Advancements And Limitations Of Pancreatic Ductal Adenocarcinoma

Pancreatic Cancer is cancer of an organ in the human body called the pancreas, which is located behind the lower part of the stomach. The function of this organ is to secrete certain essential enzymes to digest food and also secrete hormones to metabolize sugars such as insulin and glucagon (Mayoclinic). People get pancreatic cancer when the cells of the pancreas develop genetic mutations; and these can form in both the exocrine and endocrine cells of the pancreas, but exocrine tumors are more common than endocrine tumors. Because this cancer spreads very quickly throughout the body and the symptoms of the disease don’t usually appear until the cancer is at an advanced stage, it is a leading cause of death

There is another classification of pancreatic tumor help in decision making of management. This classification depends on the possibility of surgical removal of the tumor: in this way, tumors are judged to be "resectable", "borderline resectable" or "unresectable" (American Cancer Society, 2014).

Regional phenotypic evolution is driven by tremendous temporal and spatial variation in the environment (and, therefore, environmental selection forces), mostly as a result of variability of vascular density and blood flow. The prognostic significance of tumor heterogeneity has been highlighted in several malignancies, and in fact, this characteristic has been included in the grading systems for certain tumors {Yip, 2015 #242;Stahl, 2015 #136;Skibinski, 2015 #160;Singh, 2015 #230;Robertson-Tessi, 2015 #148;Supernat, 2014 #204;Longo, 2012 #339;Polyak, 2014 #223}. (Figure 1 - Permission Pending)

The indications of pancreatic adenocarcinoma don't generally show up in the disease's initial stages and are individually not different to the illness. The indications at diagnosis shift as per the area of the tumor in the pancreas, which anatomists divide into the thick head, the neck, and the decreasing body, finishing in the tail. Despite a tumor's area, the most

The client was a healthy individual growing up as a child and that continued throughout his life until about three years ago. He was diagnosed with Hypertension around his fifties, which was controlled with medication. When he became sick and received cancer treatments the hypertension disappeared to where he now has low blood pressure. He has not taken hypertension medication for about three years now. Along with Hypertension, he has been dealing with Basal Cell on the face, chest and back that are assessed frequently. Recently, in August, he had Basal Cell removed from the face and chest and now has a spot on his back that needs to be surgically removed.

When first considering cancer treatment plans, it helps to understand your general options. Types of cancer treatment can be categorized into four modalities: Medical, surgical, radiation, and chemotherapy. Examples of medical options include chemical medicines, immunotherapy, and biological/endocrine therapy. Many surgical options can be minimally invasive and utilize modern technologies to better suit the patient's personalized treatment plan. While you may have heard of radiation and chemotherapy, you may not realize the recent advancements that improve these therapies, creating healthy, successful outcomes every day.

A histologic diagnosis is not usually required in patients who are candidates for surgery. The tissue diagnosis is made at the time of the surgical procedure. Percutaneous fine-needle aspiration biopsy of the pancreas, which is used to diagnose pancreatic tumors, is also used to confirm the diagnosis in patients whose tumors are not respectable so that a palliative plan of care can be determined. This may eliminate the stress and postoperative pain of ineffective surgery. In this procedure, a needle is inserted through the anterior abdominal wall into the pancreatic mass, guided by CT, ultrasound, ERCP, or other imaging techniques. The aspirated material is examined for malignant cells. Although percutaneous biopsy is a valuable diagnostic tool, it has some potential drawbacks: a false-negative result if small tumors are missed and the risk of seeding of cancer cells

The risk factors of pancreatic cancer are habits that most Americans have developed and can not seem to break. There are five major risk factors that people should consider which include the following; Genetics, Diabetes, Smoking, Obesity and Diet (Wax, 2012). Pancreatic cancer runs in five to ten percent of people who have immediate family members who have also had it (Wax, 2012). Different genes have been indicated as risk but no “pancreatic cancer gene” has yet been discovered (Wax, 2012). “People with diabetes develop Pancreatic cancer about twice as often then people without it” (Margolis, 2002, p.497) and the two diseases have been linked (Wax, 2012). Tobacco use is known to increase the risk of pancreatic cancer (Cancer Research UK, 2013). Smoking will double the risk in developing the disease (Wax, 2012). People, who quit smoking, can reduce the risk of pancreatic, lung, mouth, and certain other cancers and diseases. It is a known fact that people with a body mass index ( BMI) higher

Pancreatic Cancer is the leading cause of cancer deaths in the United States. Currently there is no cure for this cancer and all available treatments simply prolong the life of the patient. Diagnosing pancreatic cancer rarely occurs at the onset of the disease due to the location of the pancreas in the body. Symptoms such as weight loss and upper abdominal pain do not show up until it is too late. Enzymes produced by tumors known as tumor markers are not reliable until the disease has well progressed. Once you have been diagnosed with Pancreatic Cancer there are different types of treatments that are offered to prolong your life.

