Understanding the Silent Disease (Pancreatic Cancer) PowerPoint Presentation

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Understanding the “Silent” Disease: Pancreatic Cancer Tara Woodard 1

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Statistics in the US Function of the Pancreas Types of Pancreatic Cancer An Overview of Pancreatic Cancer Who’s at Risk Signs/Symptoms Tests Staging Prognosis Diets Treatments Future of Pancreatic Cancer References Content of Pancreatic Cancer Tutorial: www.medscape.com 2

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Statistics in the US Function of the Pancreas Types of Pancreatic Cancer An Overview of Pancreatic Cancer Who’s at Risk Signs/Symptoms Tests Staging Prognosis Diets Treatments Future of Pancreatic Cancer References Content of Pancreatic Cancer Tutorial: www.medscape.com 3

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1) Lung and bronchial cancer ( > 157,000 ) 2) Colon and rectal cancer ( > 51,000 ) 3) Breast cancer ( 40,000 ) 4) Pancreatic cancer ( 37,000 ) 5) Prostate cancer ( 32,000 ) Top 5 Deadliest Cancers: 2010 Expected Deaths: 4

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Statistics from 2004-2008: http://www.seer.cancer.gov/statfacts/html/pancreas.html 5 American Cancer Society estimated >42,000 cases in 2009

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5 Year Survival from 2001-2007: http://www.seer.cancer.gov/statfacts/html/pancreas.html 7 In 2008, >35,000 deaths (compare to 40,930 deaths in 2008 from breast cancer)

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Statistics in the US Function of the Pancreas Types of Pancreatic Cancer An Overview of Pancreatic Cancer Who’s at Risk Signs/Symptoms Tests Staging Prognosis Diets Treatments Future of Pancreatic Cancer References Content of Pancreatic Cancer Tutorial: www.medscape.com 8

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http://www.mhaac.net/pancreatic_cancer_awareness.asp Anatomy & Function of the Pancreas: Spongy, 6-inch-long organ located behind the stomach. Produces digestive enzymes. Produces hormones that regulate the body’s use of starches and sugars. 9

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Statistics in the US Function of the Pancreas Types of Pancreatic Cancer An Overview of Pancreatic Cancer Who’s at Risk Signs/Symptoms Tests Staging Prognosis Diets Treatments Future of Pancreatic Cancer References Content of Pancreatic Cancer Tutorial: www.medscape.com 12

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More than 95% of all pancreatic cancer begins in the exocrine pancreas. Less than 5% begins in the endocrine pancreas. Main Types: http://pathology.jhu.edu/pc/BasicOverview3.php 13

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Statistics in the US Function of the Pancreas Types of Pancreatic Cancer An Overview of Pancreatic Cancer Who’s at Risk Signs/Symptoms Tests Staging Prognosis Diets Treatments Future of Pancreatic Cancer References Content of Pancreatic Cancer Tutorial: www.medscape.com 14

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Pancreatic Cancer: Carcinogenesis 17

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The genetic basis is extremely complex and heterogeneous An average of 63 genetic abnormalities per tumor = individualized treatment. Unique Characteristics: 18

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Statistics in the US Function of the Pancreas Types of Pancreatic Cancer An Overview of Pancreatic Cancer Who’s at Risk Signs/Symptoms Tests Staging Prognosis Diets Treatments Future of Pancreatic Cancer References Content of Pancreatic Cancer Tutorial: www.medscape.com 19

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You are at an increased risk if you: Are over 60 Are overweight or obese Have diabetes Smoke Have a family history of Pancreatic Cancer Are African American Have chronic inflammation of the pancreas blood type A, B, or AB Risk Factors: http://www.wellnessuncovered.com/joomla/index.php?option=com_content&view=article&id=2148:nicotine-raises-blood-sugar-levels-in-lab&catid=1:latest-news&Itemid=50 20

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Statistics in the US Function of the Pancreas Types of Pancreatic Cancer An Overview of Pancreatic Cancer Who’s at Risk Signs/Symptoms Tests Staging Prognosis Diets Treatments Future of Pancreatic Cancer References Content of Pancreatic Cancer Tutorial: www.medscape.com 21

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Abdominal Pain Stomach Pain Diarrhea Fatigue Fainting Weight gain Signs & Symptoms for Endocrine: http://abcnews.go.com/Health/Autism/stomach-pains-autism/story?id=10388309 22

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Vague sporadic discomfort Upper abdominal or lumbar pain which worsens at night Back pain aggravated by lying flat, relieved when sitting up Radiating pain to the back Pain occurring several hours after eating Loss of appetite Weight loss Jaundice Depression Signs & Symptoms for Exocrine: http://herbal-ayurveda-remedy.com/home-remedies/jaundice.php 23

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Statistics in the US Function of the Pancreas Types of Pancreatic Cancer An Overview of Pancreatic Cancer Who’s at Risk Signs/Symptoms Tests Staging Prognosis Diets Treatments Future of Pancreatic Cancer References Content of Pancreatic Cancer Tutorial: www.medscape.com 24

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Transabdominal ultrasound Endoscopy Ultrasound Angiogram Biopsy CT scans Endoscopic Retrograde Cholangiopancreatogram (ERCP) Elevated blood levels of bilirubin Tests for Diagnosis: 25

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Statistics in the US Function of the Pancreas Types of Pancreatic Cancer An Overview of Pancreatic Cancer Who’s at Risk Signs/Symptoms Tests Staging Prognosis Diets Treatments Future of Pancreatic Cancer References Content of Pancreatic Cancer Tutorial: www.medscape.com 26

