Cancer Education Slides

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Cancer Education Slides

• Pancreatic Cancer

2009
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What is Cancer?

• A group of 100 different diseases
• The uncontrolled, abnormal growth of cells
• Cancer may spread to other parts of the body

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What is Pancreatic Cancer?

• Fourth leading cause of cancer death in men and
  women
• An estimated 42,470 people diagnosed in the
  United States in 2009
• A disease in which normal cells in the pancreas
  grow uncontrollably
• Most cases arent detected until the cancer has
  metastasized (spread) beyond the pancreas to
  other areas of the body

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What is the Function of the Pancreas?

• Pear-shaped gland located in the abdomen between
  the stomach and spine
• Comprised of the head (where pancreatic cancer is
  most commonly diagnosed), the body, and the tail
• Helps the body digest food and produces hormones,
  such as insulin
• The most common type of pancreatic cancer is
  ductal adenocarcinoma, which occurs in cells
  lining pancreatic ducts

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What are the Risk Factors for Pancreatic Cancer?

• Age
• Gender Men at higher risk than women
• Race Black people at increased risk
• Smoking
• Obesity and diet
• Diabetes
• Family history
• Chronic pancreatitis (inflammation of the
  pancreas)
• Exposure to pesticides, benzene, certain dyes,
  and petrochemicals

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Pancreatic Cancer and Early Detection

• No tests are recommended for screening the
  general population
• Often called the silent disease because it
  usually doesnt cause symptoms in early stages

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What are the Symptoms of Pancreatic Cancer?

• Jaundice (yellow skin and eyes, darkened urine,
  clay-colored stool)
• Pain in upper abdomen or upper back
• Burning feeling in the stomach
• Floating stools with an especially bad odor
• Weakness
• Loss of appetite
• Nausea and vomiting
• Weight loss with no known explanation

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How is Pancreatic Cancer Diagnosed?

• Physical examination laboratory tests
• Diagnosis is confirmed with a biopsy
• Endoscopic retrograde cholangiopancreatography
  (ERCP), a test that checks the bile ducts and
  pancreatic ducts for blockage
• Endoscopic ultrasound (EUS), a test using a thin,
  lighted tube to get images of the pancreas using
  sound waves
• Other imaging tests, such as computerized
  tomography (CT) scans

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Pancreatic Cancer Staging

• Staging is a way of describing a cancer, such as
  the size of a tumor and if or where it has spread
• Staging is the most important tool doctors have
  to determine a patients prognosis
• Pancreas cancer is most commonly classified as
• Resectable (able to be surgically removed)
• Locally advanced (cancer confined to the area
  around the pancreas, but not resectable because
  of extension/invasion into surrounding vessels
  and organs)
• Metastatic (cancer has spread to other organs)
• Treatment depends on the stage of the cancer
• Recurrent cancer is cancer that comes back after
  treatment

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How is Pancreatic Cancer Treated?

• Treatment depends on the stage of cancer more
  than one treatment may be used
• Surgery, radiation therapy, and chemotherapy may
  be used at any stage of the disease
• Has a much higher chance of being successfully
  treated if detected at an early stage
• People with pancreatic cancer may consider
  enrolling in a clinical trial

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Cancer Treatment Surgery

• May involve removing all or part of the pancreas
• Cancer at the pancreatic head Whipple resection
  (pancreatoduodenectomy)
• Cancer at the pancreatic body or tail distal
  pancreatectomy
• Surgeons sometimes start with a diagnostic
  laparoscopy, a less invasive surgical procedure
  to get a more accurate sense of the disease stage
• Surgery may be combined with radiation therapy or
  chemotherapy before or after surgery (adjuvant
  therapy)
• Prescription hormones and enzymes can be given to
  replace those lost by pancreas removal

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Cancer Treatment Radiation Therapy

• The use of high-energy x-rays to destroy cancer
  cells
• Most common type is external-beam outside the
  body
• May be used before, during, or, after surgery is
  often given at the same time as chemotherapy
• Also used to relieve pain associated with
  pancreatic cancer
• Newer techniques, such as stereotactic
  radiosurgery (Cyberknife), are still considered
  experimental

