Pancreatic Cancer

Question 1

Pancreatic cancer is the 4th leading cause of cancer deaths. True or false?

Answer 1

True

Question 2

What is the age range that commonly experiences pancreatic cancer?

Answer 2

50-80 yo

Question 3

What is the survival rate of pancreatic cancer?

Answer 3

9.3%

Question 4

What are some etiological contributors to pancreatic cancer? (6)

Answer 4

Smoking, Hereditary cancers, Genetics, Environmental, Lifestyle, other diseases

Question 5

What are the three sections of the pancreas? (from right to left)

Answer 5

Head, Body, and Tail

Question 6

Where is the head of the pancreas located?

Answer 6

overlapped by the duodenum

Question 7

Where is the body of the pancreas located?

Answer 7

posterior to the stomach and anterior to IVC

Question 8

Where is the tail of the pancreas located?

Answer 8

terminates at the splenic hilum

Question 9

What structures is the pancreas in direct contact with? (6)

Answer 9

Duodenum, Jejunum, Stomach, Blood Vessels, Spleen and Kidneys

Question 10

Why is pancreatic cancer considered so deadly?

Answer 10

Due to its close proximity to other structures and accessibility to expand

Question 11

What is the composition of exocrine to endocrine tissue of the pancreas?

Answer 11

98% exocrine and 2% endocrine

Question 12

What do endocrine cells produce?

Answer 12

Insulin

Question 13

What is the entry in the duodenum from the panceas?

Answer 13

papilla of vater

Question 14

What is the function of the exocrine pancreas?

Answer 14

Digestive fluids production

Question 15

What is the function of the endocrine pancreas?

Answer 15

hormone production

Question 16

What are the pancreatic nodes? (5)

Answer 16

Celiac, sup and inf pancreaticoduodenal nodes, Splenic nodes, Porta hepatis nodes, Supra-pancreatic node

Question 17

What is the clinical presentation of pancreatic cancer? (4)

Answer 17

Jaundice, Abd pain, Anorexia and weight loss, obstruction due to tumor invasion

Question 18

What is the most commonly used detection technique used for pancreatic cancer?

Answer 18

Spiral CT

Question 19

How is an endoscopic ultrasound utilized in pancreatic cancer detection?

Answer 19

A transducer is sent orally into the stomach to which waves are sent off and read by the sonogram

Question 20

What percentage of pancreatic cancer is adenocarcinoma?

Answer 20

80%

Question 21

What staging system is used for pancreatic cancer?

Answer 21

TNM system

Question 22

What pattern of spread do pancreatic cancer utilize?

Answer 22

local invasion to surrounding structures, direct extension, and hematogenous to liver

Question 23

What is the treatment of choice for pancreatic cancer?

Answer 23

Surgery, not often due to unresectability

Question 24

What is another name for a pancreaticoduodenectomy?

Answer 24

Whipple procedure

Question 25

What is done during a Whipple procedure?

Answer 25

The head of the pancreas, entire duodenum, distal stomach, gallbladder, and common bile duct are resected

Question 26

What is the survival rate for pancreatic cancer after curative surgery?

Answer 26

less than 10%

Question 27

Adjuvant combine modality treatment has improved survival to 18-29 months. True or false?

Answer 27

True

Question 28

What critical structures are involved during pancreatic cancer treatment? (4)

Answer 28

Small bowel, kidney, liver, stomach

Question 29

What is the standard treatment design for pancreatic cancer? (4)

Answer 29

3 or 4 Fields, 45 Gy, Lateral dose of 20 Gy for liver and kidneys, IMRT

Question 30

What is the dose limits for pancreatic cancer radiation therapy alone? With chemo/surgery?

Answer 30

54 Gy alone, 45 Gy w/ combined

Question 31

What is the dose restriction on the kidneys?

Answer 31

23 Gy

Question 32

What is the dose restriction on the liver?

Answer 32

30 Gy

Question 33

What is the dose restriction on the Small bowel?

Answer 33

40 Gy

Question 34

What is the dose restriction on the cord?

Answer 34

45 Gy

Question 35

What is the dose restriction on the Stomach?

Answer 35

50 Gy

Question 36

What is the rule with treatment the head of the pancreas and the kidneys involvement?

Answer 36

Since the right kidney is 50% in the field of treatment, the other kidney must be 2/3 shielded

Question 37

What is the set up for pancreatic cancer? (4)

Answer 37

Supine, immobilized, arms up and leg comfort

Question 38

What are the most common side effects of pancreatic cancer?

Answer 38

N/V (antiemetics), Leukopenia, Diarrhea, Stomatitis

Question 39

What is the long term side effect of pancreatic cancer?

Answer 39

Renal Failure (rare)