Cruz Pancreatic

8/14/2019 Cruz Pancreatic

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By: Cruz Jerome “JC” R.



Anatomy of Pancreas:



What is pancreatic cancer?

Two Categories of Pancreatic Cancer:

A. “Islet Cell" or “Pancreatic Neuroendocrine"

cancers- cancers of the endocrine pancreas (the part that makes insulin)

B. Pancreatic Adenocarinoma

-cancers of the exocrine pancreas (the part that makesenzymes).



Islet cell cancers are rare and typically grow slowly

compared to exocrine pancreatic cancers. Islet

cell tumors often release hormones into the

bloodstream and are further characterized by thehormones they produce (insulin,glucagon, gastrin,

and other hormones).

Cancers of the exocrine pancreas develop from

the cells that line the system of ducts that deliver

enzymes to the small intestine and are called

commonly referred to as pancreatic

adenocarcinomas.

http://www.medicinenet.com/script/main/art.asp?articlekey=17466

http://www.medicinenet.com/script/main/art.asp?articlekey=17466



Cause of Cancer

Smoking

Advanced age

Male sex - The male-to-female ratio of

pancreatic cancer is 1.3:1. Chronic pancreatitis - Inflammation of

the pancreas, usually from excessivealcohol intake or gallstones

Diabetes mellitus

Family history of pancreatic cancer

http://www.emedicinehealth.com/script/main/art.asp?articlekey=58652






Clinical Manifestation:

Pain in the abdomen, the back, or both Weight loss, often associated with the

following:

○ Loss of appetite (anorexia)○ Bloating

Diarrhea or fatty bowel movements that

float in water (steatorrhea)

Rarely may present with new diabetesin

a person with weight loss and nausea

Jaundice (yellowing of the skin)















Pathophysiology:

Typically, pancreatic cancer first

metastasizes to regional lymph nodes, then to the

liver and, less commonly, to the lungs. It can also

directly invade surrounding visceral organs suchas the duodenum, stomach, and colon, or it can

metastasize to any surface in the abdominal cavity

via peritoneal spread. Ascites may result, and this

has an ominous prognosis. Pancreatic cancer mayspread to the skin as painful nodular metastases.

Metastasis to bone is uncommon.



Stage III: major blood vessel and nearby pancreas

Stage IV: liver, lung, and peritoneal cavity.



How to detect Pancreatic

Cancer?

o Abdominal ultrasound: This may be the initial testif a person has abdominal pain and jaundice.

o Abdominal computed tomography (CT): This is thetest of choice to help diagnose pancreatic cancer.

o Pancreatic Protocol Scan







How to prevent Pancreatic

Cancer?

No known preventative measure exists for

pancreatic cancer; however, minimizing certainrisk factors is important. Risk factors that can

be controlled include limiting smoking and

excessive alcohol intake.



What is the management for

Pancreatic Cancer? The treatment of pancreatic cancer depends on whether

complete surgical removal of the cancer is possible.

Complete surgical removal of the cancer is the only

known cure for pancreatic cancer.

Only 15-20% of people with pancreatic cancer havedisease that can be surgically removed at the time ofdiagnosis.

Cancer that is localized may be completely removed andthereby considered resectable. If all the cancer could notbe removed with surgery or if a surgery would not be safe

to perform, then the cancer is considered unresectable.







Whipple procedure:

○ the head or uncinate process.

○ removes the head and uncinate process of the pancreas,the duodenum, and thegallbladder .

○ A portion of the stomach is often removed as well.

Distal subtotal pancreatectomy:○ the body or tail of the pancreas.

○ removes the body and tail of the pancreas as well as the

spleen.









Medication:

Gemcitabine (Gemzar):This drug has direct effects

on the cancer cells and is usually given alone for

the treatment of metastatic pancreatic cancer.

Side effects include fatigue, nausea, increased risk of

infection

Fluorouracil (5-FU):This drug has direct effects on

the cancer cells and is usually used in combinationwith radiation therapy

Side effects include fatigue, diarrhea, mouth sores, and

hand-and-foot syndrome (redness, peeling, and pain on

the palms of the hands and the soles of the feet).









Pancrelipase (pancreatic enzyme

replacement) may be given if the function of

the pancreas is impaired, usually after the

surgical removal of a portion of the pancreas.









Rehabilitation for cancer patients:

After surgery and some cancer treatments,you may need rehabilitation or occupationaltherapy to help you regain or reinforce dailyliving skills.

Our therapists will work with you to evaluateyour skills, and then talk to you and your familyabout your goals.

They will prepare a program to help you

become physically able to meet goals whichcan range from walking to the mailbox to beingable to cook for your family.



Long-term rehabilitation is not a consideration formost individuals with pancreatic cancer as the

condition is usually fatal. For those individuals who have had Whipple's

procedure, intermittent positive pressure breathingexercises may be useful in preventing postoperativepulmonary complications.

Certain exercises may also be performed to reducepostoperative pain and speed recovery includingprogressive relaxation and deep breathingtechniques.

This is especially valuable during the first 48 hours

after surgery and may continue until recovery fromsurgery is complete and pain is no longer noticeablewhile walking or breathing.



endoscopic retrograde cholangoi-

pancreatography.

Cruz Pancreatic

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