Upload
yashika54
View
393
Download
1
Tags:
Embed Size (px)
Citation preview
Cancer Education Slides
Pancreatic Cancer2010
What is Cancer?
• A group of 100 different diseases
• The uncontrolled, abnormal growth of cells
• Cancer may spread to other parts of the body
What is Pancreatic Cancer?
• Fourth leading cause of cancer death in men and women
• An estimated 43,140 people diagnosed in the United States in 2010
• A disease in which normal cells in the pancreas grow uncontrollably
• Most cases aren’t detected until the cancer has metastasized (spread) beyond the pancreas to other areas of the body
What is the Function of the Pancreas?
• Pear-shaped gland located in the abdomen between the stomach and spine
• Comprised of the head (where pancreatic cancer is most commonly diagnosed), the body, and the tail
• Helps the body digest food and produces hormones, such as insulin
• The most common type of pancreatic cancer is ductal adenocarcinoma, which occurs in cells lining pancreatic ducts
What are the Risk Factors for Pancreatic Cancer?
• Age • Gender: Men at higher risk than women • Race: Black people at increased risk• Smoking• Obesity and diet• Diabetes• Family history• Chronic pancreatitis (inflammation of the pancreas)
• Exposure to pesticides, benzene, certain dyes, and petrochemicals
Pancreatic Cancer and Early Detection
• No tests are recommended for screening the general population
• Often called the “silent disease” because it usually doesn’t cause symptoms in early stages
What are the Symptoms of Pancreatic Cancer?
• Jaundice (yellow skin and eyes, darkened urine, clay-colored stool)
• Pain in upper abdomen or upper back
• Burning feeling in the stomach
• Floating stools with an especially bad odor
• Weakness
• Loss of appetite
• Nausea and vomiting
• Weight loss with no known explanation
How is Pancreatic Cancer Diagnosed?
• Physical examination; laboratory tests
• Diagnosis is confirmed with a biopsy
• Endoscopic retrograde cholangiopancreatography (ERCP), a test that checks the bile ducts and pancreatic ducts for blockage
• Endoscopic ultrasound (EUS), a test using a thin, lighted tube to get images of the pancreas using sound waves
• Other imaging tests, such as computerized tomography (CT) scans
Pancreatic Cancer Staging• Staging is a way of describing a cancer, such as
the size of a tumor and if or where it has spread• Staging is the most important tool doctors have to
determine a patient’s prognosis• Pancreas cancer is most commonly classified as:
• Resectable (able to be surgically removed)• Locally advanced (cancer confined to the area around the pancreas, but not resectable because of extension/invasion into surrounding vessels and organs)
• Metastatic (cancer has spread to other organs)• Treatment depends on the stage of the cancer• Recurrent cancer is cancer that comes back after
treatment
How is Pancreatic Cancer Treated?
• Treatment depends on the stage of cancer; more than one treatment may be used
• Surgery, radiation therapy, and chemotherapy may be used at any stage of the disease
• Has a much higher chance of being successfully treated if detected at an early stage
• People with pancreatic cancer may consider enrolling in a clinical trial
Cancer Treatment: Surgery
• May involve removing all or part of the pancreas– Cancer at the pancreatic head: Whipple resection (pancreatoduodenectomy)
– Cancer at the pancreatic body or tail: distal pancreatectomy
• Surgeons sometimes start with a diagnostic laparoscopy, a less invasive surgical procedure to get a more accurate sense of the disease stage
• Surgery may be combined with radiation therapy or chemotherapy before or after surgery (adjuvant therapy)
• Prescription hormones and enzymes can be given to replace those lost by pancreas removal
Cancer Treatment: Radiation Therapy
• The use of high-energy x-rays to destroy cancer cells
• Most common type is external-beam: outside the body
• May be used before, during, or, after surgery; is often given at the same time as chemotherapy
• Also used to relieve pain associated with pancreatic cancer
• Newer techniques, such as stereotactic radiosurgery (Cyberknife), are still considered experimental
Cancer Treatment: Chemotherapy
• Use of drugs to kill cancer cells
• Most common treatment drug for pancreatic cancer is gemcitabine (Gemzar)
• Two large clinical trials have shown a survival advantage using a combination of gemcitabine and another drug for advanced pancreatic cancer:• Gemcitabine combined with erlotinib (Tarceva) • Gemcitabine combined with capecitabine (Xeloda)
• One recently reported study showed that the combination of fluorouracil (5-FU) and oxaliplatin (Eloxatin) is effective in some patients as a second-line treatment if the tumor continues to grow.
