A Simple Guide to Pancreatic Cancer
----------------------------------------
What is Pancreatic Cancer?
------------------------------
Pancreatic Cancer is a malignant disease of the exocrine pancreas. 90% are adenocarcinomas.
What are the causes of Pancreatic Cancer?
-----------------------------------------
1.Smoking. cigarettes smoke chemicals has been known to damage the pancreatic cells
2.Diets rich in red meat- high protein tends to stmulate more enzymes frm pancreas and cause dysfunction in the cells
3.Diabetes mellitus -damage to islets in pancreas may contribute to pancreatic cancer
4.Chronic pancreatitis has been found to have some causal effect
5.Helicobacter pylori infection -known to cause stomach cancer and also pancreatic cancer
6.Occupational exposure to certain chemicals including insecticides
7.Family history -there is a family history in 5-10% of pancreatic cancer patients
8.Obesity - the high fat diet may induce more disease of bile system with blockage of its tract
What are the symptoms and signs of Pancreatic Cancer?
-------------------------------------------------------
Symptoms - non-specific and varied.
1.pain in the upper abdomen that typically radiates to the back
2.pain relieved by leaning forward
3.painless jaundice related to bile duct obstruction (carcinoma of the head of the pancreas)
4.depression is sometimes associated with pancreatic cancer
Signs:
1.tenderness in upper abdomen
2.mass in the abdomen
3.Trousseau sign- Spontaneous blood clots in veins of extremities, or the superficial veins may indicate presence of pancreatic cancer.
How do you diagnose Pancreatic Cancer?
----------------------------------------------
Diagnosis can usually be made by :
History
-----------
1.pain in upper abdomen radiating straight to the back, worse on eating
2.Weight loss severe with anorexia, early satiety, diarrhea, or steatorrhea.
3.Jaundice -initially painless, itchy with dark urine.
Painful jaundice occurs later
4.onset of atypical diabetes mellitus
5.unexplained recent thrombophlebitis
6.past history of pancreatitis
Location of cancer
-----------------------
1.Tumors in the pancreatic body or tail usually present with pain and weight loss
2.Tumors in the head of the gland typically present with steatorrhea, weight loss, and jaundice.
Courvoisier sign
-----------------
presence of jaundice and a painlessly distended gallbladder is suggestive of pancreatic cancer
Liver function tests
---------------------
may show a combination of results indicative of bile duct obstruction (raised conjugated bilirubin, SGGT and alkaline phosphatase levels).
CA19-9 (carbohydrate antigen 19.9)
----------------------------------
is a tumor marker that is frequently elevated in pancreatic cancer.
Ultrasound or abdominal CT
------------------------------
may be used to identify tumors.
Endoscopic ultrasound (EUS) is another procedure that can help visualize the tumor and obtain tissue to establish the diagnosis.
What is the treatment of Pancreatic Cancer?
------------------------------------------------
Treatment of pancreatic cancer can be surgery or chemotherapy depending on the stage of the cancer.
Surgery
--------------
1.Where the head of the pancreas is involved, the Whipple procedure is the most common surgical treatment for pancreatic cancers.
It is a major surgery involving the the resection of the head of pancreas and requres the patient to be fit for the surgery and the tumor to be localised without metastases. Only in small number of cases can the surgery be done.
2.Cancers of the tail of the pancreas can be removes by a technique called distal pancreatectomy
3.localized tumors of the pancreas have been surgically removed using laparoscopy.
4.Surgery may be performed for relief of symptoms especially if the cancer is invading or pressing on the duodenum or colon.
5.Bypass surgery may prevent the obstruction of the pancreatic ducts and improve quality of life.
Chemotherapy
-----------------
is used for patients not suitable for surgery. It can relieve symptoms and improve quality of life
Gemcitabine was approved by the US FDA after a clinical trial reported improvements in quality of life in patients with advanced pancreatic cancer
Gemcitabine may used after surgery to remove tumor tissue remaining in the body. As a result 5-year survival rates has improved.
Other drugs such as oxaliplatin and fluorouracil have also beneficial effect.
