Pancreatic cancer secondary prevention
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
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Overview
Pancreatic cancer was first discovered in the 18th-century by Italian scientist Giovanni Battista Morgagni.
Secondary prevention of pancreatic cancer
Diet
- Exocrine pancreatic insufficiency due to pancreatic duct obstruction by the tumor may lead to malabsorption.
- Malabsorption in patients presents with anorexia, weight loss, and diarrhea.
- The diet proposed for pancreatic cancer patients is based on American Cancer Society (ACS) guidelines[1]
- Pancreatic enzyme replacement therapy
- Avoidance of high-protein/high-fat diets
- Individualized dietary prescriptions from a registered dietitian
- Supplementation with omega-3 fatty acids
Palliative Therapy
Pain:
- There are various techniques for pain management as palliative therapy in patients with advanced stage of pancreatic cancer:
- Surgical techniques used to treat pain in advanced pancreatic cancer cases include:
- Endoscopic decompression with stent placement in patients with biliary or pancreatic duct obstruction
- Neurolysis of the celiac ganglia by many approaches:
- Intraoperative
- Transgastric
- Transthoracic
- Transabdominal
Jaundice:
- Obstructive jaundice can present with features of cholangitis:
- Fever and chills
- Nausea, vomiting
- Clay-colored stools
- Dark urine
- Yellowish discoloration of skin
- Pruritus
- Right upper quadrant pain
- Anorexia
- Preferred treatment in patients: Endoscopic decompression with stent placement in patients with biliary obstruction.
- Techniques of biliary decompression:
- Cholecystojejunostomy
- Choledochojejunostomy
- Types of stents:
- Metal- costly, longer lifespan
- Plastic- cheaper, need replacement every three months
Duodenal obstruction
- Preferred treatment:
References
- ↑ Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews K, Gansler T (2012). "American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity". CA Cancer J Clin. 62 (1): 30–67. doi:10.3322/caac.20140. PMID 22237782.