Pancreatic cancer : causes, symptoms stage treatment
Oncology / / August 12, 2017
Pancreatic cancer video
pancreatic cancer risk factors
types of pancreatic cancer
Symptoms of pancreatic cancer
diagnosis of pancreatic cancer
stages of pancreatic cancer
treatment of pancreatic cancer
new treatments for pancreatic cancer
treatment options by stage
pancreatic cancer Nutrition in pancreatic cancer
prognosis of pancreatic cancer
pancreatic cancer - a disease in which malignant (cancer) cells form in the tissues of the pancreascancer.Pancreatic cancer occurs when cells of the pancreas is damaged, and the malignant cancer cells begin to grow uncontrollably.
Pancreas unpaired body length of 16-22 cm., Has the shape of a pear lying on its side.The wide end of the pancreas is called the "head", the middle part is called "the body", and the narrow end - the "tail".The pancreas is located in the abdominal cavity, between the stomach and the spine.
The pancreas has two main operating functions in the body:
- its enzymes help digest food;
- hormones - such as insulin and glucagon, help control blood sugar.Both of these hormones help the body use and store energy, which it gets from food.
digestive juices produced exocrine pancreatic cells and endocrine hormones produced by pancreatic cells.About 95% of pancreatic cancers begin in the exocrine cells.
Risk factors for pancreatic cancer
- Age. Most pancreatic cancers occur in people over the age of 55 years.
- Smoking. in heavy cigarette smokers develop pancreatic cancer two to three times more likely than non-smokers.
- Obesity and physical inactivity. Pancreatic cancer is more common in people who are very overweight, and people who do not have a lot of physical activity.
- Diabetes. Pancreatic cancer is more common in people with type 2 diabetes.
- Paul. diagnosed with "pancreatic cancer" more men than women.
- Race. African-Americans are more likely than Asians or light-skinned, have a diagnosis of "cancer of the pancreas."
- Family history. risk of developing pancreatic cancer is higher if her mother had been ill with the disease of the patient, his father and siblings.
- Cirrhosis of the liver. People with cirrhosis have a higher risk of developing pancreatic cancer.
- Exposure to chemicals. impact of certain "professional" pesticides, dyes and chemicals used in the steel industry, may increase the risk of developing pancreatic cancer.
- Genetic syndromes. Some inherited gene mutations - for example, BRCA2, increase the risk of pancreatic cancer.
- Chronic pancreatitis. Long-term inflammation of the pancreas is also associated with an increased risk of developing pancreatic cancer.
- Obesity.Causes of obesity
- Diabetes: Causes, Symptoms, Diagnosis, Treatment
- Cirrhosis: causes, symptoms, diagnosis, treatment
- Pancreatitis: Causes, Symptoms, treatment of pancreatitis
There are several types of pancreatic cancer, including:
- Adenocarcinoma of the pancreas. most common cancer of the pancreas - in pancreatic ductal mucosa.
- Squamous cell carcinoma.It pancreatic cancer rare form.Certain neuroendocrine tumor of the pancreas may be benign or malignant (cancerous).
- Insulinoma. rare tumor of the pancreas, which secretes insulin - a hormone that reduces the level of glucose in the blood.
- gastrinoma. tumor that highlights above average gastrin - a hormone that stimulates the generation of an stomach acid and enzymes.Gastrinoma can lead to peptic ulcers.
- Glucagonomas . tumor which releases glucagon - a hormone which raises blood glucose, which often leads to a rash.