Radiation therapy
--------------------
The use of additional radiation therapy follwing surgery has been used in USA while rejected by most doctors in Europe.
What is the Prognosis of pancreatic cancer?
-------------------------------------------------
The prognosis of pancreatic cancer is poor
1.because the cancer usually causes no early symptoms resulting in advanced or metastatic disease at the time of diagnosis.
2.Median survival from diagnosis is around 3-4 months;
3.5-year survival is lower than 5%.
4.Pancreatic cancer has the highest mortality of all the cancers.
5.Pancreatic cancer may sometimes cause diabetes.
How to prevent Pancreatic Cancer?
----------------------------------------
1.a healthy lifesyle
2.increase consumption of fruits, vegetables
3.reduce red meat intake
4.Vitamin D can reduce the risk of pancreatic cancer
5.B vitamins such as B12, B6, and folate in food but not in tablets may reduce the risk of pancreatic cancer
6.Avoid smoking and drinking of alcohol
Showing posts with label pancreatitis. Show all posts
Showing posts with label pancreatitis. Show all posts
Wednesday, June 18, 2008
Sunday, June 15, 2008
A Simple Guide to Pancreatitis
A Simple Guide to Pancreatitis
------------------------------
What is Pancreatitis?
----------------------
Pancreatitis is an acute or chronic inflammation of the pancreas.
What are the causes of Pancreatitis?
-----------------------------------------
Pancreatitis is usually caused by the following:
1. Alcoholism and diseases of the biliary tract
2. bacterial infections from salmonella typhi and streptococcus
3. viral infection especially mumps, coxsackie virus, cytomegalovirus
4. trauma
Chronic disease follows attacks of acute infection.
What are the symptoms and signs of Pancreatitis?
-------------------------------------------------------
Persons who has Acute Pancreatitis has the following symptoms:
1.acute onset of abdominal pain starting from the epigastrium, radiating to the back in 50% of cases.
2.Pain usually very severe occuring a large meal or drinking bout
3.Pain is worse lying supine, therefore patients sit or lean forward
4.mild fever and bodyaches
5.nausea and vomitting
6.hypotension followed by clinical shock
Signs:
1.Tenderness at the epigastrium with muscle spasm
2.Distension and diminished bowel sounds
3.Pleural effusion 10%,abdominal mass 20%, ascites 20%
4. Acute renal failure, respiratory failure following shock.
Chronic Pancreatitis
---------------------
Symptoms:
1.repeated attacks of epigastric abdominal pain
2.Pain worse after eating, radiates to the back
3.weight loss
4.Fever
Signs:
1.abdominal tenderness
2.abdominal mass may suggest swelling and pseudocysts
3.tender subcutaneous masses seen indicating fat necrosis
How do you diagnose Pancreatitis?
--------------------------------
Diagnosis can usually be made by :
1.Physical examination with tenderness in the epigastrium
2.Serum and urine amylase very high after 6 hours
3.White blood cell count high
4.Serum lipase high in 50% patients
5.Blood calcium may be low
6.Blood glucose tolerance test for diabetes
7.Ultrasound may show up the presence of pseudocyst in pancreas
8.CAT scan and MRI may show swelling and pseudocysts in pancreas
What is the complications of Pancreatitis?
-------------------------------------
1.Pseudocysts from damage to pancreatic tissues
2.Hemorrhage - bleeding due to damage to the blood vessels in pancreas
3.peritonitis from rupture of pseudocysts and bleeding
4.diabetes mellitus from damage to the glands in the pancreas producing insulin
What is the treatment of Pancreatitis?
-------------------------------------
Acute Pancreatitis:
----------------------
Admission to hospital
Gastric suction and fluid replacement
Analgesic or antispasmodic medicine usually by injection
Antibiotics for infections
Treat biliary tract diseases and alcoholism
surgical drainage of pseudocysts after acute episode.
Chronic Pancreatitis:
-----------------------
Pancreatic extracts and enzymes together with meals
Sodium bicarbonate and cimetidine to prevent enzymes breakdown
Analgesic or antispasmodic medicine usually by injection
Surgical procedures usually unsuccessful
What is the prognosis of Pancreatitis?
----------------------------------------
Prognosis is usually good after treatment of acute pancreatitis with recovery in 5-7 days.
Hemorhagic Pancreatitis has high mortality of 50-90%
Most trauma cases has complete resolution
Some alcoholic pancreatitis may go on to chronic pancreatitis.
Chronic pancreatitis relapses frequently
Rupture of pseudocysts may result in death
How do you prevent Pancreatitis?
------------------------------------------------
Avoid alcohol and oily food
Take precautions during mumps and other viral infection
Avoid injury to the abdomen especially the mid section below the sternum
------------------------------
What is Pancreatitis?
----------------------
Pancreatitis is an acute or chronic inflammation of the pancreas.
What are the causes of Pancreatitis?
-----------------------------------------
Pancreatitis is usually caused by the following:
1. Alcoholism and diseases of the biliary tract
2. bacterial infections from salmonella typhi and streptococcus
3. viral infection especially mumps, coxsackie virus, cytomegalovirus
4. trauma
Chronic disease follows attacks of acute infection.
What are the symptoms and signs of Pancreatitis?
-------------------------------------------------------
Persons who has Acute Pancreatitis has the following symptoms:
1.acute onset of abdominal pain starting from the epigastrium, radiating to the back in 50% of cases.
2.Pain usually very severe occuring a large meal or drinking bout
3.Pain is worse lying supine, therefore patients sit or lean forward
4.mild fever and bodyaches
5.nausea and vomitting
6.hypotension followed by clinical shock
Signs:
1.Tenderness at the epigastrium with muscle spasm
2.Distension and diminished bowel sounds
3.Pleural effusion 10%,abdominal mass 20%, ascites 20%
4. Acute renal failure, respiratory failure following shock.
Chronic Pancreatitis
---------------------
Symptoms:
1.repeated attacks of epigastric abdominal pain
2.Pain worse after eating, radiates to the back
3.weight loss
4.Fever
Signs:
1.abdominal tenderness
2.abdominal mass may suggest swelling and pseudocysts
3.tender subcutaneous masses seen indicating fat necrosis
How do you diagnose Pancreatitis?
--------------------------------
Diagnosis can usually be made by :
1.Physical examination with tenderness in the epigastrium
2.Serum and urine amylase very high after 6 hours
3.White blood cell count high
4.Serum lipase high in 50% patients
5.Blood calcium may be low
6.Blood glucose tolerance test for diabetes
7.Ultrasound may show up the presence of pseudocyst in pancreas
8.CAT scan and MRI may show swelling and pseudocysts in pancreas
What is the complications of Pancreatitis?
-------------------------------------
1.Pseudocysts from damage to pancreatic tissues
2.Hemorrhage - bleeding due to damage to the blood vessels in pancreas
3.peritonitis from rupture of pseudocysts and bleeding
4.diabetes mellitus from damage to the glands in the pancreas producing insulin
What is the treatment of Pancreatitis?
-------------------------------------
Acute Pancreatitis:
----------------------
Admission to hospital
Gastric suction and fluid replacement
Analgesic or antispasmodic medicine usually by injection
Antibiotics for infections
Treat biliary tract diseases and alcoholism
surgical drainage of pseudocysts after acute episode.
Chronic Pancreatitis:
-----------------------
Pancreatic extracts and enzymes together with meals
Sodium bicarbonate and cimetidine to prevent enzymes breakdown
Analgesic or antispasmodic medicine usually by injection
Surgical procedures usually unsuccessful
What is the prognosis of Pancreatitis?
----------------------------------------
Prognosis is usually good after treatment of acute pancreatitis with recovery in 5-7 days.
Hemorhagic Pancreatitis has high mortality of 50-90%
Most trauma cases has complete resolution
Some alcoholic pancreatitis may go on to chronic pancreatitis.
Chronic pancreatitis relapses frequently
Rupture of pseudocysts may result in death
How do you prevent Pancreatitis?
------------------------------------------------
Avoid alcohol and oily food
Take precautions during mumps and other viral infection
Avoid injury to the abdomen especially the mid section below the sternum
Friday, March 21, 2008
A Simple Guide to Gallstones
A Simple Guide to Gallstones
------------------------------
What are gallstones?
----------------------
Gallstones are stones which are found in the gallbladder which is a sac storing bile from the liver.
They are made from cholesterol and other substances in the bile.
What causes gallstones?
-------------------------
Gallstones are formed when cholesterol and other substances like calcium found in bile combine to form stones.
They are more common in
1.overweight people
2.Females more than males
What are the symptoms?
------------------------------
Most people with gallstones do not have symptoms.
Symptomsoccur when a gallstone causes blockage in the bile duct causing obstruction to flow of bile from the liver to the intestine.
The symptoms may be:
1.mild pain in the upper right part of the abdomen and also just below the sternum just like gastritis.
2.Pain in the right upper back or shoulder blade area.
3.Pain is worse when you eat.
4.fever and chills
5.Yellowness of the eyes or skin
6.Dark coloured urine
7.Chest pain occurs when the pain radiates to the chest
How are gallstones diagnosed?
--------------------------------
1.Pain in the right side of the abdomen
2. Murphy's sign positive.
A thumb pressing against the right of the epigastrium causes more pain when the patients breathes in deeply
3.An ultrasound of the right side of the abdomen is the best way to find gallstones.
Most gallstones can be detected from the ultrasound.
4.gallbladder scan. A dye is injected into a vein in your arm.
X-rays are taken as the dye moves through your liver, bile duct, gallbladder.
What are the complications of gallstones?
-------------------------------------------------
A gallsone which is stuck in the bile duct(a tube which leads the bile from the liver to the gallbladder and small intestine) can give rise to:
1.Gallbladder inflmmation or infection(Cholecystitis)
2.Swelling and inflammation of the Pancreas(pancreatitis)
3.Hepatitis due to reflux of the bile back to the liver
4.Peritonitis(inflammation of the inner lining of the abdomen) if the bile duct or gallbladder perfoates or burst.
This is an emergency.
What is the treatment of gallstones?
----------------------------------------
1.If there is no symptoms, treatment is not needed.
2.If there is mild pain, some pain and antispasmodic medicines are given.
Patient is kept for observation.
If the pain goes away, the gallsone may have become unstuck in the bile duct and pass out into the intestine.
3.If there is severe pain or recurrence of another attack of pain, it is advisable to have the gallbladder removed.
a.Normal surgery to remove the gallbladder and the gallstones involve 4 holes in the abdomen and the use of a laparoscopic to cut away the gallbladder followed by stitching.
The surgery is usually very safe and the patient may not need to be hospitalised.
b.In an emergency, such as perforated gallbladder, immediate surgery may be required to remove the gallbladder and cleared the inner abdomen of leaked bile.
What is the prognosis of gallstones?
----------------------------------------------
Most people with gallstones do not have symptoms.
Sometimes gallstones may be detected while having tests for other health problems.
Sometimes an ultrasound done on an woman during pregnancy may show gallstones.
The prognosis for patients after surgery is usually good.
The bile will go straight to the intestine from the liver.
Digestion of oily food may not as good as before and is usually not noticeable.
------------------------------
What are gallstones?
----------------------
Gallstones are stones which are found in the gallbladder which is a sac storing bile from the liver.
They are made from cholesterol and other substances in the bile.
What causes gallstones?
-------------------------
Gallstones are formed when cholesterol and other substances like calcium found in bile combine to form stones.
They are more common in
1.overweight people
2.Females more than males
What are the symptoms?
------------------------------
Most people with gallstones do not have symptoms.
Symptomsoccur when a gallstone causes blockage in the bile duct causing obstruction to flow of bile from the liver to the intestine.
The symptoms may be:
1.mild pain in the upper right part of the abdomen and also just below the sternum just like gastritis.
2.Pain in the right upper back or shoulder blade area.
3.Pain is worse when you eat.
4.fever and chills
5.Yellowness of the eyes or skin
6.Dark coloured urine
7.Chest pain occurs when the pain radiates to the chest
How are gallstones diagnosed?
--------------------------------
1.Pain in the right side of the abdomen
2. Murphy's sign positive.
A thumb pressing against the right of the epigastrium causes more pain when the patients breathes in deeply
3.An ultrasound of the right side of the abdomen is the best way to find gallstones.
Most gallstones can be detected from the ultrasound.
4.gallbladder scan. A dye is injected into a vein in your arm.
X-rays are taken as the dye moves through your liver, bile duct, gallbladder.
What are the complications of gallstones?
-------------------------------------------------
A gallsone which is stuck in the bile duct(a tube which leads the bile from the liver to the gallbladder and small intestine) can give rise to:
1.Gallbladder inflmmation or infection(Cholecystitis)
2.Swelling and inflammation of the Pancreas(pancreatitis)
3.Hepatitis due to reflux of the bile back to the liver
4.Peritonitis(inflammation of the inner lining of the abdomen) if the bile duct or gallbladder perfoates or burst.
This is an emergency.
What is the treatment of gallstones?
----------------------------------------
1.If there is no symptoms, treatment is not needed.
2.If there is mild pain, some pain and antispasmodic medicines are given.
Patient is kept for observation.
If the pain goes away, the gallsone may have become unstuck in the bile duct and pass out into the intestine.
3.If there is severe pain or recurrence of another attack of pain, it is advisable to have the gallbladder removed.
a.Normal surgery to remove the gallbladder and the gallstones involve 4 holes in the abdomen and the use of a laparoscopic to cut away the gallbladder followed by stitching.
The surgery is usually very safe and the patient may not need to be hospitalised.
b.In an emergency, such as perforated gallbladder, immediate surgery may be required to remove the gallbladder and cleared the inner abdomen of leaked bile.
What is the prognosis of gallstones?
----------------------------------------------
Most people with gallstones do not have symptoms.
Sometimes gallstones may be detected while having tests for other health problems.
Sometimes an ultrasound done on an woman during pregnancy may show gallstones.
The prognosis for patients after surgery is usually good.
The bile will go straight to the intestine from the liver.
Digestion of oily food may not as good as before and is usually not noticeable.
Wednesday, October 3, 2007
A Simple Guide to Mumps
A Simple Guide to Mumps
------------------------------
What is Mumps?
--------------------
Mumps is a highly contagious viral infection that causes painful swelling in the salivary glands (the glands which produce saliva) which include the parotid, submandibular and submental glands.
How is Mumps spread?
---------------------------
The mumps (paramyxovirus) virus is spread by coughing, sneezing and through the saliva of an infected person.
It can also be spread by contact with contaminated items and surfaces.
It is contagious 1 - 2 days before the appearance of symptoms to 1 - 2 days after the symptoms disappear.
The incubation period is about 18 days.
An attack gives lifelong immunity.
Who is infected in Mumps?
-------------------------------
Although mumps may affect adults, children between the ages of 5 - 15 years are most prone.
What are the Symptoms of Mumps?
-----------------------------------------
Symptoms
1.Prodromal symptoms such as fever, headache and sore throat
2.Facial pain and swelling
3.pain or lumps in their testicles
4.Abdominal pain
Signs:
1.Swollen and tender parotid glands in front of the ear, cheek and neck.
Submandibular glands below the jaws are less affected
2.Dry mouth - less saliva ,fever
3.Males may experience pain or lumps in their testicles, and swelling in the scrotum. However this rarely causes infertility problems.
4.Pain in the abdomen may indicate pancreatitis, a rare complication
5.Meningoencephalitis (infection of the central nervous system) with fever, headache and neck rigidity. It usually does not cause permanent damage.
What is the Treatment of Mumps?
----------------------------------------
Mumps is a viral disease and cannot be cured.
It normally run its course within 1 week.
Treatment of mumps is therefore symptomatic.
1.Rest and soft diet.
2.Lots of fluids
3.Paracetamol can be given to reduce fever and relieve pain. For children, aspirin should not be given because of the risk of Reye's syndrome which can damage the brain.
4.Warm or cold compresses can be given to relieve pain and swelling in the parotid glands.
5.Cool compresses and scrotal support can be given to reduce pain and swelling in the testicles.
6.Avoid foods that stimulate the parotid glands (stimulating the glands causes pain) such as fruit juices and tart beverages.
What are the complications of Mumps?
----------------------------------------------
The mumps virus may affects many different glands including the brain.
It can affect the testes (orchitis)in boys or ovaries (oophoritis) in girls during puberty rarely causing infertility.
It can also affect the pancreas in some patients giving rise to Juvenile Diabetes or pancreatitis.
In the brain rarely encephalitis or meningitis may occur with damage to some brain cells.
What is the prognosis of Mumps?
--------------------------------------
Prognosis is good in all cases.
Very rarely do complications such orchitis or meningitis occur.
How is Mumps Prevented?
------------------------------
Mumps can be prevented by administering the Mumps, Measles, Rubella vaccine (MMR). This vaccine is given at the age of 15 months and again at 12 years old.
------------------------------
What is Mumps?
--------------------
Mumps is a highly contagious viral infection that causes painful swelling in the salivary glands (the glands which produce saliva) which include the parotid, submandibular and submental glands.
How is Mumps spread?
---------------------------
The mumps (paramyxovirus) virus is spread by coughing, sneezing and through the saliva of an infected person.
It can also be spread by contact with contaminated items and surfaces.
It is contagious 1 - 2 days before the appearance of symptoms to 1 - 2 days after the symptoms disappear.
The incubation period is about 18 days.
An attack gives lifelong immunity.
Who is infected in Mumps?
-------------------------------
Although mumps may affect adults, children between the ages of 5 - 15 years are most prone.
What are the Symptoms of Mumps?
-----------------------------------------
Symptoms
1.Prodromal symptoms such as fever, headache and sore throat
2.Facial pain and swelling
3.pain or lumps in their testicles
4.Abdominal pain
Signs:
1.Swollen and tender parotid glands in front of the ear, cheek and neck.
Submandibular glands below the jaws are less affected
2.Dry mouth - less saliva ,fever
3.Males may experience pain or lumps in their testicles, and swelling in the scrotum. However this rarely causes infertility problems.
4.Pain in the abdomen may indicate pancreatitis, a rare complication
5.Meningoencephalitis (infection of the central nervous system) with fever, headache and neck rigidity. It usually does not cause permanent damage.
What is the Treatment of Mumps?
----------------------------------------
Mumps is a viral disease and cannot be cured.
It normally run its course within 1 week.
Treatment of mumps is therefore symptomatic.
1.Rest and soft diet.
2.Lots of fluids
3.Paracetamol can be given to reduce fever and relieve pain. For children, aspirin should not be given because of the risk of Reye's syndrome which can damage the brain.
4.Warm or cold compresses can be given to relieve pain and swelling in the parotid glands.
5.Cool compresses and scrotal support can be given to reduce pain and swelling in the testicles.
6.Avoid foods that stimulate the parotid glands (stimulating the glands causes pain) such as fruit juices and tart beverages.
What are the complications of Mumps?
----------------------------------------------
The mumps virus may affects many different glands including the brain.
It can affect the testes (orchitis)in boys or ovaries (oophoritis) in girls during puberty rarely causing infertility.
It can also affect the pancreas in some patients giving rise to Juvenile Diabetes or pancreatitis.
In the brain rarely encephalitis or meningitis may occur with damage to some brain cells.
What is the prognosis of Mumps?
--------------------------------------
Prognosis is good in all cases.
Very rarely do complications such orchitis or meningitis occur.
How is Mumps Prevented?
------------------------------
Mumps can be prevented by administering the Mumps, Measles, Rubella vaccine (MMR). This vaccine is given at the age of 15 months and again at 12 years old.
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