Esophagus And Pancreas Flashcards
___ is the 4th leading cause of cancer death. Most common in men, between 50-80
Pancreatic cancer
What are factors that causes pancreatic cancer
Smoking Familial cancer (colorectal and breast) Exposure To industrial chemicals Obesity Diets in high fats, red meats and processed meats
Where is the location of the pancreas
Located RETROperitoneally at L1-L2 transversely in the upper abdomen
The 3 anatomical regions of the pancreas
Head- overlapped by the duodenum
Body-posterior to the stomach and anterior to IVC
Tail- terminates in the splenic hilum
Pancreas is in direct contact of with ….
Duodenum, jejunum, stomach, IVC, spleen and kidney
T/F
The pancreas is usually resectable
False
Pancreas is usually un-resectable
The pancreas is composed of _____ tissue and _____ tissue
98 percent exocrine
2 percent endocrine
What is the most common histology of upper and middle thoracic esophageal cancer
Squamous cell carcinoma
What is the most common histology for distal 1/3 esophageal cancer
Adenocarcinoma
What is the most common histology for pancreatic cancer
Adenocarcinoma
The pancreas is typically located at what level
L1-L2
The esophagus is typically located at what level
C6-T10 and it is posterior to the trachea and anterior to the vertebral body
What is the treatment of choice for pancreatic cancer
Surgery (Whipple procedure)
What is the treatment of choice for post op pancreatic cancer
Chemo and XRT
What is odynophagia
Related to esophageal cancers
It’s painful swallowing
90% of patients with esophageal cancer experience…
Dysphagia and weight loss
What is NOT a common symptom for pancreatic cancer
Nausea
What are the most common presenting symptoms for pancreatic cancer
Jaundice
Abdominal pain
Anorexia
Weight loss
Tumors in the head of the pancreas causes…
Obstruction to the biliary system
Tumors to the body and tail of the pancreas does NOT cause obstruction but instead commonly causes…
Back pain and weight loss
Most pancreatic cancers occur In what region of the pancreas
Head and neck of pancreas
When treating with RADIATION ONLY, to what dose is the pancreatic cancer treated with
4500-5400cGy (45-54Gy)
treating with XRT and surgery or chemo, have to be LESS than 45Gy
When treating he head of the pancreas, at least how much of the left kidney must be shielded
2/3 of the left kidney
T/F
Early stage esophageal cancer has a high cure rate
TRUE
Esophageal cancer is deadly due to the fact that it distendable, lack or serosal layer and richness of lymphatics
What nodal group is associated with cervical esophagus
Internal jugular nodes
Cervical nodes
Supraclavicular nodes
What nodal group is associated with upper/middle esophagus
Subcarinal nodes Paraesophagus node Paratracheal node Mediastinal node Hilar node
What nodal group is associated with lower esophagus
Gastric nodes
Celiac axis node
Curvature of the stomach nodes
What is NOT a prognostic indicator for esophageal cancer
Tumor grade/ histology
HOWEVER, the earlier the discovery, a higher chance (90%) is curable*
Which nodal group drains the lower esophagus
Gastric and celiac nodes
What is the dose limiting structure of most concern for radiation treatments of the esophagus
Spinal cord
The endocrine function of the pancreas is responsible for
Releasing insulin into the body
Which of the following is the most common cancer in the US
Colorectal cancer
Which cancer has the highest incidence of cancer related deaths in the US
Colorectal cancer
The Whipple is a surgical procedure associated with cancer of what organ
Pancreas
The esophagus is located ____ to the trachea
Posterior
What condition is most closely associated with gastroesophageal reflux
Barret’s esophagus
Why is esophageal cancer so deadly
The esophagus is distendable
Lack of serosal layer
Richness of lymphatic Channels
T/F
Most esophageal cancers are discovered in early stages
FALSE
Radiation treatment fields for the distal esophagus typically include what lymph node
Celiac axis nodes
Most of the Pancreas is made up of what kind of tissue
98% exocrine (makes pancreatic juices)
2% endocrine (release insulin into the body)
The tail of the pancreas is located ….
In the hilum of the spleen
A 3 field technique using a hinge angle of 120 degrees is ofte used in the treatment of what cancer
Esophageal cancer
What is the preferred treatment regimen post op for pancreatic cancer
Chemo radiation
GERD is associated with cancer of what region
Esophagus
What is the number 1 cause of esophageal cancer in the US
Smoking and alcohol
What is no part of the digestive system
Appendix
What is he TD5/5 for liver
30Gy
The cervical esophagus extends from what distance from he incisors
18cm
The upper thoracic esophagus extends at what distance from the incisors
24cm
The middle thoracic esophagus extends at what distance from the incisors
32cm
The lower thoracic extends at what distance from the incisors.
40cm
The contraction of the intestinal tract is known as
Peristalsis
