PANCREAS

PANCREASDR. INDIYAH SURYANI, SpPDANATOMI PANCREASPANCREAS merupakan organ di dalam rongga abdoman yang berada di depan tulang belakang Pancreas memiliki 2 fungsi :Membuat hormon insulin yg berguna untuk meregulasi kadar gula darah Membuat enzim yang membantu pencernaan protein sehingga partikel yang dicerna dapat diserap oleh GIT dan digunakan sebagai energi Enzim yg diproduksi pancreas masuk kedalam saluran pencernaan yang berhubungan dengan usus halus ( duodenum )

Pancreatic cancer facts

Most pancreatic cancers are adenocarcinomas.Few patients diagnosed with pancreatic cancer have identifiable risk factors.Pancreatic cancer is highly lethal.Pancreatic cancer is difficult to diagnose, and the diagnosis is often made late in the disease course. Symptoms include weight loss, back pain, and jaundiceThe only curable treatment is surgical removal of all cancer.Chemotherapy after surgery can lower the chances of the cancer returningTUMOR PANCREASAbout 40,000 cases of pancreatic cancer occur yearly in the United States

Tumor pancreas dapat digolongkan dalam 2 kategoriCancer endokrin pancreas ( islet cell cancer atau pancreatic neuroendocrine )Merupakan kasus yg jarangseringkali mengeluarkan hormon kedalam peredaran darah ( insulin, glukagon, gastrin )2. Cancer eksokrin pancreas ( pancreatic adenocarcinoma ) angka kejadian sekitar 95%Signs and symptomsPain in the upper abdomen that typically radiates to the backLoss of appetite (anorexia) and/or nausea and vomitingSignificant weight loss (cachexia)Painless jaundicewhen a cancer of the head of the pancreas (75% of cases)[6] obstructs the common bile duct as it runs through the pancreasTrousseau sign,Diabetes mellitus

Signs and symptomsClinical depressionSymptoms of pancreatic cancer metastasis. Typically, pancreatic cancer first metastasizes to regional lymph nodes, and later to the liver or to the peritoneal cavity and, rarely, to the lungs; it rarely metastasizes to bone or brainRisk factorsFamily history: 510% of pancreatic cancer patients have a family history of pancreatic cancerAge. The risk of developing pancreatic cancer increases with age. Most cases occur after age 60, while cases before age 40 are uncommonSmoking. Cigarette smoking has a risk ratio of 1.74Diets low in vegetables and fruitsDiets high in sugar-sweetened drinks (soft drinks).Risk factorsObesityDiabetes mellitusChronic pancreatitisHelicobacter pylori infectionGingivitis or periodontal diseaseSome studies suggest a relationship, the risk increasing with increasing amount of alcohol intake. The risk is greatest in heavy drinkersThere appears to be no increased risk for people consuming up to 30g of alcohol a dayStaging pancreatic cancerPancreatic cancer is broken into four stages with stage I being the earliest stage and stage IV being the most advanced (metastatic disease). pancreatic cancer are typically grouped into three categories: those with local disease, those with locally advanced unresectable disease, and those with metastatic disease. Initial therapy often differs for patients in these three groups. The stage of a pancreatic cancer is determined by 3 factors: T, N, and M. A value is assigned for each of these factors based on the diagnostic test resultsStaging pancreatic cancerT= location and size of the tumorN= evidence of metastases in lymph nodes close to the cancerM= evidence of distant metastaseStage 0 : Tis N0 M 0Stage IA : T1 N0 M 0Stage IB: T2 N0 M 0Stage IIA: T3 N0 M 0Stage IIB: T1 N1 M 0 T2 N1 M 0 T3 N1 M 0

Staging pancreatic cancerStage III : T4 any N M 0Stage IV: anyT any N M 1TREATMENT PANCREATIC CANCERSurgeryRadiationChemotheraphy

T 1

T2

Tumor limited to the pancreas, more than 2 cm in greatest dimensionT3

Tumor extends beyond the pancreas but without involvement of the celiac axis or the superior mesenteric arteryT4

Tumor involves the celiac axis or superior mesenteric artery (unresectable primary tumor)n0

No regional lymph node metastasisN1

Regional lymph node metastasis

Stage IV

TERIMA KASIH