Doctor insights on:
How Does Pancreatic Cancer Kill
Spread : Common sites are liver and peritoneal cavity leading to ascites, jaundice, liver failure. Obstructed bile ducts and invasion into coeliac neural plexus can cause agonizing pain. Cancers of the head and pancreatic neck may differ from ampulla or pancreatic tail. The latter have longer survival and somewhat better prognosis. ...Read more
Cancer is a group of diseases that is characterized by uncontrolled cell growth leading to invasion of surrounding tissues that spread to other parts of the body. Cancer can begin anywhere in the body and is usually related to one or more genetic mutations that allow normal cells to become malignant by interfering with internal cellular control mechanisms, such as programmed cell death or by preventing ...Read more
From initial onset of symptoms, how fast does pancreatic cancer tend to spread and kill in a patient when diagnosed (I know if varies, but generally)?
See below: Pancreatic cancer is the fourth most common cause of cancer-related deaths. Pancreatic cancer has a poor prognosis: for all stages combined, the 1- and 5-year relative survival rates are 25% and 6%, respectively. For local disease the 5-year survival is approximately 20% while the median survival for locally advanced and for metastatic disease, is 10 and 6 months. ...Read more
Depends on location: Pancreas is a fish-shaped organ with its head tucked into the duodenum (c-shaped beginning of small intestine coming off stomach). If tumor blocks bile duct or panc duct, causes abdominal pain, pancreatitis, jaundice. If it's in tail, will cause no symtptoms till very large or spread to other areas. Most common: weight loss, mental status change such as new onset depression. ...Read more
Surgery is Key:
The best option for cure is surgery. About 20% of patients with pancreatic cancer are candidates for surgery. The surgery is pancreaticoduodenectomy, also called a Whipple procedure. It usually involves removing.
1. The head of the pancreas
2. A part of the duodenum
3. An of a portion of the common bile duct
4. The gall bladder
5. In many instances a portion of the stomach ...Read more
Highly variable: Each person is different. Much of the early stage of pancreas cancer has no symptoms. May have gradual onset of lack or appetite and gradual weight loss. Later posdible yellow jaunduce formation. Later stage pancreas cancer can cause a severe boring pain from the mid upper abdomen into the upper back. ...Read more
Biopsy sometimes: Patients with pancreatic masses, elevated ca19-9 levels, and clinical features of cancer can fairly reliably be clinically diagnosed with pancreatic cancer. Biopsy should only be performed when the tumor is unresectable, metastasized, or if neoadjuvant (before surgery) chemo/radiation is being offered. Surgical resection should proceed to provide definitive pathology; needle biopsy often misses. ...Read more
It may be hereditary: There is some evidence that pancreatic cancer may occur more in some families. Johns hopkins was doing a study on families with pancreatic cancer whereby relatives were having very close followup that included ct scanning and surgery if there was suspicion of a developing cancer. I do not know if the study is still ongoing. ...Read more
Tumor size & spread.:
Stage i: the cancer is not touching the major blood vessels near the pancreas.
Stage ii: the cancer extends beyond the pancreas, or the cancer has spread to a nearby lymph node.
Stage iii: the cancer has wrapped around the major blood vessels near the pancreas.
Stage iv: the cancer has spread to other organs.
Surgery is usually not recommended for stage iii or IV tumors, but there are exceptions. ...Read more
See a doctor: The first thing to do in the work up of a possible pancreatic caricnoma is to visit with a doctor and have him/her take a history and perform a physical examination. If there is concern for cancer, the physician can perform laboratory testing and imaging studies to investigate the biochemical functioning of the pancreas and its anatomy. If those are concerning, then a biopsy may be performed. ...Read more
Pain, weight loss: Symptoms and signs can include pain in the upper abdomen, sometimes traveling to the back, and weight loss. Jaundice, a yellowing of the skin and eyes, can occur. Doctors may be able to detect a tender mass in the abdomen or enlarged lymph nodes. Unfortunately sometimes these symptoms aren't present until later. Smoking and obesity are 2 important and modifiable risk factors for pancreatic cancer. ...Read more
The staging defines tumors by size, involvement of local structures, nodal status and metastasis. Size <2 cm=t1, >2cm-t2, beyond pancreas=t3, sma/celiac involvement=t4. T1/2 tumors with no nodes or mets=stage 1, T3 (liothyronine) with no nodes/mets=stage 2a, t1-3 with nodes positive=stage 2b, any t4=stage 3, any mets=stage 4.
