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Martina Rastovac Mentor: A. Žmegač Horvat

Martina Rastovac Mentor: A. Žmegač Horvat

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Martina Rastovac Mentor: A. Žmegač Horvat

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  1. Pancreatic Carcinoma Martina Rastovac Mentor: A. Žmegač Horvat

  2. Actor Patrick Swayze died after a 20-month battle with pancreatic cancer. He was 57.

  3. Epidemiology: • < 2% of all malignancies • ~ 6500 deaths/year • Typical patient: • male > 60yrs old • Risk factors: • smoking • alcohol • carcinogens • chronic pancreatitis

  4. Pancreas: head body tail

  5. Symptoms & signs: • jaundice • pain in the upper or middle abdomen and back • unexplaind weight loss • loss of appetite • fatigue

  6. Investigations: • transabdominal ultrasound • contrast-enhanced spiral CT scan • laparoscopy • ERCP • percutaneous needle biopsy • MRI scanning and endoscopic ultrasound • several tumour markers (CA19-9)

  7. Pathology: • mostly ductal adenocarcinoma (metastasizes early; presents late) Location of tumor: - 60% head - 25% body - 15% tail

  8. Stages of pancreatic cancer: I II III IV

  9. Treatment: • surgery • Whipple`s procedure • total pancreatectomy • distal pancreatectomy • radiation therapy • chemotherapy

  10. Whipple`s procedure:

  11. WHO Pain relief ladder Freedom from cancer pain

  12. Prognosis: • dismal Mean survival: < 6 months 5yr survival: < 2 % After Whipple`s procedure: 5-14% Better if:tumour < 3 cm no nodes involved negative resection margins at surgery ampullary or islet cell tumors

  13. References: • http://www.meb.uni-bonn.de/cancer.gov/CDR0000062957.html • Longmore, Oxford Handbook of Clinical Medicine, Oxford University Press, 2010