pancreatic cancer Flashcards
occurs more frequently in men or women?
men
survival rate of pancreatic cancer
5%
increased risk with
age smoking chemical or toxin exposure certain petroleum etoh, high fat and protien, low fiber may increase risk
10-20% of those diagnosed with pancreatic cancer also are having
diabetes
why is pancreatic cancer called the “silent disease”?
early cancer does not cause symptoms
if tumor blocks the common bile duct then he bile can not pass into the digestive system
they m
if tumor blocks the common bile duct then he bile can not pass into the digestive system
pt will become jaundice
pain of pancreatic cancer can
develops in upper abdomen then back
be caused when a person lies down or eats
s/s of pancreatic cancer
nausea, loss of appetite, weight loss, weakness
clinical manifestations of pancreatic cancer
present of pain and jaundice
rapid/progressive wt loss
mid to upper abd pain unrelated to GI function
pain/dysfunction described as boring to mid back pain unrelieved by posture or activity
worse in supine position
pain is relived sitting up and leaning forward
pain is progressive and severe, requires use of opioids for pain relief
disease is progressed (jaundice and pruitis)
assessment of pancreatic cancer
appearance of jaundice clay colored stools dark urine dry skin fatigue dull pain associated w eating back pain w nerve plexus anorexia w early satiety, nausea, flactulance, vomiting, gi bleed diabetes
what can occur w late state pancreatic cancer?
ascites
whats gonna be elevated w pancreatic cancer?
amylase, lipase, alkaline phosphate, bilirubin, CEA, DU-pan 2
Du-pan2 test
non specific for carcinomas
dx studies
angiogram
ct
mri
ERCP (special xray of bile duct)
Percutaneous trans-hepatic biliary drain
aspiration of fluid, also reveals malignant cells and elevated amylase
types of tumors
head of pancreas- bile duct blockage
islet tumors- hyperinsulinemia
pre op whipple
high protien diet hydration correct pt w vit k tx anemia TPN biliary shunt may be placed to decrease jaundice
hyperinsulinism
caused by over production of insulin islet cells
s/s: decreased bgt
trx: po/iv glucose
needs to have a surgical excision of hyperplasia
ulcerogenic tumors
zollinger-ellison syndrome: islets hypersecrete ulcers gastric acid and cause ulcers to form
surgical intervention is needed
use of radiation with pancreatic cancer
pallative reasons- decrease tumors and decrease pain
does not improve the survival rates
survival rate of a non resectable pancreatic tumoe
6 months
surgical interventions for a pancreatic tumor stage I or II
total pancreatectomy
whipple
nis for post pancreas surgeries
tpn
monitor BG
nutritional support
enteral feeds/ tpn
post op whipple
ng suction tpn to rest gut pitting edema volume needs to be replaced monitor bgts h/h subacute rehab is most likely needed
ng drainage post op whipple
should be serosanguinous not colorless or bile tinged or frank blood
why is a thrombophlebitis likely after a tumor resection
increased levels of thromboplastic factors in the blood and necrotic properties results in bloods hypercoagulated state
(also due to bed rest)