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diagnosis According to Sloan-Kettering Memorial Hospital in New York City, in the United States, only about 20% of pancreatic cancers are diagnosed while the tumor is confined entirely within the pancreas. Detecting pancreatic cancer in its early stages is difficult as signs and symptoms usually do not appear until the cancer is large or has spread (metastasized) to other tissues. Because the pancreas is relatively hidden behind the stomach and inside a loop of the small intestine, small tumors are difficult to detect during routine exams. No effective screening test for pancreatic cancer is currently available. Diagnostic tests Biopsy: In a pancreas biopsy, a small sample of tissue is removed and examined for malignant cells under a microscope. Biopsies of the pancreas and bile ducts can be performed in several ways. If there is a tumor that can be reached with a needle, a doctor may perform a fine-needle aspiration (FNA). During a FNA, a very thin needle is inserted through the skin of the abdomen and into the pancreas. An ultrasound or CT scan is often used to guide the needle's placement. The needle withdraws cells from the tumor that are then sent to a lab for further study. Tissue samples may also be removed during an endoscopic retrograde cholangiopancreatiography (ERCP) or an endoscopic ultrasound (EUS). In another procedure similar to ERCP, a surgeon sometimes uses an endoscope to pass a catheter into the bile duct where it empties into the small intestine. Instead of injecting dye, the surgeon uses a small brush introduced through the catheter to scrape cells and small pieces of tissue from the lining of the duct. The cells are then sent for microscopic analysis to determine if pancreatic cancer exists. Computerized tomography (CT) scan: A computerized tomography (CT) scan allows a doctor to visualize the internal organs, including the pancreas, in two-dimensions. Split-second computer processing captures these images as a series of very thin X-ray beams pass through the body. Sometimes a dye (contrast medium) may be injected into a vein before the test to make it easier to distinguish a tumor from normal tissue. Endoscopic retrograde cholangiopancreatiography (ERCP): In an endoscopic retrograde cholangiopancreatiography (ERCP), a thin, flexible tube (endoscope) is gently passed down the throat, through the stomach, and into the upper part of the small intestine. A doctor may inflate the intestinal tract with air to make the openings of the pancreatic and bile ducts more visible. Then a dye is injected into the ducts through a small hollow tube (catheter) that is passed through the endoscope. X-rays are then taken of the ducts. The individual's throat may be sore for a time after the procedure, and he/she may feel bloated from the extra air in the intestine. Endoscopic ultrasound (EUS): In an endoscopic ultrasound (EUS), an ultrasound device is passed through an endoscope into the stomach. The device directs sound waves to the pancreas. A computer then translates the sound waves into close-up images of the pancreas and the bile and pancreatic ducts. The images can detect small pancreatic tumors. Laparoscopy: A laproscopic procedure or laproscopy uses a small, lighted instrument called a laparoscope to view the pancreas and surrounding tissue. The instrument is attached to a television camera and inserted through a small incision in the abdomen. A surgeon may take tissue samples to help confirm a diagnosis of cancer. Laparoscopy may also be used to determine how far the cancer has spread. Risks include bleeding and infection and a slight chance of injury to the abdominal organs or blood vessels. Magnetic resonance imaging (MRI): Magnetic resonance imaging (MRI) uses a powerful magnetic field and radio waves to create images of the pancreas. During the test, individuals are placed in a cylindrical tube chamber. Because the tube is narrow and confining, anti-anxiety drugs may be given before the test, such as alprazolam (Xanax®), to relax the individual. Percutaneous transhepatic cholangiography (PTC): Percutaneous transhepatic cholangiography (PTC) is an X-ray test used to determine whether there is a blockage in the liver or the bile ducts. A special dye is injected directly into the drainage system of the liver. In a healthy liver, the dye, which is visible on X-rays, spreads out to fill the whole drainage system. If it does not, a blockage may be diagnosed. This type of blockage might result from a gallstone or a cancer in the liver. Ultrasound imaging: In ultrasound imaging, a device called a transducer is placed on the upper abdomen. High-frequency sound waves from the transducer reflect off the abdominal tissues and are translated by a computer into moving images of the internal organs, including the pancreas. Staging pancreatic cancer Staging tests help determine the size and location of cancer and whether it has spread. Staging is crucial in helping a doctor determine the best treatment for the individual. Pancreatic cancer may be staged in several ways. Resectable: A resectable tumor means that all the tumor nodules can be removed. Locally advanced: A locally advanced tumor can no longer be completely removed because the cancer has spread to tissues around the pancreas or into the blood vessels. Metastatic: In the metastatic stage, the cancer has spread to distant organs, such as the lungs and liver. A doctor may also refer to the cancer as stage 1, 2, 3, or 4. Stage 1 pancreatic cancer is confined to the pancreas. Stage 2 pancreatic cancer has spread somewhat, possibly to the lymph nodes, but not into large blood vessels nearby. Stage 3 pancreatic cancer has invaded large blood vessels, may be in the lymph nodes, but has not spread to distant sites. Stage 4 indicates the cancer has spread to one or more distant sites in the body. signs and symptoms Signs and symptoms of pancreatic cancer often do not occur until the disease is advanced and the cancer has spread to other organs and areas of the body. Diabetes: Exocrine cancers of the pancreas may cause diabetes by destroying the insulin-making cells; however, this is very rare. Digestive problems: Cancer may prevent pancreatic enzymes from being released into the intestine making it difficult to digest foods, especially those high in fat. This may result in significant weight loss (as much as 25 pounds or more) and malnutrition. Gallbladder enlargement: If the cancer blocks the bile duct, the gallbladder may become enlarged from bile build up. The bile ducts are thin tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. This enlargement may be felt by a doctor during a physical exam or it may be detected by imaging studies, such as computerized tomography (CT) or magnetic resonance imaging (MRI). Itching: Severe itching may develop in the later stages of pancreatic cancer. The itching occurs when high levels of bile acids, another component of bile, accumulate in the skin. Itching is also a common symptom of jaundice. Jaundice: Jaundice, or yellowing of the skin and the whites of the eyes, occurs when bilirubin, a breakdown product of worn-out blood cells, accumulates in the blood. Normally, bilirubin is eliminated in bile, a fluid produced in the liver, which is then excreted with the feces. However, if a pancreatic tumor blocks the flow of bile, excess pigment from bilirubin may turn the skin and the whites of the eyes yellow. Urine may be dark brown and stools white or clay-colored. Jaundice is a common sign of pancreatic cancer and occurs in about half of individuals with pancreatic cancer. Loss of appetite and unintentional weight loss: In addition to weight loss caused by the cancerous (malignant) cells depriving healthy cells of nutrients, weight loss may also result from loss of appetite associated with pancreatic cancer. Nausea and vomiting: In advanced cases of pancreatic cancer, the tumor may block a portion of the digestive tract, usually the upper portion of the small intestine (duodenum), causing nausea and vomiting. Upper abdominal