I was just doing a class presentation on pancreatic cancer, and I was thinking I'd want my facts straight for the competition, so I've attached my script in thte spoiler below if anyone would mind taking a critical look..
Spoiler
Pancreatic cancer is the ninth most common cancer in men and tenth most common cancer in women in Australia.
Unfortunately pancreatic cancer has a low survival rate as it is most often diagnosed at an advanced stage due to its initial lack of symptoms. Pancreatic cancer is the fifth most common cause of cancer death over all in Australia.
Cancer of the pancreas, and all cancers for that matter, are genetic diseases. This means that it is caused by an abnormality in the genetic material in our cells.
In this presentation, I am going to explain the current stage at which medical treatment of pancreatic cancer is, and what the future holds.
What is cancer?
When most people think of cancer, a malicious, alien-like infestation comes to mind. However, thanks to scientific progress, we know that that is far from being true.
The word cancer, when translated from Latin, literally means ‘crab’.
The condition was called cancer in ancient times because an advanced cancer was thought to resemble a crab with claws reaching out into surrounding tissues.
Cancer is in fact any disease caused by the continuous uncontrolled division and replication of cells in a damaging manner. In other words, cancer is the result of some cells in the body reproducing uncontrollably. Due to this vast, all-encompassing definition, cancer does not come in one form, but rather as a group of over 200 related diseases.
Okay, so let’s take a look at what makes cancerous tissue so distinguishable and dangerous.
Whilst most healthy body tissues contain cells that have the ability to grow, replicate and reproduce, they are programmed to cease once their role has been completed and stasis has maintained. They do this by undergoing "programmed cell death" or "apoptosis", in which the cell sacrifices itself for the good of others around it. For example, cells in tissues such as the skin, which last for an average of two weeks, or the cells in the colon, which have it rough, with a typical span of about four days, are constantly being recycled and replaced. So cells reproduce to meet the needs of the body.
However, in the case of a cancer, cell replication continues unnecessarily, in a positive feedback loop, so as to spread abnormal and unwanted cells into the surrounding tissues, often causing further mutation and replication, along with damage. In many of the most serious cancers, the cancer cells travel from their origin – which is known as the ‘primary tumour’ – through the blood and lymph vessels and begin to colonise secondary, or metastatic tumours. This process by which the cancer travels is called ‘metastasis’.
It is important to note that when a cancer metastasises, the new tumour, which we know is called a metastatic or secondary tumour, is very similar in its properties to the primary tumour from which it originated. For this reason when pancreatic cancer metastasises to, say, the colon, it is then called metastatic pancreatic cancer, not colon cancer.
As for the cause of this cellular mutation, factors such as a genetic flaw, exposure to cancer causing agents (which are known as carcinogens), radiation, viruses, and plenty of further causes are often to blame.
What is the pancreas?
The pancreas is a thin, lumpy, hormone-emitting organ, (making it a gland,) which lies between your stomach and your spine. It is about 13 centimetres long and is joined by a duct, or tube, which connects it to the first part of the small intestine, immediately following the stomach, which is called the duodenum. The pancreas is primarily concerned with your body’s digestive system and plays two key roles; producing insulin, and producing enzymes.
Signs and symptoms
Pancreatic cancer rarely causes symptoms until the cancer is big enough to touch and affect organs nearby.
However, some of the following signs and symptoms are listed on the screen.
A symptom is an abnormality detected by the patient.
A sign is an abnormality detected by their doctor.
Pain in the lower back and upper abdomen (indicative of the tumour’s location)(worse at night)
Jaundice – a yellow to the eyes or skin (due to obstruction of the bile ducts located near to the pancreas)
Diagnosis
Blood tests
Imaging;
Ultrasound - which uses the reflections of very high frequency sound to construct an image of the body.
MRI - which monitors the resonance of protons in a magnetic field, allowing it to figure out the densities of protons in different areas, and hence creating an image.
CT which uses lots of X-rays from different perspectives, and
PET scanning, which uses a similar technique as CT scanning in that it constructs a 3D image from lots of 2D 'slices', only a PET scan measures an organ's metabolic rate - how 'active' it is.
Tissue sampling – needle biopsy, endoscopy and laparoscopy
Causes
The specific cause are not known but factors known to increase the risk of developing the disease are..
smoking
age (it occurs mostly in people over the age of 65)
diabetes
a family history of pancreatic, ovarian or colon cancer
chronic pancreatitis – the inflammation of the pancreas.
And patients who have undergone a gastrectomy – a procedure in which some or all of the stomach is removed.
Prevention
As there is still relatively little known about what causes pancreatic cancer, there is not yet much knowledge as to what can be done to prevent it. The exception to this is quitting or not smoking in the first place - smokers are two to three times more likely to develop pancreatic cancer.
Treatment and management
Over the years, many treatments for cancer have been developed, most notably surgery, chemotherapy, radiation therapy, hormonal therapy and targeted therapy. These different treatments are prescribed and applied based upon the form of cancer, the location, and grade of cancer, as well as the patient’s individual preferences and separate health conditions.
The most common treatments for pancreatic cancer are include
surgical removal of the tumour,
an endoscopic stent – in which a stent, or small tube (as pictured) is inserted into the bile duct, allowing bile to drain away, preventing symptoms of jaundice as seen earlier. This is done during an endoscopy, (pictured here again), while the doctor guides the stent into position using an X-ray.
,chemotherapy, which is the use of chemical substances – an unfortunate side-effect of which is that patients undergoing this treatment often lose their hair.
or radiotherapy, the use of ionising radiation to kill or control cancerous cells.
These treatments are often given as a combination, so as to be more effective.
For early disease, surgery is the most common treatment – usually the Whipple operation, which is removal of part of the pancreas, the first part of the small bowel (duodenum), part of the stomach and the gall bladder, and part of the bile duct. Enough of the pancreas is left to allow the pancreas to still produce digestive enzymes and hormones.
The future of cancer research and treatment.
-nanobots
nanobots are cylindrical clamshells on flexible DNA hinges. They carry a molecular payload, like a cancer drug, inside. The cancer drugs are engineered to react only with specific molecules or proteins on the surfaces of cancer cells.
High intensity focused ultrasound.
A treatment given using a machine that gives off high frequency sound waves. These waves deliver a strong, concentrated beam to a specific part of the cancer. Some cells die when this high intensity ultrasound beam is focused directly onto them.
Doctors have been interested in this type of treatment for nearly 50 years. But it is only in recent years that they have been seriously investigating its use in treating different types of cancer. One advantage of this type of treatment is that because it only uses sound waves to kill the cancer cells, it doesn’t have as many side effects as other types of cancer treatments already in use.
Lasers
‘laser’ stands for light amplification by stimulated emission of radiation. Laser light is a very focused, high intensity beam that can cut through steel or even diamonds. Because of this, it has become a major area of interest due to its potential surgical uses as a very precise scalpel.
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