Symptoms of pancreatic cancer
The most common symptoms of pancreatic cancer.However, each individual may experience different symptoms.Symptoms may include:
- abdominal pain in the upper or middle part,
- back pain;
- loss of appetite;
- jaundice (yellowing of the skin and eyes, dark urine);
- fatigue (tiredness);
- enlarged abdomen from swollen gallbladder;
- pale, greasy and loose stool in the toilet;
- weight loss for no apparent reason;
- feeling very tired.
pancreatic cancer is difficult to detect and diagnose at an early stage for the following reasons:
- there are subtle signs or symptoms in the early stages of pancreatic cancer;
- symptoms of pancreatic cancer are similar to the symptoms of many other diseases;
- the pancreas is hidden behind other organs - such as the stomach, small intestine, liver, gallbladder, spleen, and bile ducts.
cancer In addition to a complete medical record of the patient and physical examination, diagnosis of pancreatic cancer could be the following:
- Ultrasound (also called "sonography"). It is a diagnostic imaging technique that uses high-frequency sound waves to create images of internal organs.Ultrasound is used to view the internal abdominal organs - such as the liver, pancreas, spleen, kidneys and assess blood flow through various vessels.An ultrasound of the pancreas can be done using internal or external devices;
- transabdominal ultrasound. technician places the ultrasound device on the abdomen to create the image of the pancreas;
- Endoscopic ultrasonography. doctor inserts an endoscope - a flexible small tube with an ultrasound device on the end through the mouth and the stomach and the small intestine.When he slowly removes the endoscope, ready to image the pancreas and other organs;
- Computed tomography (CT) - a diagnostic procedure that uses a combination of X-rays and computer technology to produce horizontal and axial images of the body.CT shows detailed images of any part of the body including the bones, muscles, fat and organs.CT scans are more detailed study than general X-rays;
- Magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radio frequencies and a computer to produce detailed images of organs and structures in the body;
- Endoscopic retrograde cholangiopancreatography (ERCP). procedure that allows the doctor to diagnosis and treatment of liver problems, gallbladder, bile ducts and pancreas.The procedure combines x-ray and the use of an endoscope - a long, flexible, lighted tube.The endoscope is guided through the patient's mouth and throat, then through the esophagus, stomach and duodenum (the first part of the small intestine).The physician can examine the inside of these organs and detect any abnormalities.The tube is then passed through the desired area (pancreas), which introduced a dye that will be seen on x-ray the bile and pancreatic ducts;
- Endoscopic retrograde cholangiography (ERHRG). needle is inserted through the skin and into the liver, where the dye (contrast) is injected (injected) so that the structure of biliary ducts can be seen on x-rays.This test is usually done when ERCP can not be done;
- A biopsy of the pancreas. procedure that is removed (with a needle or during surgery) pancreatic tissue sample for examination under a microscope it;
- Laparoscopy - a surgical procedure during which a doctor looks organs in the abdomen to check for signs of disease.Small incisions are made in the abdominal wall and a laparoscope (a thin tube) is inserted into one of the small incisions.A laparoscope may be at the end of the probe for the investigation of internal organs (e.g., pancreas).This laparoscopic ultrasound.Through the same or other sections can be inserted, and other tools to perform necessary procedures - taking pancreatic tissue samples of liquid specimens from the abdominal cavity to test for cancer, etc .;
- Blood and urine tests - biochemical studies in which a blood sample is checked to measure the amounts of certain substances - such as bilirubin, discharged through the blood to the organs and tissues in the body.Unusual (higher or lower than normal), the amount of the substance can be a sign of the disease in an organ or tissue;
- test for tumor markers. procedure in which a blood sample is checked, urine or tissue to measure the amount of certain substances - such as CA 19-9 and carcinoembryonic antigen (CEA), in charge of the tumors in organs, tissues or cells of the body.Some substances are associated with specific types of cancer, when it is found in the body within the inflated.This so-called "tumor markers";
- Positron emission tomography (PET). type nuclear medicine procedures.For this test, a radioactive substance - usually associated with a type of sugar, injected into a vein before the body scan.The radioactive sugar accumulates in the cancer cells that will appear in the images.PET is often done in combination with CT.
stages of pancreatic cancer
There are three ways ubiquitous cancer in the body:
1. A fabric . Cancer cells invade the surrounding normal tissue;
2. After lymphatic system. Cancer cells invade the lymphatic system and pass through the lymph vessels to other places in the body;
3. Through blood . Cancer cells invade the capillaries and veins and blood - in other places in the body.
When cancer cells detach from the primary tumor and travel through the blood or lymph nodes in other areas of the body may be formed other secondary tumors.This process is referred to as "metastasis."Secondary (metastatic) tumors are of the same type of cancer as the primary tumor.For example, if breast cancer spreads to the bones, the cancer cells in the bones - it actually breast cancer cells.And Disease - metastatic breast cancer, not bone cancer.
