Quiz 2: Pancreatic Cancer & Lymphoma – Flashcards
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GI System
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Gastrointestinal System; include stomach, liver, pancreas, rectum, gallbladder
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GU System
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Genitourinary system
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Epidemiology
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• 5th leading cause of death in the U.S.* • About 1:1 risk men vs. women • 1/71 risk • More common in Af. Americans vs. Whites
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Etiology
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• Age peaks around 72 yo • Cigarette smoking 2-3x increased risk • Chronic Pancreatitis • Diabetes • Obesity • Diet: high fat & red meats • Family history
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Presenting Symptoms
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• Usually none until the disease in late stages • (90%) Pain in upper abdomen • Indicating celiac lymph node involvement • Loss of appetite • N & V • Constipation • Weight loss due to early satiety • Jaundice
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Chronic Pancreatitis
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inflammation of the pancreas
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Detection & Diagnosis
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• Physical Examination - Jaundice, Palpable masses, enlarged organ(s), enlarged lymph nodes • Blood Tests - CBC, CEA elevated in 50% of cases, CA 19-9 elevated in 70-80% of cases • Endoscopy • Stool Guaiac - blood in the stool • U/S - ultrasound • CT/MRI • PET - petscan (imaging) • Biopsy • CT guided FNA
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CEA
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Carcinoembryonic Antigen
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Treatment
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• Usually just palliation however, if the tumor is small enough and has not metastasized.... • Surgery • XRT - for unresectable or palliative treatment • Chemotherapy
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Surgery
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Whipple Total Pancreatectomy Palliation
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Whipple
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Removes head of pancreas, gallbladder, part of stomach, small intestine, & bile duct
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Total Pancreatectomy
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Removes whole pancreas, part of stomach, part of the small intestine, common bile duct, gallbladder, spleen & LNs
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Palliation Surgery
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Billiary bypass - If cancer is blocking small intestine and bile is building up in the gall bladder Stent - To drain bile built up, either outside the body or into small intestine around blockage Gastric bypass - If blocking flow of food from stomach
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Side Effects of Radiation Therapy
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nausea, illness, vomitting, skin yellow
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How is Jaundice created?
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when cancer is in the head of the pancreas; blockage of ducts
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Five-Year Survival Rates
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•All Stages = 4% (10% if resectable) •Localized = 12% (25% if resectable) •Regional Spread = 5% •Distant Spread = 2%