pain: Pain is a common symptom of advanced pancreatic cancer. Upper abdominal pain, which is often caused by a tumor pressing on surrounding organs and nerves, may radiate to the middle or upper back. The pain may be constant or intermittent and is often worse after eating or when lying down. complications Metastasis: The most serious complication of pancreatic cancer is metastasis or spread of cancer cells throughout the body. The pancreas is surrounded by several vital organs, including the stomach, spleen, liver, lungs, and intestines. Because pancreatic tumors are rarely discovered in the early stages, they often have time to spread to these organs or to nearby lymph nodes. Pain: Large pancreatic tumors may press on surrounding nerves, leading to back or abdominal pain that may be severe. Problems with glucose metabolism: Tumors that affect the ability of the pancreas to produce insulin can lead to problems with glucose metabolism, including diabetes. Weight loss, malnutrition: The pancreas produces a number of enzymes, such as trypsin, chymotrypsin, pancreatic lipase, and pancreatic amylase, which break down food so that the body can absorb nutrients. Pancreatic tumors often interfere with the production or flow of these enzymes. As a result, the body cannot easily absorb nutrients, which can lead to diarrhea and severe weight loss. causes and risk factors Although scientists still do not know exactly what causes most cases of pancreatic cancer, they have found several risk factors that can make an individual more likely to get this disease. Recent research has reported that some of these risk factors affect the DNA of cells in the pancreas, which can result in abnormal cell growth and may cause tumors. According to the American Cancer Society, the following risk factors have the most scientific evidence: Age: As a person ages, the risk of developing cancer of the pancreas increases. The majority of pancreatic cancer patients are older than 45 years. According to the American Cancer Society (ACS), nearly 90% are older than 55 years and more than 70% are older than 65 years. The average age at the time of diagnosis is 72 years. Chronic pancreatitis: Chronic pancreatitis, or long-term inflammation of the pancreas, is linked with an increased risk of pancreatic cancer. However, most patients with pancreatitis never develop cancer of the pancreas. Cigarette smoking: Pancreatic cancer is 2-3 times more common in smokers than non-smokers. Scientists attribute this to the cancer-causing chemicals present in cigarette smoke, such as benzene and formaldehyde, that enter the blood and damage the pancreas. The ACS estimates that cigarette smoking contributes to about 20-30% of pancreatic cancer cases. Diabetes: Pancreatic cancer is more common in patients with diabetes, particularly type 2 diabetes, which typically starts in adulthood and is often related to being overweight or obese. It is not clear if people with type 1 (juvenile) diabetes have a higher than average risk. Diet: Diets high in fat, sugar, red meat, pork, and processed meat, such as sausage and bacon, may be associated with an increased risk of pancreatic cancer. Diets high in antioxidant fruits and vegetables have been linked to reduced risks of pancreatic cancer. Gender: Men have a slightly increased risk of cancer of the pancreas than women. Scientists hypothesize that this may be partially due to increased tobacco use among men. Genetics: Cancer of the pancreas may be hereditary; individuals with family members with pancreatic cancer may be at an increased risk. The ACS estimates that up to 10% of pancreatic cancers may be related to inherited DNA changes (mutations). Individuals with the inherited form of chronic pancreatitis may have a high lifetime risk for developing pancreatic cancer (between 40-75%). Obesity and physical inactivity: Overweight and inactive individuals are more likely to develop pancreatic cancer. Less physical activity may increase the risk for type 2 diabetes, causing stress on the pancreas. BMI