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Pancreatic Cancer

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Following specialists treat  Pancreatic Cancer.

Overview

Pancreatic cancer is a highly aggressive malignancy arising from a glandular organ, called pancreas. It is the fourth leading cause of cancer deaths in the United States. This is attributed to the late presentation and rapid metastasis of this cancer. There are various types of pancreatic cancers. The most common type is adenocarcinoma (an exocrine pancreatic cancer). It represents more than 80% of pancreatic cancers. Hence, this description will mainly cover the pancreatic adenocarcinoma. About 75% of pancreatic cancers involve the pancreatic head or neck. The remaining 15% to 25% occur in the body or tail of the pancreas.

Causes

  • Cigarette smoking (the most common cause)
  • Chronic pancreatitis
  • Diabetes mellitus
  • Obesity
  • Cigarette smoking (the most common cause)
  • Dietary factors:
    • Diet low in fresh fruits and vegetables
    • Consumption of red meat confers a higher risk of pancreatic cancer
  • Hereditary (genetic) factors:
    • Family history of pancreatic cancer
    • Hereditary pancreatitis
    • KRAS2 gene mutation

Clinical Presentation

Patients with pancreatic cancer may experience the following signs and symptoms:

  • Remarkable weight loss
  • Malaise
  • Painless obstructive jaundice: A pathognomic sign of cancer of head of the pancreas
  • Epigastric pain (may radiate to the midback)
  • Diabetes mellitus
  • Pruritis (intense itching due to obstruction of the bile duct and the buildup of bile in blood)
  • Migratory thrombophlebitis (Trousseau sign) and superficial venous thrombosis: Maybe the initial presentation
  • Palpable gallbladder (Courvoisier sign)
  • Advanced disease
    • Ascites (abnormal accumulation of fluid in the abdominal cavity)
    • Splenomegaly from obstruction of portal vein
    • Hepatomegaly from liver metastases
    • Metastasis (spread) to paraumbilical area (or Sister Mary Joseph nodules)
    • Metastasis to cervical nodes, including those behind the left clavicle (Virchow's node)

Diagnosis

  • Imaging like CT scan abdomen: Shows the presence of pancreatic mass and aids in determining the stage of cancer
  • Endoscopic ultrasound guided or CT guided tissue biopsy
  • Blood CA-19-9 levels: A gold-standard tumor marker elevated in most if not all cases of pancreatic cancer

Treatment

The only definitive therapy is surgical resection. However, pancreatic cancer has a poor prognosis. Moreover, cancer may not be amenable to surgery in most instances. Chemotherapy and/or radiation therapy may be required.

FDA Approved Medicines

  • FDA approved secretin, sold as SecreFlo, manufactured by Repligen as to aid in the diagnosis of pancreatic dysfunction and gastrinoma ( Gastrinoma | Pancreatic Cancer ) in year 2002.
  • FDA approved irinotecan liposome injection, sold as Onivyde, manufactured by Merrimack for the treatment of metastatic pancreatic cancer following gemcitabine-based therapy ( Pancreatic Cancer ) in year 2015.
  • FDA approved sunitinib malate, sold as Sutent, manufactured by Pfizer for the treatment of pancreatic neuroendocrine tumors ( Neuroendocrine Tumor | Pancreatic Cancer ) in year 2011.

Videos

Some facts about Pancreatic Cancer

Cancer of the pancreas is the 12th most common cancer in the U.S. but 4th leading cause of cancer related deaths in the US.Unfortunately, 80% of pancreatic cancer patients have terminal disease at the time of diagnosis with an average life expectancy of 4-6 months and has the lowest survival rate of all cancers. Pancreatic cancer mostly affects people between 55 and 84 years of age.

Feb 4, 2017

Blog(s)

Nanoliposomal Irinotecan, a New Medicine for Pancreatic Cancer

Cancer of the pancreas is one of the leading causes of cancer deaths in the Western world. The commonest and most aggressive form is adenocarcinoma of the pancreas, which accounts for 85% of cases. Typically late in producing characteristic signs and symptoms,  it is all too often diagnosed when it has spread beyond the pancreas. Unfortunately, when it has reached this stage, it is considered to be incurable. The focus of treatment then shifts on to palliative care and possible life extension using radiotherapy and/or chemotherapy. Even with such therapy, the prognosis is still poor, with the median survival time after diagnosis being a miserable 3-6 months. The standard first-line chemotherapeutic agent is gemcitabine, given as single therapy. The problem with this drug is that, although it usually gives a good initial response, pancreatic cancer cells often become resistant to the drug and other, second line agents, often in combination, would then have to be used. One such agent is fluorouracil, given together with folinic acid (folinic acid is not a chemotherapeutic agent in itself but enhances the cancer-fighting actions of fluorouracil). Other drug combinations are also used as second-line agents, but all appear to offer more or less the same outcome.

Read More
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Can metformin be used to treat patients with pancreatic cancer?

Cancer is the uncontrolled growth of cells which can arise from almost any tissue in the body. As well as growing in the place where they originate, many cancer cells also develop the ability to move around the body – or metastasise. Cancer can make people unwell in a huge number of ways; the growing mass can block structures (such as blood vessels or airways), the cancer tissue can consume the natural organ and prevent it from working, the metastases (new masses of cancer which grow around the body) can cause pain and blockages wherever they develop. In addition the growing tissue uses up a huge amount of energy, making the person feel very tired and lose huge amounts of weight as the cancer is ‘stealing’ all the person’s energy.

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Research

Recent research related to Pancreatic Cancer