Reference
- Pancreatic CancerPrimary cancer of the pancreas. Pancreatic cancer does not present many symptoms until it is fairly advanced, making it difficult to diagnose at a treatable stage. Pancreatic cancer is notoriously aggressive, growing rapidly within the pancreas and quick to metastasize (spread to other parts of the body).
Symptoms and Diagnostic Path
The key symptoms of pancreatic cancer include dull pain in the upper abdomen that characteristically improves or goes away when leaning forward, unintended and usually rapid weight loss, jaundice, sudden onset of diabetes. There may also be tarry stools, indicating gastrointestinal bleeding, or steatorrhea (smelly stools that float) indicating undigested fat. Loss of appetite and changes in taste and smell are also common. The diagnostic path includes biomarker blood tests and imaging procedures such as ultrasound, computed tomography (CT) scan, and magnetic resonance imaging (MRI) scan. A fine-needle biopsy of a suspected pancreatic tumor can confirm the diagnosis.
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Streaming Media
- Pancreatic Cancer—Second OpinionA diagnosis of pancreatic cancer is devastating both for patients and their family. This cancer is often only caught in its advanced stage, when survival rates are much lower. Peter Suess was diagnosed with pancreatic cancer more than 5 years ago, and the story of his ongoing treatment and survival is one of hope and inspiration. We also answer whether pancreatic cancer a death sentence, and outline five ways to support someone with cancer.
- All in Her Stride: A Cancer Patient Advocates for Voluntary EuthanasiaLeverne McDonnell was an Australian actor who died in 2013 from pancreatic cancer. ALL IN HER STRIDE depicts elements of her life and documents her facing death, with her consideration of the topic of euthanasia.
Online Resources
- Pancreatic cancerPancreatic cancer is a highly lethal disease, for which mortality closely parallels incidence. Most patients with pancreatic cancer remain asymptomatic until the disease reaches an advanced stage. There is no standard programme for screening patients at high risk of pancreatic cancer (eg, those with a family history of pancreatic cancer and chronic pancreatitis). Most pancreatic cancers arise from microscopic non-invasive epithelial proliferations within the pancreatic ducts, referred to as pancreatic intraepithelial neoplasias. There are four major driver genes for pancreatic cancer: KRAS, CDKN2A, TP53 , and SMAD4. KRAS mutation and alterations in CDKN2A are early events in pancreatic tumorigenesis. Endoscopic ultrasonography and endoscopic ultrasonography-guided fine-needle aspiration offer high diagnostic ability for pancreatic cancer. Surgical resection is regarded as the only potentially curative treatment, and adjuvant chemotherapy with gemcitabine or S-1, an oral fluoropyrimidine derivative, is given after surgery. FOLFIRINOX (fluorouracil, folinic acid [leucovorin], irinotecan, and oxaliplatin) and gemcitabine plus nanoparticle albumin-bound paclitaxel (nab-paclitaxel) are the treatments of choice for patients who are not surgical candidates but have good performance status.
- Recent progress in pancreatic cancerAnswer questions and earn CME/CNE Pancreatic cancer is currently one of the deadliest of the solid malignancies. However, surgery to resect neoplasms of the pancreas is safer and less invasive than ever, novel drug combinations have been shown to improve survival, advances in radiation therapy have resulted in less toxicity, and enormous strides have been made in the understanding of the fundamental genetics of pancreatic cancer. These advances provide hope but they also increase the complexity of caring for patients. It is clear that multidisciplinary care that provides comprehensive and coordinated evaluation and treatment is the most effective way to manage patients with pancreatic cancer.
Pancreatic Cancer
Pancreatic Cancer. Contemporary Issues in Cancer Imaging: a Multidisciplinary Approach
Written by a team of expert authors from all members of the multidisciplinary cancer care team, Pancreatic Cancer summarizes our current understanding of the epidemiology, genetics, imaging and treatment of these complex malignancies. Each imaging modality is reviewed, with an emphasis on MDCT, MRI and EUS; the key aspects of image interpretation are covered. Separate chapters focus on diagnosis and staging of ductal adenocarcinoma, cystic pancreatic neoplasms and neuroendocrine tumors; rare neoplasms and benign pancreatic disorders that mimic pancreatic cancer are also considered. All treatment options are discussed in detail, including surgery, chemotherapy and radiation therapy, and the multidisciplinary approach to patients with more advanced disease is fully reviewed. This volume is a state-of-the-art review of current practice and knowledge of pancreatic cancer.