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Gastrinoma Insulinoma Miscellaneous Recurrent Staging for Endocrine: http://www.nsf.gov/news/news_images.jsp?cntn_id=109781&org=NSF 27

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Stage 1A: Tumor found only in pancreas, ≤ 2cm Stage 1B : Tumor found only in pancreas, > 2cm Stage 2A : Cancer spread to nearby organs but does not involve celiac axis or superior mesenteric artery Stage 2B : Cancer spread to regional lymph nodes Stage 3 : Cancer spread to celiac axis or the superior mesenteric artery Stage 4 : Distant metastasis Staging for Exocrine: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0041-87812004000400008 28

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Statistics in the US Function of the Pancreas Types of Pancreatic Cancer An Overview of Pancreatic Cancer Who’s at Risk Signs/Symptoms Tests Staging Prognosis Diets Treatments Future of Pancreatic Cancer References Content of Pancreatic Cancer Tutorial: www.medscape.com 29

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Still considered largely incurable. Low survival rates are most likely due to: < 10% of patients' tumors are confined to the pancreas at time of diagnosis Progressed malignancy The Prognosis: http://www.indianasnewscenter.com/news/local/Early-Detection-Can-Mean-Survival-For-Some-With-Pancreatic-Cancer-106817298.html 30

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Statistics in the US Function of the Pancreas Types of Pancreatic Cancer An Overview of Pancreatic Cancer Who’s at Risk Signs/Symptoms Tests Staging Prognosis Diets Treatments Future of Pancreatic Cancer References Content of Pancreatic Cancer Tutorial: www.medscape.com 31

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Increase in cruciferous vegetables (cabbage), Folic acid, and Vitamin C. (A) Alpha-lipoic acid (PA) Curcumin (PS) Genstein (A) Green tea (A) limonene (P) Melatonin (A) Mistletoe (PSA) Omega-3 fatty acid (S) Probiotics (P) Selenium [P= preventative, A= anticancer, S= supportive] Diets that are Thought to Help: 32

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Statistics in the US Function of the Pancreas Types of Pancreatic Cancer An Overview of Pancreatic Cancer Who’s at Risk Signs/Symptoms Tests Staging Prognosis Diets Treatments Future of Pancreatic Cancer References Content of Pancreatic Cancer Tutorial: www.medscape.com 33

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When tumors can be removed Can remove all, or part of the pancreas Whipple procedure. Long term survival: 15-20% with a median survival rate of around 15-24 months. Recurrence is about 85% Surgery: http://www.diseaseproof.com/archives/hurtful-food-bypass-surgery.html 34

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Uses radiation in order to damage the cancer cells and prevent them from growing. This is given 5 days a week, for 5-6 weeks. Side effects: nausea, vomiting, and diarrhea. Radiation Therapy: http://www.igrt.com/prostate_cancer.asp 35

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Kills cells that are growing or multiplying. Given in cycles: Treatment, followed by recovery. Side effects: More likely to get infections, hair loss, digestive problems including nausea and vomiting. Chemotherapy: http://medicineworld.org/stories/lead/4-2009/is-that-chemotherapy-working.html 36

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Designed to restore the patients immune system. BRMs Side effects: flu-like symptoms, nausea, vomiting, and diarrhea. Biological Therapy/ Immunotherapy: http://www.scientificamerican.com/article.cfm?id=patient-heal-thyself-body 37

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Statistics in the US Function of the Pancreas Types of Pancreatic Cancer An Overview of Pancreatic Cancer Who’s at Risk Signs/Symptoms Tests Staging Prognosis Diets Treatments Future of Pancreatic Cancer References Content of Pancreatic Cancer Tutorial: www.medscape.com 38

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New targeted agents are in clinical development, including: Small-molecule inhibitors of oncogenes and signaling pathways Monoclonal antibodies targeting cell-membrane proteins Nanotechnology and adenoviral agents The Future: http://science.howstuffworks.com/innovation/scientific-experiments/scientific-method.htm 39

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Statistics in the US Function of the Pancreas Types of Pancreatic Cancer An Overview of Pancreatic Cancer Who’s at Risk Signs/Symptoms Tests Staging Prognosis Diets Treatments Future of Pancreatic Cancer References Content of Pancreatic Cancer Tutorial: www.medscape.com 40

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http://www.medicinenet.com/pancreatic_cancer_pictures_slideshow/article.htm http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/pancreas/anatomy.html http://www.nejm.org/doi/full/10.1056/NEJMra0901557 http://www.mayoclinic.com/health/pancreatic-cancer/DS00357 http://www.seer.cancer.gov/statfacts/html/pancreas.html “Choices- The Most Complete Sourcebook for Cancer Information.” Morra, Potts. 4th Edition. Harper Collins Publishers Inc. New York, NY. Oct 2003. “The Definitive Guide to Cancer- An Integrative Approach to Prevention, Treatment, and Healing.” Alschuler, Fabno, Gazella. 3rd Edition. Random House, Inc. New York. 2010 InnoVision Health Media. http://www.pancreatic.org/site/c.htJYJ8MPIwE/b.891917/k.5123/Prognosis_of_Pancreatic_Cancer.htm http://www.seer.cancer.gov/csr/1975_2005/results_single/sect_01_table.01.pdf http://www.msnbc.msn.com/id/39102353/ns/health-cancer/ References: 41