Doctor insights on:
Mrcp Pancreatic Cancer
Does mild scaring seen in MRCP & EUS increase pancreatic cancer in future? Asymptomatic. Gastros not concerned but I read studies on risk.
No: But need follow up care of the ' mild scaring ' its nature ...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
Is the accuracy high for finding early pancreatic cancer with normal MRCP (not the Secretin-enhanced MRCP)?
Depends: The secretin-enhanced MRCP is a technique to help image the pancreatic duct. The MRCP is just one arrow in the quiver to diagnose hepato-biliary and pancreatic disease non-invasively; especially in the setting of painless jaundice. It can often direct the next step along the diagnostic process. ...Read more
In layman's terms what does this mean: "study for detecting pancreatic cancer states: sensitivity of mrcp with respect to diagnosis PC was 84 percent and specificity was 97%." A study done on detecting PC.
Screen vs Confirm: Sensitivity means that if you had 100 people with biopsy proven PC, then 84 out of the 100 people with PC had a (+) test. Specificity means that if you had a (+) test result there is a 97% probability that you have PC and a 3% probability that you have a "false positive" (which means you do not have PC). High sensitivity tests are used to screen for a condition whereas high specificity confirms. ...Read more
My A1C is climbing from 5.6 to 5.8 in over 1 year. I also have fluctuating lipase numbers without symtoms. This has been going on 4 years. MRCP clear. Does this sound like early pancreatic cancer?
Panc Ca: The change in A1C is not significant. Its unlikely you have pancreatic cancer. But if you are concerned get a CT of the abdomen. (However, we now know that CT scans can significantly increase the risk of a number of cancers.) ...Read more
Hi doctor I recently had mri with and without contrast and mrcp and the results cameback normal should I still worry about pancreatic cancer?
Since I had-: -pancreatitis, l have gone thu the screening process. Amylase is high sometimes, endoscopic ultrasound, MRI with IV contrast all have been done & all is clear. Had in Jan, 2016 & now have my final MRI with IV contrast on 1 NOV 2016. That's the workup after pancreatitis, as far as screening, I would feel amylase levels. The rest R costly 4 screening ...Read more
If MRCP & CT scan with contrast were clear of Pancreatic Cancer, what are chances EUS can find Pancreatic Cancer? Are odds on my side with clear MRCP?
Pancreatic cancer: Was the CT tailored for pancreatic mass protocol? If so it is highly accurate for detecting even very small panc masses. If it was a routine CT, the accuracy is still high, but very small tumors may not be seen. MRCP is also not specifically tailored to look for panc mass, so very small lesions may not be seen. No test is 100%, so it is always possible that another test could pick something up. ...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. A 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 where by 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
Magnetic resonance cholangiopancreatography (mrcp) uses a strong magnet to obtain images of the biliary and pancreatic ducts. It is an alternative to the more invasive endoscopic retrograde cholangiopancreatography (ERCP) done with an endoscope. Mrcp can be used to visualize gallstones, bile duct narrowing and the structures surrounding the bile ducts. For ...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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