


Signs/Symptoms


Tests


Staging


Prognosis


Diets


Treatments


Future of Pancreatic
Cancer


References


Content of Pancreatic
Cancer Tutorial:

www.medscape.com


1) Lung
and bronchial cancer
( > 157,000 )


2) Colon
and rectal cancer ( >
51,000 )


3) Breast cancer ( 40,000 )


4)
Pancreatic
cancer ( 37,000 )


5) Prostate cancer ( 32,000 )

Top 5 Deadliest Cancers:
2010 Expected Deaths:

Statistics from 2004
-
2008:

http://www.seer.cancer.gov/statfacts/html/pancreas.html

American Cancer Society estimated >42,000 cases in
2009

5 Year Survival from 2001
-
2007:

http://www.seer.cancer.gov/statfacts/html/pancreas.html

In 2008, >35,000
deaths

(compare
to
40,930 deaths in 2008 from breast cancer)


Statistics in the
US


Function of the Pancreas


Types of Pancreatic
Cancer


An Overview of Pancreatic Cancer


Who’s at Risk


Signs/Symptoms


Tests


Staging


Prognosis


Diets


Treatments


Future of Pancreatic
Cancer


References


Content of Pancreatic
Cancer Tutorial:

www.medscape.com


















http
://www.mhaac.net/pancreatic_cancer_awareness.asp

Anatomy & Function of
the Pancreas:


Spongy, 6
-
inch
-
long organ
located behind the
stomach
.


Produces digestive
enzymes.


Produces hormones
that
regulate the body’s use of
starches and sugars.



Statistics in the
US


Function of the Pancreas


Types of Pancreatic
Cancer


An Overview of Pancreatic Cancer


Who’s at Risk


Signs/Symptoms


Tests


Staging


Prognosis


Diets


Treatments


Future of Pancreatic
Cancer


References


Content of Pancreatic
Cancer Tutorial:

www.medscape.com


More than 95%
of all pancreatic
cancer begins in
the
exocrine
pancreas.


Less than 5%
begins in the
endocrine

pancreas.

Main Types:


http
://pathology.jhu.edu/pc/BasicOverview3.php


Statistics in the
US


Function of the Pancreas


Types of Pancreatic
Cancer


An Overview of Pancreatic Cancer


Who’s at Risk


Signs/Symptoms


Tests


Staging


Prognosis


Diets


Treatments


Future of Pancreatic
Cancer


References


Content of Pancreatic
Cancer Tutorial:

www.medscape.com




Pancreatic Cancer:
Carcinogenesis


The genetic basis is extremely
complex and heterogeneous


An average of
63 genetic abnormalities

per tumor


= individualized treatment.

Unique Characteristics:


Statistics in the
US


Function of the Pancreas


Types of Pancreatic
Cancer


An Overview of Pancreatic Cancer


Who’s at Risk


Signs/Symptoms


Tests


Staging


Prognosis


Diets


Treatments


Future of Pancreatic
Cancer


References


Content of Pancreatic
Cancer Tutorial:

www.medscape.com


You are at an increased risk
if you:


Are over 60


Are overweight or obese


Have diabetes


Smoke


Have a family history of
Pancreatic
C
ancer


Are African American


Have chronic inflammation
of the pancreas


blood type A, B, or AB

Risk Factors:

http://www.wellnessuncovered.com/joomla/index.php?option=com_content
&view=article&id=2148:nicotine
-
raises
-
blood
-
sugar
-
levels
-
in
-
lab&catid=1:latest
-
news&Itemid=50


