Pancreatic Cancer Flashcards
Pancreatic cancer is the 4th leading cause of cancer deaths. True or false?
True
What is the age range that commonly experiences pancreatic cancer?
50-80 yo
What is the survival rate of pancreatic cancer?
9.3%
What are some etiological contributors to pancreatic cancer? (6)
Smoking, Hereditary cancers, Genetics, Environmental, Lifestyle, other diseases
What are the three sections of the pancreas? (from right to left)
Head, Body, and Tail
Where is the head of the pancreas located?
overlapped by the duodenum
Where is the body of the pancreas located?
posterior to the stomach and anterior to IVC
Where is the tail of the pancreas located?
terminates at the splenic hilum
What structures is the pancreas in direct contact with? (6)
Duodenum, Jejunum, Stomach, Blood Vessels, Spleen and Kidneys
Why is pancreatic cancer considered so deadly?
Due to its close proximity to other structures and accessibility to expand
What is the composition of exocrine to endocrine tissue of the pancreas?
98% exocrine and 2% endocrine
What do endocrine cells produce?
Insulin
What is the entry in the duodenum from the panceas?
papilla of vater
What is the function of the exocrine pancreas?
Digestive fluids production
What is the function of the endocrine pancreas?
hormone production
What are the pancreatic nodes? (5)
Celiac, sup and inf pancreaticoduodenal nodes, Splenic nodes, Porta hepatis nodes, Supra-pancreatic node
What is the clinical presentation of pancreatic cancer? (4)
Jaundice, Abd pain, Anorexia and weight loss, obstruction due to tumor invasion
What is the most commonly used detection technique used for pancreatic cancer?
Spiral CT
How is an endoscopic ultrasound utilized in pancreatic cancer detection?
A transducer is sent orally into the stomach to which waves are sent off and read by the sonogram
What percentage of pancreatic cancer is adenocarcinoma?
80%
What staging system is used for pancreatic cancer?
TNM system
What pattern of spread do pancreatic cancer utilize?
local invasion to surrounding structures, direct extension, and hematogenous to liver
What is the treatment of choice for pancreatic cancer?
Surgery, not often due to unresectability
What is another name for a pancreaticoduodenectomy?
Whipple procedure
What is done during a Whipple procedure?
The head of the pancreas, entire duodenum, distal stomach, gallbladder, and common bile duct are resected
What is the survival rate for pancreatic cancer after curative surgery?
less than 10%
Adjuvant combine modality treatment has improved survival to 18-29 months. True or false?
True
What critical structures are involved during pancreatic cancer treatment? (4)
Small bowel, kidney, liver, stomach
What is the standard treatment design for pancreatic cancer? (4)
3 or 4 Fields, 45 Gy, Lateral dose of 20 Gy for liver and kidneys, IMRT
What is the dose limits for pancreatic cancer radiation therapy alone? With chemo/surgery?
54 Gy alone, 45 Gy w/ combined
What is the dose restriction on the kidneys?
23 Gy
What is the dose restriction on the liver?
30 Gy
What is the dose restriction on the Small bowel?
40 Gy
What is the dose restriction on the cord?
45 Gy
What is the dose restriction on the Stomach?
50 Gy
What is the rule with treatment the head of the pancreas and the kidneys involvement?
Since the right kidney is 50% in the field of treatment, the other kidney must be 2/3 shielded
What is the set up for pancreatic cancer? (4)
Supine, immobilized, arms up and leg comfort
What are the most common side effects of pancreatic cancer?
N/V (antiemetics), Leukopenia, Diarrhea, Stomatitis
What is the long term side effect of pancreatic cancer?
Renal Failure (rare)
