Pancreatic cancer secondary prevention: Difference between revisions
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{{Pancreatic cancer}} | {{Pancreatic cancer}} | ||
==Overview== | |||
'''Pancreatic cancer''' is a [[cancer|malignant tumour]] within the [[pancreas|pancreatic gland]]. | |||
About 95 percent of pancreatic tumors are [[adenocarcinoma]]s. The remaining 5 percent include other tumors of the exocrine pancreas (e.g. serous cystadenomas), acinar cell cancers, and pancreatic [[neuroendocrine tumor]]s (such as [[insulinoma]]s). These tumors have a completely different diagnostic and therapeutic profile, and generally a more favorable prognosis.<ref name=Ghaneh>{{cite journal |author=Ghaneh P, Costello E, Neoptolemos JP |title=Biology and management of pancreatic cancer |journal=Gut |volume=56 |issue=8 |pages=1134-52 |year=2007 |pmid=17625148 |doi=10.1136/gut.2006.103333}}</ref> | |||
=== Diet === | === Diet === | ||
Revision as of 19:36, 14 November 2017
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Overview
Pancreatic cancer is a malignant tumour within the pancreatic gland.
About 95 percent of pancreatic tumors are adenocarcinomas. The remaining 5 percent include other tumors of the exocrine pancreas (e.g. serous cystadenomas), acinar cell cancers, and pancreatic neuroendocrine tumors (such as insulinomas). These tumors have a completely different diagnostic and therapeutic profile, and generally a more favorable prognosis.[1]
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[2]
- 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
- ↑ Ghaneh P, Costello E, Neoptolemos JP (2007). "Biology and management of pancreatic cancer". Gut. 56 (8): 1134–52. doi:10.1136/gut.2006.103333. PMID 17625148.
- ↑ 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.