PANCREATIC CARCINOMA (Pancreatic Cancer)

 Yesterday, Steve Jobs, founder Apple inc, was died. who had killed him? he was killed by cancer. what kind of this cancer?. It's called Pancreatic Carcinoma. Today, Mbah Dukun Bagong, modern shaman from medical and health information will explain about this cancer.

DEFINITION
Pancreatic carcinoma is one form of pancreatic tumors. The term squamous carcinoma of the pancreas has a meaning that appears in the exocrine glands. Approximately 95% of tumors that are cancerous (malignant) in pancreatic adenocarcinoma Adenocarcinoma is usually derived from glandular cells lining the pancreatic duct. Most adenocarcinomas occur in  pancreas caput, the part closest to the first part of the small intestine (duodenum).

ETIOLOGY
The actual cause of pancreatic cancer remains unclear. Epidemiologic studies showed no association with pancreatic cancer several exogenous factors (environmental) and endogenous factors of the patient. Etiology of pancreatic cancer is a complex interaction between endogenous factors of patients and environmental fac tors and genetic factors.
1. Exogenous factors (Environment)
Has been investigated several exogenous risk factors associated with pancreatic cancer, among other things: smoking, high dietary fat, alcohol, coffee, and industrial carcinogens. The most consistent risk factor is smoking.
2. Endogenous Factor (Patient)
There are three important things as an endogenous risk factors are: age, pancreatic disease (chronic pankreastitis and diabetes mellitus) and genetic mutations. Genetic factors in the present role of genetic factors in pancreatic cancer more and more known. Approximately 10% of patients with pancreatic cancer have an inherited genetic predisposition. Suspected pancreatic cancer carcinogenesis process is an accumulation of many incidents of genetic mutations.

Pancreatic Cancer

ANATOMICAL PATHOLOGY
Pancreatic cancer is almost 90% came from the duct, where 75% of the classical form of ductal adenocarcinoma cells that produce mucin. Most (70%) located in the caput pancreatic cancer, 15-20% in the collum of the pancreas, and 10% in the cauda of the pancreas. In general, the tumor extends into the retroperitoneal to the back of the pancreas, and attached to the lining of blood vessels, and there were microscopically peripancreas infiltration in adipose tissue, lymph channels, and perineural. At an advanced stage pancreatic cancer caput often metastasize to the duodenum, stomach, peritoneum, liver, and gallbladder. Pancreatic cancer in the collum and cauda pnkreas can metastasize to the liver, peritoneum, spleen, stomach, and left adrenal gland.

Pancreatic Cancer anatomy

SYMPTOMS and SIGNS
Carcinoma of the pancreas is usually asymptomatic until the expansion of other structures. Early symptoms may include feeling of fullness, bloating, in the gut. Anorexia, nausea, vomiting, diarrhea, and lethargy. These complaints are not typical because of complaints similar to pancreatitis and other intraabdominal tumors. Initial complaints usually arise more than two months before the diagnosis of cancer. The main complaint of patients with pancreatic cancer the most common are abdominal pain, weight loss, and jaundice.
Complaints of abdominal pain is most often found in pancreatic cancer. Location of abdominal pain usually in the gut. Initially pain is diffuse, then more localized. The pain may spread to the  patient's back, due to a retroperitoneal tumor invasion and infiltration occurs in the splanchnic nerve.
• Alert tumor CEA (carcinoembryonic antigen) and Ca 19-9 (carbohydrate antigenic determinant 19 -9)
• Radiography (Gastroduodenografi, Duodenografi hipotonis)
• Ultrasonography (USG)
• Computed Tomography (CT) abdominal
• Magnetic Resonance Imaging (MRI)
• Endoscopic Retrogade Cholangio-pancreaticography (ERCP)

TREATMENT and THERAPY
Because, adenocarcinoma of the pancreas usually spread to other parts of the body before it was discovered, the prognosis is very low. Less than 2% of people suffering from adenocarcinoma of the pancreas survive for 5 years after diagnosis. Hope is the only cure is surgery, which occurred on 10sampai 20% of people who believe that the cancer had not spread. One of the pancreas and duodenum or pancreas single lifted. After some operations, only 15 to 20% of people live to 5 years. Additional chemotherapy and radiation therapy are usually given but it is not possible to improve times or survival rates substantially.
Eliminated the possibility of mild pain with aspirin or acetaminophen. Often, strong pain killers, like codeine or morphine are used by mouth, is required. For 70 to 80% patients with extreme  pain, injections into the nerves to block pain can produce relief. Leaks on pancreatic digestive enzymes can be treated with an oral enzyme preparation. If diabetes is formed, insulin treatment may be needed.
• ERCP or PTC with mounting Stents: reduced biliary obstruction a major priority in patients with jaundice.
• Surgery: in some cases pancreotico-duodenectomy (Whipple procedure), offers a cure with surgery. Surgery can also be useful in patients with advanced-stage disease in providing a combination of biliary and gastroduodenal bypass.
• Palliative therapy: reducing the jaundice and pain control are the main objectives at an advanced stage, and many patients require Opiate analgesics. Anorexia and weight loss remains a major problem