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Cancer Treatment Chemotherapy

• Use of drugs to kill cancer cells
• Most common treatment drug for pancreatic cancer
  is gemcitabine (Gemzar)
• Two large clinical trials have shown a survival
  advantage using a combination of gemcitabine and
  another drug for advanced pancreatic cancer
• Gemcitabine combined with erlotinib (Tarceva)
• Gemcitabine combined with capecitabine (Xeloda)
• One recently reported study showed that the
  combination of fluorouracil (5-FU) and
  oxaliplatin (Eloxatin) is effective in some
  patients as a second-line treatment if the tumor
  continues to grow.
• Patients well enough to consider more aggressive
  therapy may consider enrolling in a clinical
  trial

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Cancer Treatment Advanced Pancreatic Cancer

• Treatments can help patients with advanced
  pancreatic cancer live longer
• Treatment options include palliative (symptom
  relief) surgery, radiation therapy, and
  chemotherapy
• In rare cases, chemotherapy and radiation therapy
  may shrink the tumor enough in patients with
  locally advanced cancer so it can be surgically
  removed (downstaging)
• Patients with advanced pancreatic cancer may
  consider enrolling in a clinical trial

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Current Research

• New tools for early detection
• Studies of pancreatic cancer genes
• Other chemotherapy agents new formulations of
  paclitaxel (Taxol)
• Biologic therapy
• Targeted therapy
• Multidrug therapy

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The Role of Clinical Trials for the Treatment of
Pancreatic Cancer

• Clinical trials are research studies involving
  people
• They test new treatment and prevention methods to
  determine whether they are safe, effective, and
  better than the standard treatment
• The purpose of a clinical trial is to answer a
  specific medical question in a highly structured,
  controlled process
• Clinical trials can evaluate methods of cancer
  prevention, screening, diagnosis, treatment,
  and/or quality of life

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Clinical Trials Patient Safety

• Informed consent participants should understand
  why they are being offered entry into a clinical
  trial and the potential benefits and risks
  informed consent is an ongoing process
• Participation is always voluntary, and patients
  can leave the trial at any time
• Other safeguards exist to ensure ongoing patient
  safety

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Clinical Trials Phases

• Phase I trials determine the safety and dose of a
  new treatment in a small group of people
• Phase II trials provide more detail about the
  safety of the new treatment and determine how
  well it works for treating a specific type of
  cancer
• Phase III trials take a new treatment that has
  shown promising results when used to treat a
  small number of patients with cancer and compare
  it with the standard treatment for that disease
  phase III trials involve a large number of
  patients

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Clinical Trials Resources

• Coalition of Cancer Cooperative Groups
  (www.CancerTrialsHelp.org)
• CenterWatch (www.centerwatch.com)
• National Cancer Institute (www.cancer.gov/clinical
  _trials)
• EmergingMed (www.emergingmed.com)

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Coping with Side Effects

• Side effects are treatable talk with the doctor
  or nurse
• Fatigue is a common, treatable side effect
• Pain is treatable non-narcotic pain-relievers
  are available
• Antiemetic drugs can reduce or prevent nausea and
  vomiting
• For more information, visit www.cancer.net/sideeff
  ects

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After Treatment

• Talk with the doctor about developing a follow-up
  care plan
• For patients who have had surgery, doctors
  visits every three to six months
• Blood tests
• In some cases, a CT scan may be appropriate

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Where to Find More InformationCancer.Net Guide
to Pancreatic Cancer(www.cancer.net/pancreatic)

• Overview
• Medical Illustrations
• Risk Factors
• Symptoms
• Diagnosis
• Staging
• Treatment

• Clinical Trials
• Side Effects
• After Treatment
• Current Research
• Questions to Ask the Doctor
• Patient Information Resources

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Cancer.Net (www.cancer.net)

• Comprehensive, oncologist-approved cancer
  information
• Guides to more than 120 types of cancer and
  cancer-related syndromes
• Coping resources
• Survivorship information
• Cancer information in Spanish
• Weekly feature articles
• The latest cancer news
• For patient information resources, please call
  888-651-3038