Statistics in the
US


Function of the Pancreas


Types of Pancreatic
Cancer


An Overview of Pancreatic Cancer


Who’s at Risk


Signs/Symptoms


Tests


Staging


Prognosis


Diets


Treatments


Future of Pancreatic
Cancer


References


Content of Pancreatic
Cancer Tutorial:

www.medscape.com


Abdominal Pain


Stomach Pain


Diarrhea


Fatigue


Fainting


Weight gain

Signs & Symptoms for
Endocrine:

http://abcnews.go.com/Health/Autism/stomach
-
pains
-
autism/story?id=10388309


Vague sporadic discomfort


Upper abdominal or lumbar pain which
worsens at night


Back pain aggravated by lying flat,
relieved when sitting up


Radiating pain to the back


Pain occurring several hours after eating


Loss of appetite


Weight loss


Jaundice


Depression


Signs & Symptoms for
Exocrine:

http://herbal
-
ayurveda
-
remedy.com/home
-
remedies/jaundice.php


Statistics in the
US


Function of the Pancreas


Types of Pancreatic
Cancer


An Overview of Pancreatic Cancer


Who’s at Risk


Signs/Symptoms


Tests


Staging


Prognosis


Diets


Treatments


Future of Pancreatic
Cancer


References


Content of Pancreatic
Cancer Tutorial:

www.medscape.com


Transabdominal

ultrasound


Endoscopy


U
ltrasound


Angiogram


Biopsy


CT scans


Endoscopic Retrograde
Cholangiopancreatogram

(ERCP)


Elevated blood levels of bilirubin

Tests for Diagnosis:


Statistics in the
US


Function of the Pancreas


Types of Pancreatic
Cancer


An Overview of Pancreatic Cancer


Who’s at Risk


Signs/Symptoms


Tests


Staging


Prognosis


Diets


Treatments


Future of Pancreatic
Cancer


References


Content of Pancreatic
Cancer Tutorial:

www.medscape.com


Gastrinoma


Insulinoma


Miscellaneous


Recurrent

Staging for Endocrine:

http://www.nsf.gov/news/news_images.jsp?cntn_id=109781&org=
NSF


Stage 1A:
Tumor found only in
pancreas, ≤ 2cm


Stage
1B :
Tumor found only in
pancreas, > 2cm


Stage 2A :
Cancer spread to
nearby organs but does not
involve celiac axis or superior
mesenteric artery


Stage 2B :
Cancer spread to
regional lymph nodes


Stage 3 :
Cancer spread to celiac
axis or the superior mesenteric
artery


Stage
4 :
Distant metastasis

Staging for Exocrine:

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S00
41
-
87812004000400008


Statistics in the
US


Function of the Pancreas


Types of Pancreatic
Cancer


An Overview of Pancreatic Cancer


Who’s at Risk


Signs/Symptoms


Tests


Staging


Prognosis


Diets


Treatments


Future of Pancreatic
Cancer


References


Content of Pancreatic
Cancer Tutorial:

www.medscape.com


Still considered largely incurable.


L
ow
survival rates
are most likely due to:


< 10
% of patients' tumors are confined to
the pancreas at
time
of
diagnosis


Progressed malignancy

T
he Prognosis:

http://www.indianasnewscenter.com/ne
ws/local/Early
-
Detection
-
Can
-
Mean
-
Survival
-
For
-
Some
-
With
-
Pancreatic
-
Cancer
-
106817298.html


Statistics in the
US


Function of the Pancreas


Types of Pancreatic
Cancer


An Overview of Pancreatic Cancer


Who’s at Risk


Signs/Symptoms


Tests


Staging


Prognosis


Diets


Treatments


Future of Pancreatic
Cancer


References


Content of Pancreatic
Cancer Tutorial:

www.medscape.com


Increase in cruciferous vegetables (cabbage), Folic acid, and
Vitamin C.


