Pancreatic cancer secondary prevention: Difference between revisions
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{{Pancreatic cancer}} | {{Pancreatic cancer}} | ||
=== Diet === | |||
* Exocrine pancreatic insufficiency due to pancreatic duct obstruction by the tumor may lead to malabsorption. | |||
Malabsorption in patients presents with anorexia, weight loss, and diarrhea. | * Malabsorption in patients presents with anorexia, weight loss, and diarrhea. | ||
* The diet proposed for pancreatic cancer patients is based on American Cancer Society (ACS) guidelines<ref name="pmid22237782">{{cite journal |vauthors=Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews K, Gansler T |title=American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity |journal=CA Cancer J Clin |volume=62 |issue=1 |pages=30–67 |year=2012 |pmid=22237782 |doi=10.3322/caac.20140 |url=}}</ref> | |||
Pancreatic enzyme replacement therapy | ** Pancreatic enzyme replacement therapy | ||
** Avoidance of high-protein/high-fat diets | |||
Individualized dietary prescriptions from a registered dietitian | ** Individualized dietary prescriptions from a registered dietitian | ||
Supplementation with omega-3 fatty acids | ** Supplementation with omega-3 fatty acids | ||
=== Palliative Therapy === | === Palliative Therapy === | ||
* | * Pain: | ||
** There are various techniques for [[pain]] management as [[Palliative care|palliative therapy]] in patients with advanced stage of [[pancreatic cancer]]: | ** There are various techniques for [[pain]] management as [[Palliative care|palliative therapy]] in patients with advanced stage of [[pancreatic cancer]]: | ||
*** [[Narcotic]] [[Analgesic|analgesics]] | *** [[Narcotic]] [[Analgesic|analgesics]] | ||
| Line 18: | Line 18: | ||
*** [[Radiation therapy]] | *** [[Radiation therapy]] | ||
* Surgical techniques used to treat [[pain]] in advanced [[pancreatic cancer]] cases include: | |||
* Surgical techniques used to treat [[pain]] in advanced [[pancreatic cancer]] cases include: | |||
** [[Endoscopy|Endoscopic]] [[decompression]] with [[stent]] placement in patients with [[Bile duct|biliary]] or [[pancreatic duct]] [[obstruction]] | ** [[Endoscopy|Endoscopic]] [[decompression]] with [[stent]] placement in patients with [[Bile duct|biliary]] or [[pancreatic duct]] [[obstruction]] | ||
** [[Neurolysis]] of the [[celiac ganglia]] by many approaches: | ** [[Neurolysis]] of the [[celiac ganglia]] by many approaches: | ||
Revision as of 19:34, 14 November 2017
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Diet
- Exocrine pancreatic insufficiency due to pancreatic duct obstruction by the tumor may lead to malabsorption.
- Malabsorption in patients presents with anorexia, weight loss, and diarrhea.
- The diet proposed for pancreatic cancer patients is based on American Cancer Society (ACS) guidelines[1]
- Pancreatic enzyme replacement therapy
- Avoidance of high-protein/high-fat diets
- Individualized dietary prescriptions from a registered dietitian
- Supplementation with omega-3 fatty acids
Palliative Therapy
- Pain:
- There are various techniques for pain management as palliative therapy in patients with advanced stage of pancreatic cancer:
- Surgical techniques used to treat pain in advanced pancreatic cancer cases include:
- Endoscopic decompression with stent placement in patients with biliary or pancreatic duct obstruction
- Neurolysis of the celiac ganglia by many approaches:
- Intraoperative
- Transgastric
- Transthoracic
- Transabdominal
Jaundice:
- Obstructive jaundice can present with features of cholangitis:
- Fever and chills
- Nausea, vomiting
- Clay-colored stools
- Dark urine
- Yellowish discoloration of skin
- Pruritus
- Right upper quadrant pain
- Anorexia
- Preferred treatment in patients: Endoscopic decompression with stent placement in patients with biliary obstruction.
- Techniques of biliary decompression:
- Cholecystojejunostomy
- Choledochojejunostomy
- Types of stents:
- Metal- costly, longer lifespan
- Plastic- cheaper, need replacement every three months
Duodenal obstruction
- Preferred treatment:
References
- ↑ Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews K, Gansler T (2012). "American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity". CA Cancer J Clin. 62 (1): 30–67. doi:10.3322/caac.20140. PMID 22237782.