Martina Rastovac Mentor A mega Horvat Actor Patrick

Martina Rastovac Mentor: A. Žmegač Horvat

Actor Patrick Swayze died after a 20 -month battle with pancreatic cancer. He was 57.

• Epidemiology: – < 2% of all malignancies – ~ 6500 deaths/year • Typical patient: – male > 60 yrs old • Risk factors: – smoking – alcohol – carcinogens – chronic pancreatitis

• Pancreas: – head – body – tail

• Symptoms & signs: – – – jaundice pain in the upper or middle abdomen and back unexplaind weight loss of appetite fatigue

• Investigations: – – – – transabdominal ultrasound contrast-enhanced spiral CT scan laparoscopy ERCP percutaneous needle biopsy MRI scanning and endoscopic ultrasound several tumour markers (CA 19 -9)

• Pathology: – mostly ductal adenocarcinoma (metastasizes early; presents late) Location of tumor: - 60% head - 25% body - 15% tail

• Stages of pancreatic cancer: I II IV

• Treatment: – surgery • Whipple`s procedure • total pancreatectomy • distal pancreatectomy – radiation therapy – chemotherapy

• Whipple`s procedure:

• WHO Pain relief ladder Freedom from cancer pain

• Prognosis: – dismal Mean survival: < 6 months 5 yr survival: < 2 % After Whipple`s procedure: 5 -14% Better if: tumour < 3 cm no nodes involved negative resection margins at surgery ampullary or islet cell tumors

References: • http: //www. meb. uni-bonn. de/cancer. gov/CDR 0000062957. html • Longmore, Oxford Handbook of Clinical Medicine, Oxford University Press, 2010