or body mass index is a measure of weight for height. For adults over 20 years old, BMI falls into one of these categories: below 18.5 (underweight), 18.5-24.9 (normal), 25.0-29.9 (overweight), and 30.0 and above (obese). Occupational exposure: Frequent exposure to certain pesticides (such as organochlorines, creosote, and sulfallate), dyes (including hair dye), and chemicals used in metal refining (such as arsenic) may increase the risk of developing cancer of the pancreas. Ethnicity: African Americans have been found to have higher rates of pancreatic cancer than Caucasians. Stomach problems: Infection of the stomach with Helicobacter pylori (also called H. pylori,the ulcer-causing bacteria) may increase the risk of developing pancreatic cancer. Some researchers believe that excess stomach acid may also increase the risk. Other: Coffee drinking and alcohol consumption have been linked to pancreatic cancer. However, some studies have found little or no correlation. Additional research is needed to confirm these findings.
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Prema " detaljan vodič : žučovoda Cancer " na Cancer.org , postoji niz različitih stadija da ljudi s žuč kanal raka može biti s dijagnozom , ovisno o veličini njihovog raka i da li se proširio na druge dijelove tijela . Vrsta i oblik raka pomaže liječnicima da donose odluke o tretmanu. Faza 1A opisuje kada se rak može se naći samo u žučovoda ; fazi 1B , kada se proširio na zid žučovoda , ali nije prisutan u obližnje limfne čvorove , scenski 2A , kada ga se može naći u jetri , gušterače , žučnog mjehura i krvne žile , ali ne i obližnje limfne čvorove , stage 3 , kad se širi krvne žile koje nose krv do jetre , tankog i debelog crijeva , trbušni zid , želuca i /ili limfnih čvorova u trbuhu i fazi 4 , kada ga se može naći u dijelovima tijela koji su daleko od žučovoda , kao što su pluća . Rak se također ocjenjuju , kada se ispituje pod mikroskopom , temelji na tome slično kancerogene stanice okreću drugim stanicama i kako brzo oni rastu . Oni smatraju low - grade , ako oni izgledaju drugih vrsta stanica u tijelu , imaju polagan i krivulja rasta , a time i manje vjerojatno da će brzo proširila . Visokovrijedne tumori su oni koji izgledaju abnormalno i vjerojatno će rasti i širiti brže . Žutica Jedan od najčešćih simptoma žuč kanal raka je žutica . To je kada ježutilo u koži i na bjeloočnica . Kadjetra nije u stanju riješiti žuči , postojivišak kemijske zove bilirubina u krvi i tjelesnom tkivu . Ako su žučnih blokiran , bilirubin često nije u mogućnosti putovati u tankom crijevu . Žutica također može biti uzrokovan kamena iz žučnjaka koji blokiražučovoda , tako da može biti pokazatelj drugih zdravstvenih problema . Žutica Tretmani to je moguće tretirati žuticu bez operacije kroz dva moguća postupka , u skladu sa pregledom žuč kanal raka Mayo klinike . Jedan uključuje umetanje cijevi zovestent u zastoju žučovoda . Stent će pomoći raspremiti žuč koja blokira žučnog kanala . Liječnik može koristiti dilator , napuhavanje balon , kako bi pružio suženu žučnog kanala , tako dase može umetnuti stent . Stentovi obično treba zamijeniti u tijelu svaka tri do četiri mjeseca ili žutica može vratiti . Drugi postupak uključuje žicu sastent koji je uveden kroz blokiranog žučovoda . Tijekom ovog postupka ,liječnik može ostaviti uređaj nazvankatetera unutar žučovoda . Jedan dio kateter će biti u žuč kanal , a drugi će biti spojeni na vrećicu koja će preuzeti suvišnu žuč . Kateteri obično drže u tijelu nekoliko dana prije nego što je uklonjen . Nakon toga , liječnici će staviti bolesnika na antibiotike kako bi bili sigurni da ne dobiju infekcije . Ostali simptomi Neke druge uobičajene simptome žuč kanal raka su svrbež kože , gubitak apetita ,visoka temperatura i gubitak težine . Neki ljudi također mogu imati neugodan osjećaj u trbuhu i /ili mijenjanje boje u mokraći i stolici ili . To znači da oni mogu doživjeti urin koji je tamno žuta iblijeda stolica . Neki od tih simptoma također može biti pokazatelj drugih uvjeta , što je razlog zašto