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Only Possible Prevention of Pancreatic Cancer is to Avoid Known Risk Factors

BY: Ritu Choudhary | Category: Pancreatic Cancer | Submitted: 2011-02-20 12:22:31
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Pancreatic cancer affects more men than women. It occurs most often after age 55. A Chronic and excessive use of alcohol is probably the most serious risk factor of pancreatic cancer. It has also been implicated as risk factors for eating too much, especially animal fat, diabetes mellitus. In reality, the risk factors are poorly known. However, this cancer can occur without any known risk factor. Clinical signs are usually late, dominated by the alteration of general condition, abdominal pain, possibly jaundice. The prognosis depends on the extent of the tumor, the type and quality of surgery. Treatment is based primarily on surgery, chemotherapy may be offered as a supplement, as well as radiotherapy.

The pancreas is a gland in the abdomen, behind the stomach. This organ has two important functions: The first, called exocrine is the production of juices that are involved in digestion and flowing into the intestine, the duodenum (the portion of the intestine immediately following the stomach and upper jejunum, first segment of small intestine) by the pancreatic duct. The second, known as endocrine, is the production of insulin, a hormone produced by the islets of Langerhans and directly discharged into the blood. The pancreas is anatomically composed of three parts, from left to right, tail, body and head of the pancreas. Most pancreatic cancers are adenocarcinomas, at the head of the pancreas. More exceptionally, there may be a cystadenocarcinoma or intraductal papillary-mucinous tumors. The only possible prevention of pancreatic cancer is to avoid known risk factors that can promote it, especially alcohol or a diet particularly rich in animal fats. But pancreatic cancer can occur without any known risk factor and then there is no effective prevention.

No systematic screening can be offered against this cancer. Its clinical features are usually late, so at an advanced stage of disease, mainly characterized by impairment of general health, weight loss, abdominal pain. Jaundice may also occur if the cancer occurs at the head of the pancreas and compresses the channel that normally ensures the flow of bile. These are the medical imaging that will make the diagnosis, including abdominal ultrasound and computed tomography (CT). Other tests may be useful, especially in a pre-surgery: endoscopic retrograde (that is to opacify the pancreatic duct by injecting a contrast agent during an endoscopy), arteriography. These tests are most useful to the surgeon to assess whether the tumor may or may not be removed surgically. There are also biological markers, including antigen CA19.9 whose elevation in serum is present in 80% of cases. The CA19.9 is not sensitive for detecting small tumors.

The main treatment currently in use is surgery. The objective is to ensure the removal of the entire tumor, which is unfortunately not always possible. The best case is that of a localized cancer of the pancreas head, less than 2 cm, which covers only 10% of all cases. The response is either a total pancreatectomy or a pancreaticoduodenectomy. Chemotherapy and radiotherapy can complement surgery. Sometimes the tumor is resectable and surgery can only be palliative. The surgeon then strives to ensure the best living comfort to the patient by ensuring the removal of obstacles due to tumor invasion. But pancreatic cancer prognosis is severe enough, even if there is progress with new chemotherapies. Note that for tumors whose origin is the endocrine pancreas prognosis is better.

If the surgical procedure includes total pancreatectomy, the patient should receive pancreatic enzymes externally, ie in the form of medications taken during meals. And of course, diabetes resulting from lack of insulin will also be subject to special treatment. If the surgery has resulted in a satisfactory resection of the tumor tissue, regular monitoring will then be necessary to ensure that no local or remote recovery of the neoplastic process.

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