Stages 1 and 2=resectable, stage 3= borderline, locally advanced (unresectable). ...Read more
Multiple: Has it spread outside the pancreas? Does the cancer involve the lymph nodes? What type-- adenocarcinoma or neuroendocrine cancer? Has a surgical oncologist evaluated whether the patient is a surgical candidate? Other than the pancreatic cancer, how healthy is the patient? These are just a few of the factors that affect the treatment and prognosis of pancreatic cancer. ...Read more
Depends on stage: Median survival 6-7 months. Also, depends on response to treatment. ...Read more
Very aggressive : Sadly, the prognosis of patients with adenocarcinoma of the pancreas is poor, in part because it often presents in an advanced stage. A patient with an early stage may have a fighting chance but not great. Of course, there are other cancers that can develop in the pancreas besides adeno with different prognosis. If this is about you, I wish you the best. ...Read more
Depends: Patients with end-stage pancreatic can pass in different ways depending on where the cancer is in the body. Often patients stop eating and drinking, become jaundiced and pass in their sleep from failing liver and/or other liver function. A patient's doctor may be able to give some more specific predictions. I hope you or your loved one are comfortable. ...Read more
Probably viral: Pancreatic Ca is a lethal disease of probable viral origin. The tumor begins 15-20 yrs before a clinical lesion can be defined. It appears in the head where painless jaundice is seen, in the body with symptoms of invasion of celiac plexus and tail with pseudo varices of vasa brevia. Even with surgery for 10% of patients the survival here is 10%. Chemo with gemzar (gemcitabine) and Abraxane used. ...Read more
Yes/no: It's one of the worst cancers and the cure rates are low. It also depends on the stage and location of the tumor. Some early detected cancers with a tumor location away from the duodenum and biliary pathways carry better prognosis than other types. Also, the longer the tumor doesn't give out metastasis, the higher the chance of cure. ...Read more
No, but it's serious: Pancreatic cancer is often fatal because it is not caught early. If the cancer is small and can be completely removed, it can be cured. We have better chemo drugs and better surgeries, but still, 5 years after diagnosis only about 5% of patients are alive. Patients with small tumors have better chances than those with large tumors with spread to lymph nodes. ...Read more
Maybe: Whether alcohol abuse is an important risk factor for pancreatic cancer isn't clear; smoking clearly is. Abuse alcohol though and you're asking for chronic pancreatitis, a confusingly-named lifetime severe pain syndrome involving damage to the deep nerves of the area. You don't want that, or any of several other unpleasant sequelae. Best wishes; make smart decisions & drink moderately if at all. ...Read more
Moved to other organ: Metastatic pancreatic cancer is cancer that started in the pancreas and then moved to other organs. Most commonly it moves to the liver. It can spread throughout the body though. ...Read more
Yes?: As a rule, stage 4 cancer of the pancreas is incurable. As to being terminal, it depends on the definition. If you mean it will kill the patient at some point, the vast majority of the times the answer is yes. If you mean it will kill the patient right away, it depends on the situation. Never say never, though, some patients have surprised me in the past. Sorry if it is about you or a loved one. ...Read more
Different for each: Unfortunately pancreatic cancer can be very painful. Each person responds differently and no one solution for everyone. Use of narcotics is usually the first step. Nerve block and nerve abalation techniques are also helpful for some. ...Read more
Doesnt exist: After failing chemo which all pancreatic malignancies do, a newer approach is using monoclonal antibodies targeting an immunogenic protein, a post translational modification of MUC5ac, to bring the tumor under control. With the proper dosage, added chemo and later the radiolabelled Alpha emitter given sequentially, better results are anticipated. ...Read more
Abdominal organ. It is digestive organ: it secretes enzymes into the small bowel which break down food and help its absorption. It is also an endocrine organ: it produces hormones involved in sugar control and control of digestion. Insulin is one of these hormones. Diabetics either lack Insulin (type 1 diabetes) or have inadequate ...Read more
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