(
A
) Alpha
-
lipoic

acid


(
PA
)
Curcumin


(
PS
)
Genstein


(
A
) Green tea


(
A
) limonene


(
P
) Melatonin


(
A
) Mistletoe


(
PSA
) Omega
-
3 fatty acid


(
S
) Probiotics


(
P
) Selenium



[
P
= preventative,
A
= anticancer,
S
= supportive]

Diets that are Thought to
Help:


Statistics in the
US


Function of the Pancreas


Types of Pancreatic
Cancer


An Overview of Pancreatic Cancer


Who’s at Risk


Signs/Symptoms


Tests


Staging


Prognosis


Diets


Treatments


Future of Pancreatic
Cancer


References


Content of Pancreatic
Cancer Tutorial:

www.medscape.com


When tumors can be removed


Can remove all, or part of the
pancreas


Whipple procedure.


Long term survival: 15
-
20%
with a median survival rate of
around 15
-
24 months.


Recurrence is about 85%

Surgery:

http://www.diseaseproof.com/archives/hurtful
-
food
-
bypass
-
surgery.html


Uses radiation in
order to damage
the cancer cells and
prevent them from
growing.


This is given 5 days
a week, for 5
-
6
weeks.


Side
effects: nausea,
vomiting, and
diarrhea
.

Radiation Therapy:

http://www.igrt.com/prostate_cancer.asp


Kills cells that are growing or
multiplying.


Given in cycles: Treatment,
followed by recovery
.


Side effects: More likely to get
infections, hair loss, digestive
problems including nausea and
vomiting.

Chemotherapy:

http://medicineworld.org/stories/lead/4
-
2009/is
-
that
-
chemotherapy
-
working.html


Designed to restore the patients
immune system.


BRMs


Side effects: flu
-
like symptoms,
nausea
, vomiting, and
diarrhea.

Biological Therapy/
Immunotherapy
:

http://www.scientificamerican.com/article.cfm?id=
patient
-
heal
-
thyself
-
body


Statistics in the
US


Function of the Pancreas


Types of Pancreatic
Cancer


An Overview of Pancreatic Cancer


Who’s at Risk


Signs/Symptoms


Tests


Staging


Prognosis


Diets


Treatments


Future of Pancreatic
Cancer


References


Content of Pancreatic
Cancer Tutorial:

www.medscape.com


New targeted agents are
in clinical development,
including:


Small
-
molecule inhibitors
of oncogenes and
signaling pathways


Monoclonal antibodies
targeting cell
-
membrane
proteins


Nanotechnology and
adenoviral agents

The Future:

http://science.howstuffworks.com/innovation/scientific
-
experiments/scientific
-
method.htm


Statistics in the
US


Function of the Pancreas


Types of Pancreatic
Cancer


An Overview of Pancreatic Cancer


Who’s at Risk


Signs/Symptoms


Tests


Staging


Prognosis


Diets


Treatments


Future of Pancreatic
Cancer


References


Content of Pancreatic
Cancer Tutorial:

www.medscape.com



http
://
www.medicinenet.com/pancreatic_cancer_pictures_slideshow/article.
htm


http://
www.vivo.colostate.edu/hbooks/pathphys/endocrine/pancreas/anatom
y.html


http://
www.nejm.org/doi/full/10.1056/NEJMra0901557


http://www.mayoclinic.com/health/pancreatic
-
cancer/DS00357


http://
www.seer.cancer.gov/statfacts/html/pancreas.html


“Choices
-

The Most Complete Sourcebook for Cancer Information.”
Morra
,
Potts. 4
th

Edition. Harper Collins Publishers Inc. New York, NY. Oct 2003.


“The Definitive Guide to Cancer
-

An Integrative Approach to Prevention,
Treatment, and Healing.”
Alschuler
,
F
abno
,
Gazella
. 3
rd

Edition. Random
House, Inc. New York. 2010
InnoVision

Health Media.


http://
www.pancreatic.org/site/c.htJYJ8MPIwE/b.891917/k.5123/Prognosis_of
_Pancreatic_Cancer.htm


http://
www.seer.cancer.gov/csr/1975_2005/results_single/sect_01_table.01.pdf


http://www.msnbc.msn.com/id/39102353/ns/health
-
cancer
/


References: