Esophagus And Pancreas

Question 1

___ is the 4th leading cause of cancer death. Most common in men, between 50-80

Answer 1

Pancreatic cancer

Question 2

What are factors that causes pancreatic cancer

Answer 2

Smoking 
Familial cancer (colorectal and breast)
Exposure To industrial chemicals
Obesity 
Diets in high fats, red meats and processed meats

Question 3

Where is the location of the pancreas

Answer 3

Located RETROperitoneally at L1-L2 transversely in the upper abdomen

Question 4

The 3 anatomical regions of the pancreas

Answer 4

Head- overlapped by the duodenum
Body-posterior to the stomach and anterior to IVC
Tail- terminates in the splenic hilum

Question 5

Pancreas is in direct contact of with ….

Answer 5

Duodenum, jejunum, stomach, IVC, spleen and kidney

Question 6

T/F

The pancreas is usually resectable

Answer 6

False

Pancreas is usually un-resectable

Question 7

The pancreas is composed of _____ tissue and _____ tissue

Answer 7

98 percent exocrine

2 percent endocrine

Question 8

What is the most common histology of upper and middle thoracic esophageal cancer

Answer 8

Squamous cell carcinoma

Question 9

What is the most common histology for distal 1/3 esophageal cancer

Answer 9

Adenocarcinoma

Question 10

What is the most common histology for pancreatic cancer

Answer 10

Adenocarcinoma

Question 11

The pancreas is typically located at what level

Answer 11

L1-L2

Question 12

The esophagus is typically located at what level

Answer 12

C6-T10 and it is posterior to the trachea and anterior to the vertebral body

Question 13

What is the treatment of choice for pancreatic cancer

Answer 13

Surgery (Whipple procedure)

Question 14

What is the treatment of choice for post op pancreatic cancer

Answer 14

Chemo and XRT

Question 15

What is odynophagia

Answer 15

Related to esophageal cancers

It’s painful swallowing

Question 16

90% of patients with esophageal cancer experience…

Answer 16

Dysphagia and weight loss

Question 17

What is NOT a common symptom for pancreatic cancer

Answer 17

Nausea

Question 18

What are the most common presenting symptoms for pancreatic cancer

Answer 18

Jaundice
Abdominal pain
Anorexia
Weight loss

Question 19

Tumors in the head of the pancreas causes…

Answer 19

Obstruction to the biliary system

Question 20

Tumors to the body and tail of the pancreas does NOT cause obstruction but instead commonly causes…

Answer 20

Back pain and weight loss

Question 21

Most pancreatic cancers occur In what region of the pancreas

Answer 21

Head and neck of pancreas

Question 22

When treating with RADIATION ONLY, to what dose is the pancreatic cancer treated with

Answer 22

4500-5400cGy (45-54Gy)

treating with XRT and surgery or chemo, have to be LESS than 45Gy

Question 23

When treating he head of the pancreas, at least how much of the left kidney must be shielded

Answer 23

2/3 of the left kidney

Question 24

T/F

Early stage esophageal cancer has a high cure rate

Answer 24

TRUE

Esophageal cancer is deadly due to the fact that it distendable, lack or serosal layer and richness of lymphatics

Question 25

What nodal group is associated with cervical esophagus

Answer 25

Internal jugular nodes Cervical nodes Supraclavicular nodes

Question 26

What nodal group is associated with upper/middle esophagus

Answer 26

``` Subcarinal nodes Paraesophagus node Paratracheal node Mediastinal node Hilar node ```

Question 27

What nodal group is associated with lower esophagus

Answer 27

Gastric nodes Celiac axis node Curvature of the stomach nodes

Question 28

What is NOT a prognostic indicator for esophageal cancer

Answer 28

Tumor grade/ histology **HOWEVER, the earlier the discovery, a higher chance (90%) is curable***

Question 29

Which nodal group drains the lower esophagus

Answer 29

Gastric and celiac nodes

Question 30

What is the dose limiting structure of most concern for radiation treatments of the esophagus

Answer 30

Spinal cord

Question 31

The endocrine function of the pancreas is responsible for

Answer 31

Releasing insulin into the body

Question 32

Which of the following is the most common cancer in the US

Answer 32

Colorectal cancer

Question 33

Which cancer has the highest incidence of cancer related deaths in the US

Answer 33

Colorectal cancer

Question 34

The Whipple is a surgical procedure associated with cancer of what organ

Answer 34

Pancreas

Question 35

The esophagus is located ____ to the trachea

Answer 35

Posterior

Question 36

What condition is most closely associated with gastroesophageal reflux

Answer 36

Barret's esophagus

Question 37

Why is esophageal cancer so deadly

Answer 37

The esophagus is distendable Lack of serosal layer Richness of lymphatic Channels

Question 38

T/F | Most esophageal cancers are discovered in early stages

Answer 38

FALSE

Question 39

Radiation treatment fields for the distal esophagus typically include what lymph node

Answer 39

Celiac axis nodes

Question 40

Most of the Pancreas is made up of what kind of tissue

Answer 40

98% exocrine (makes pancreatic juices) | 2% endocrine (release insulin into the body)

Question 41

The tail of the pancreas is located ....

Answer 41

In the hilum of the spleen

Question 42

A 3 field technique using a hinge angle of 120 degrees is ofte used in the treatment of what cancer

Answer 42

Esophageal cancer

Question 43

What is the preferred treatment regimen post op for pancreatic cancer

Answer 43

Chemo radiation

Question 44

GERD is associated with cancer of what region

Answer 44

Esophagus

Question 45

What is the number 1 cause of esophageal cancer in the US

Answer 45

Smoking and alcohol

Question 46

What is no part of the digestive system

Answer 46

Appendix

Question 47

What is he TD5/5 for liver

Answer 47

30Gy

Question 48

The cervical esophagus extends from what distance from he incisors

Answer 48

18cm

Question 49

The upper thoracic esophagus extends at what distance from the incisors

Answer 49

24cm

Question 50

The middle thoracic esophagus extends at what distance from the incisors

Answer 50

32cm

Question 51

The lower thoracic extends at what distance from the incisors.

Answer 51

40cm

Question 52

The contraction of the intestinal tract is known as

Answer 52

Peristalsis