Transcript Pancreatic cancer

Pancreatic
cancer
• Pancreatic cancer refers to a malignant
neoplasm of the pancreas. The most
common type of pancreatic cancer,
accounting for 95% of these tumors is
adenocarcinoma, which arises within
the exocrine component of the
pancreas. A minority arises from the
islet cells and is classified as a
neuroendocrine tumor.
資料來源：http://en.wikipedia.org/wiki/Pancreatic_cancer (維基百科)
• The symptoms that lead to diagnosis
depend on the location, the size, and
the tissue type of the tumor. They may
include abdominal pain and jaundice
(if the tumor compresses the bile duct).
• Pancreatic cancer is the fourth most
common cause of cancer death across
the globe.
資料來源：http://en.wikipedia.org/wiki/Pancreatic_cancer (維基百科)
Signs and
symptoms
Common symptoms include:
• Pain in the upper abdomen that typically
radiates to the back
• Loss of appetite and/or nausea and vomiting
• Significant weight loss
• Painless jaundice
• Trousseau sign, in which blood clots form
spontaneously in the portal blood vessels, the
deep veins of the extremities, or the superficial
veins anywhere on the body.
• Diabetes mellitus, or elevated blood sugar levels
資料來源：http://en.wikipedia.org/wiki/Pancreatic_cancer (維基百科)
• Clinical depression has been reported in
association with pancreatic cancer,
sometimes presenting before the cancer
is diagnosed. However, the mechanism
for this association is not known.
• Symptoms of pancreatic cancer
metastasis. Typically, pancreatic cancer
first metastasizes to regional lymph
nodes, and later to the liver and, less
commonly, to the lungs; it occasionally
metastasizes to bone or brain.
資料來源：http://en.wikipedia.org/wiki/Pancreatic_cancer (維基百科)
Risk factors
Risk factors for pancreatic
cancer may include:
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Family history
Age
Smoking
Diets low in vegetables and fruits
Diets high in red meat
Diets high in sugar-sweetened drinks
(soft drinks)
• Obesity
資料來源：http://en.wikipedia.org/wiki/Pancreatic_cancer (維基百科)
• Diabetes mellitus is both risk factor for
pancreatic cancer.
• Helicobacter pylori infection
• Gingivitis or periodontal disease
資料來源：http://en.wikipedia.org/wiki/Pancreatic_cancer (維基百科)
Alcohol
• It is controversial whether alcohol
consumption is a risk factor for pancreatic
cancer. Overall, the association is
consistently weak and the majority of
studies have found no association
Although drinking alcohol excessively is a
major cause of chronic pancreatitis, which
in turn predisposes to pancreatic cancer,
chronic pancreatitis associated with
alcohol consumption is less frequently a
precursor for pancreatic cancer than other
types of chronic pancreatitis.
資料來源：http://en.wikipedia.org/wiki/Pancreatic_cancer (維基百科)
Diagnosis
• Pain is present in 80% to 85% of patients
with locally advanced or advanced
metastatic disease. The pain is usually felt
in the upper abdomen as a dull ache that
radiates straight through to the back.
• Courvoisier sign defines the presence of
jaundice and a painlessly distended
gallbladder as strongly indicative of
pancreatic cancer, and may be used to
distinguish pancreatic cancer from
gallstones. Tiredness, irritability and
difficulty eating because of pain also exist.
資料來源：http://en.wikipedia.org/wiki/Pancreatic_cancer (維基百科)
Pathology
• The definitive diagnosis is made by an
endoscopic needle biopsy or surgical
excision of the radiologically suspicious
tissue. Endoscopic ultrasound is often used
to visually guide the needle biopsy
procedure.
 Exocrine pancreas cancers
 Pancreatic cystic neoplasms
 Endocrine pancreatic cancers
資料來源：http://en.wikipedia.org/wiki/Pancreatic_cancer (維基百科)
Prevention
• The ACS recommends keeping a healthy
weight, and increasing consumption of
fruits, vegetables, and whole grains, while
decreasing red meat intake, although there
is no consistent evidence this will prevent
or reduce pancreatic cancer specifically.
Screening：
People who may have a high risk of
pancreatic cancer due to a family
history can be followed .
資料來源：http://en.wikipedia.org/wiki/Pancreatic_cancer (維基百科)
Treatment
Exocrine pancreas cancer：
• Surgery：
Treatment of pancreatic cancer depends
on the stage of the cancer .
• Chemotherapy：
In patients not suitable for resection with
curative intent, palliative chemotherapy
may be used to improve quality of life and
gain a modest survival benefit.
資料來源：http://en.wikipedia.org/wiki/Pancreatic_cancer (維基百科)
• Endocrine pancreatic tumors：
The majority of these tumors are histologically
benign. Treatment of pancreatic endocrine tumors,
including the less common malignant tumors, may
include:
Watchful waiting
Surgery
Hormone therapy
Radiation therapy
Radiolabeled hormone
Radiofrequency ablation (RFA), cryoablation,
hepatic artery embolization
Chemotherapy
資料來源：http://en.wikipedia.org/wiki/Pancreatic_cancer (維基百科)
Prognosis
• For all stages combined, the 1-year relative
survival rate is 25%, and the 5-year survival is
estimated as less than 5% to 6%.
• For local disease, the 5-year survival is
approximately 20%.
• For locally advanced and for metastatic
disease, which collectively represent over 80%.
to 85-90%of individuals, the median survival is
about 10 and 6 months, respectively. Without
active treatment, metastatic pancreatic cancer
has a median survival of 3–5 months; complete
remission is rare.
資料來源：http://en.wikipedia.org/wiki/Pancreatic_cancer (維基百科)