Approximately 20% of pancreatic cancer is found to be operable or resectable. The complete resection of the primary lesion is best treatment for patients with localized pancreatic cancer. However the risk of both local and distal recurrence is high in following resection. In early stage pancreatic cancer the complete resection are associated with considerable morbidity in 40–60% of patients and mortality in less than 3% of patients (Sohn et al., 2000; Winter et al., 2006). Moreover, it takes 2–3 months for complete recovery to a normal quality of life. Although the 5-year survival rate of resected pancreatic cancer is approximately 20% and the median overall survival time is 17–27 months (Winter et al., 2006).

Table 1: Causes of Pancreatic Cancer What are the symptoms of pancreatic cancer? The symptoms are wide ranged but usually do not appear till in the late stages of the cancer. That is one of the reasons that this is such a deadly killer. Some of the more common symptoms are shared by other diseases and is another factor that causes this disease so hard to diagnose. Pain in the upper back or upper abdomen, loss of appetite, weight loss, jaundice (yellowing of the eyes and skin, dark urine), indigestion, nausea and vomiting. This is a list of the more common symptoms but as with each individual the symptoms can be different in each. As with any unknown disease, a physician is the best place to start to protect peopleshealth and get a correct diagnosis. How is pancreatic cancer diagnosed? The physician will order a variety of possible diagnostic tests. A blood test can assess various pancreatic and liver functions and may suggest pancreatic cancer. If cancer is suspected a needle biopsy is usually conducted to examine the pancreas cells themselves for signs of cancer (Britannica Online 2007). These procedures are invasive and can cause complications including pancreatitis. In order to make a correct diagnosis and to determine the stage of the cancer it is possible to use multiple imaging techniques to allow doctors to see the pancreas even though it

Finding a panacea for cancer will be an arduous task with a very lengthy and discouraging trial and error period. Inevitably there will be some trying hurdles to get past in search of this cancer panacea, but, one that seems to be the most difficult to get passed is the severity and variety of the case presented. Doctors see this as overwhelming and very daunting since they do not want to get a patient’s hopes up if the medicine turns out not to work, or cause things to get worse. If doctors believe they have found this new and astonishing drug that cures all cancer at all stages and they prescribe it but turns out to only make the cancer worse, they will have to live knowing that they hurt all of these people and their families forever. In

My mom was diagnosed with pancreatic cancer stage IV last July. “I could believe what was happening to me, at the age of 44 I considered myself a healthy person, I was never sick, I never smoked, I was highly active and had a healthy diet. I couldn't find a possible explanation that justified this illness.” she said. It was really though for my family, we couldn't even say the word “cancer” for a few months. We became angry because we thought that my mom didn’t deserved that. The doctors were confident, even though stage IV of pancreatic cancer has 1% of survival rate in the US. In addition to that, my mom’s tumor couldn't be removed because the cancer spread to distant organs.

This year, an estimate of 53,070 adults, have been or will be diagnosed with pancreatic cancer. (27,670 men and 25,400 women). Pancreatic cancer is the ninth most common cancer in women. Pancreatic cancer should have the most attention because doctors still don’t know how to diagnose this type of cancer yet. The main problem is cost-effective screening tests that easily and reliably find early-stages of pancreatic cancer in people, sometimes show no symptoms.Often “times it is” not found until later stages when the cancer can no longer be surgically removed and has spread from the pancreas to other parts of the body. ("Pancreatic Cancer: Statistics", 2017)

Patients in the early stages of cancer, prior to metastasis, can often be cured by surgically removing the tumor. On the other hand, patients with advanced cancer that has already metastasized must be treated with systemic therapies. Common therapies used today are radiation and chemotherapy. Although in some cases these treatments are effective at removing tumors, they are not selective against cells within the tumor and are frequently toxic to the patient. A relatively new approach towards cancer treatment is targeted therapy: drugs that inhibit specific molecules involved in tumor development. These drugs are more specific towards tumor cells and less damaging to normal cells [1]. Although initial therapeutic responses to targeted therapy drugs are promising, many patients will experience regrowth and progression of the tumor within several months following treatment [1, 2]. Typical detectable metastatic lesions are expected to contain hundreds of cells resistant to the drug before the start of treatment. These cells likely expand during treatment, repopulate the tumor, and cause treatment failure [1]. Along with preexisting mutations, these targeted therapies put massive selective pressure on the diverse cell populations of the tumor, which then drive the tumor cells to select for mutations that cause resistance. This resistance can result from several different processes, which can include genetic alternation in the drug targets