• Patients well enough to consider more aggressive therapy may consider enrolling in a clinical trial
Cancer Treatment: Advanced Pancreatic Cancer
• Treatments can help patients with advanced pancreatic cancer live longer
• Treatment options include palliative (symptom relief) surgery, radiation therapy, and chemotherapy
• In rare cases, chemotherapy and radiation therapy may shrink the tumor enough in patients with locally advanced cancer so it can be surgically removed (downstaging)
• Patients with advanced pancreatic cancer may consider enrolling in a clinical trial
Current Research
• New tools for early detection
• Studies of pancreatic cancer genes
• Other chemotherapy agents: new formulations of paclitaxel (Taxol)
• Biologic therapy
• Targeted therapy
• Multidrug therapy
The Role of Clinical Trials for the Treatment of Pancreatic Cancer
• Clinical trials are research studies involving people
• They test new treatment and prevention methods to determine whether they are safe, effective, and better than the standard treatment
• The purpose of a clinical trial is to answer a specific medical question in a highly structured, controlled process
• Clinical trials can evaluate methods of cancer prevention, screening, diagnosis, treatment, and/or quality of life
Clinical Trials: Patient Safety
• Informed consent: participants should understand why they are being offered entry into a clinical trial and the potential benefits and risks; informed consent is an ongoing process
• Participation is always voluntary, and patients can leave the trial at any time
• Other safeguards exist to ensure ongoing patient safety
Clinical Trials: Phases
• Phase I trials determine the safety and dose of a new treatment in a small group of people
• Phase II trials provide more detail about the safety of the new treatment and determine how well it works for treating a specific type of cancer
• Phase III trials take a new treatment that has shown promising results when used to treat a small number of patients with cancer and compare it with the standard treatment for that disease; phase III trials involve a large number of patients
Clinical Trials Resources
• Coalition of Cancer Cooperative Groups (www.CancerTrialsHelp.org)
• CenterWatch (www.centerwatch.com)
• National Cancer Institute (www.cancer.gov/clinical_trials)
• EmergingMed (www.emergingmed.com)
Coping with Side Effects
• Side effects are treatable; talk with the doctor or nurse
• Fatigue is a common, treatable side effect
• Pain is treatable; non-narcotic pain-relievers are available
• Antiemetic drugs can reduce or prevent nausea and vomiting
• For more information, visit www.cancer.net/sideeffects
After Treatment
• Talk with the doctor about developing a follow-up care plan
• For patients who have had surgery, doctor’s visits every three to six months
• Blood tests
• In some cases, a CT scan may be appropriate
Where to Find More InformationCancer.Net Guide to Pancreatic Cancer
(www.cancer.net/pancreatic)
• Overview• Medical
Illustrations• Risk Factors• Symptoms• Diagnosis• Staging• Treatment
• Clinical Trials• Side Effects• After Treatment• Current Research• Questions to Ask the
Doctor• Patient Information
Resources
Cancer.Net
• The expertise of ASCO, the voice of the world’s cancer physicians
• Guides to more than 120 types of cancer and cancer-related syndromes
• Clinical trials information• Weekly feature articles• Videos and podcasts• Information in Spanish• The latest cancer news• Learn more at www.cancer.net or 888-651-3038