Pancreatic cancer is divided into the following stages:
- Stage 0 (carcinoma in situ). abnormal cells are pancreatic mucosa.These abnormal cells may become cancer and spread to adjacent healthy tissue.
- 1 stage. In stage I cancer has formed and is found only in the pancreas.In stage IA tumor - 2 cm or less.Stage I is divided into stages IA and IB - depending on the tumor size.In stage IB tumors larger than 2 centimeters.
- Stage 2. cancer can spread to nearby tissues and organs, as well as, possibly, to the lymph nodes in the pancreas.Stage II is divided into stages IIA and IIB, depending on the places where the cancer has spread.Stage IIA: Cancer has spread to nearby tissue and organs but has not spread to nearby lymph nodes.Stage IIB: Cancer has spread to nearby lymph nodes and can spread to nearby tissues and organs.
- Stage 3. cancer has spread to the major blood vessels near the pancreas and may spread to nearby lymph nodes.These include: superior mesenteric artery (near the pancreas, aorta extends from slightly below the celiac trunk at the level of XII thoracic or lumbar vertebra I and supplies the large intestine), celiac trunk (short vessel 1-2 cm long, extending from the anterior surface of the aorta), common hepatic artery and portal Vienna.
- Stage 4. cancer can be any size and spreading to distant organs - the lungs, the liver and the abdominal cavity (the space in the abdominal cavity, which contains the intestines, stomach and liver).Cancer can also spread to nearby tissues and organs of the pancreas or lymph nodes.
to determine the stage of pancreatic cancer using TNM system (abbreviated from the English terms «Tumor» - «swelling» - the size of the tumor and the degree of its growing into the tissue; «Lymph Node»- "lymph node" - lymph nodes; "metastasis" - "metastases" - the presence or absence of metastases).
TNM categories define the stage of the cancer (numbered from 0 to IV).
«T» in this system indicates the extent of the primary tumor in the pancreas:
- TH - inadequate information to assess the primary tumor
- of T0 - no evidence of primary tumor (the primary tumor site is not defined).
- Tis Carcinoma in situ - carcinoma in situ.The cells - cancer, but the tumor does not extend beyond their places of origin (a precancerous condition, intraductal papillary mucinous tumors with high-grade dysplasia).
- T1 - Tumor is limited outside the pancreas, its size - 2 cm or less.T1A - tumor less than 2 cm in greatest dimension.T1B - tumor larger than 2 cm in greatest dimension.
- T2 - the tumor grows into one of the neighboring organs: the duodenum, bile duct, or tissue around the pancreas, it is more than 2 cm in diameter.
- T3 - the tumor grows beyond the pancreas, in one of the neighboring organs: stomach, spleen, colon, closely spaced large vessels, but it is not associated with the blood vessels of the celiac trunk or superior mesenteric artery.
- T4 - tumor is present in the blood vessels of the celiac trunk or superior mesenteric artery (two blood vessels that operate near the pancreas).
«N» - regional lymph nodes.The system determines whether the cancer has spread (metastasized) to the lymph nodes in the area of the pancreas:
- NX - regional lymph nodes can not be assessed.
- N0 - no lymph node metastases in regional (cancer has not spread to the lymph nodes, they are not impressed by metastases).
- N1 - metastasis was struck by regional lymph nodes (the cancer has spread to the lymph nodes).
«M» - distant metastases, the tumor has spread to other organs outside the pancreas:
- MX - not enough information to determine the distant metastases.
- M0 - distant metastases were found - they will most likely not.
- M1 - distant metastases were found.
After notation T, N and M are set for a particular patient, they may be combined.
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