je važno da posjetite liječnika ako ih doživjeti za nekoliko tjedana ili ako se pogoršaju . Dijagnoza Prema Mayo klinici pregled žuč kanal raka , za one sa simptomima žuč kanal raka , postojiniz testova kako bi se utvrdilo gdje su bolest . To uključuje i ultrazvuk , kompjutorizirana tomografija ili CT , magnetska rezonancija ili MRI , a endoskopske retrogradni cholangiopancreatography , a perkutanoj transhepatic cholangiography , što je angiografija, biopsije, endoskopska ultrazvuka ili laparotomija . U ultrazvuka , zvučni valovi su korišteni da se slike žučovoda i okolne organe . Tijekom CT ,niz x- zrake su učinili , uzimajući trodimenzionalne slike tijela . S MRI , magnetska polja se koriste , umjesto da X-zrake , da se trodimenzionalne slike tijela . Endoskopska retrogradna cholangiopancreatography se koristi da se detaljnije rentgensko gušterače kanala i žučovoda . To se također može koristiti da biste dobili osloboditi materijali blokiraju žučnog kanala . Perkutana transhepatic cholangiography je drugi postupak koji se pružaju Rendgenske snimke žučnih kanala . Angiografija jetest koji se radi kako bi pokazati je li se krvne žile u blizini jetre su pogođeni tumora . Biopsija je učinjeno nakon drugih testova , akoliječnik sumnja daosoba ima žuč kanal raka . Liječnik će uzeti uzorak stanica ili tkiva i pogledati ga pod mikroskopom . Endoskopski ultrazvuk skeniranje se koristi kako bi se slika o gušterači i struktura oko njega . Akoliječnik ne mogu postaviti dijagnozu na temelju drugih testova , on ili ona će se koristiti laparotomija . Ova vrsta pregleda uključuje liječnika rezanje otvoren trbuh pogledati žučovoda i okolno tkivo kirurgiju Prema " detaljan vodič : Bile Cancer " . na Cancer.org , za osobe s žuč kanal raka ,najčešći tip liječenja je operacija . Postoji veliki broj operacija koje mogu biti izvedena , na temelju stadiju karcinoma . Ako se rak nije proširio izvan žučovoda , možda je moguće ukloniti tumor . To također može biti potrebno ukloniti žučnog kanala , akoje rak lokaliziran i pridružiti preostale kanalima do tankog crijeva , tako da će protok žuči kroz tijelo još jednom . Postupak se zove djelomična resekcija jetre može biti učinjeno , gdje je uklonjendio jetre koja je zahvaćena . Ostali postupci mogu također biti izvedena za uklanjanje tkiva i limfne čvorove kojirak je dosegao . Neki liječnici mogu preporučiti transplantaciju jetre , ako se rak samo proširio na jetru , ali se ne može ukloniti drugim tretmanima . Ako se rak proširio na mala crijeva , jetre, gušterače , žuči i limfnih čvorova , ljudi svibanj morati dobiti sve ove strukture kirurški ukloniti . Prilikom uklanjanja tjelesnih organa nije moguće , liječnici mogu obavljati bypass operacije , što pomaže da se zaustavi bilo kakve blokade i dopustiti žuči da teče u tankom crijevu . Tijekom ovog postupka ,žučnog mjehura je spojen na dijelu tankog crijeva . Ostali tretmani Ostali tretmani koji se mogu koristiti za liječenje žuč kanal raka su radioterapija , kemoterapije i fotodinamička terapija . Radioterapija i kemoterapija su mogućnosti liječenja koje se daju pacijentima s različitim vrstama karcinoma . Tijekom terapije zračenjem , visoke energetske x -zrake se koriste za ubiti stanice raka i smanjivanja tumora . U terapiju zračenjem za rak žučnih vodova , radioaktivni izvori staviti unutar žučovoda za kratko vrijeme . Kemoterapija koristi lijekove za ubijanje brzo dijele stanice raka . Kemoterapija i zračenje je utvrđeno da je najučinkovitija kada se koriste zajedno . Jedan problem je da kemoterapija je nađeno da samo usporavaju progresiju raka žučnog kanala , a tretman je učinkovit samo za vrijeme od nekoliko tjedana ili mjeseci . Fotodinamička terapija koristi kemikaliju koja je osjetljiva na svjetlo , koja se ubrizgava u pacijenata , prema pregledu Mayo Clinic u žuč kanal raka . Nakonkemijski je napravio svoj put u canceous stanica ,uređaj nazivaendoskop je umetnuta u žučovoda s laserom prilogu kako bi se uništili off kancerogenih stanica . From:http://hr.265health.com/cancer/other-cancers/1016028445.html