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Pancreatic Cancer

  • Chulja J. PekEmail author
Chapter
Part of the Principles of Specialty Nursing book series (PSN)

Abstract

Epidemiology

Pancreatic cancer has a very poor prognosis, and its therapy is an interdisciplinary challenge. At the time of diagnosis, tumors are usually not eligible for resection, and chemotherapy results in terms of cure are disappointing.

Diagnostics

The abdominal CT scan is currently the golden standard for the radiological diagnosis of pancreatic cancer.

Treatment

Surgery is currently the only available treatment for pancreatic cancer with a chance of curing the patient. Neoadjuvant treatment is a promising novel strategy but is currently only being performed within a clinical trial setting.

Palliative Care

Palliative and/or supportive care is aimed at treating the multiple morbidity occurring in patients with pancreatic cancer. In many cases, palliative care is the only treatment option due to the late stage of diagnosis. A case manager which is accessible to the patient, family, general practitioner, and other professionals involved and who is familiar with the diagnosis and treatment from beginning to end offers trust, clarity, and continuity.

Keywords

Pancreatic cancer Obstructive jaundice Poor prognosis Whipple procedure Oncology nurse Quality of life Multidisciplinary approach 

References

  1. 1.
    Hariharan D, Saied A, Kocher HM. Analysis of mortality rates for pancreatic cancer across the world. HPB (Oxford). 2008;10(1):58–62.CrossRefGoogle Scholar
  2. 2.
    Hackert T, Buchler MW. Pancreatic cancer: advances in treatment, results and limitations. Dig Dis. 2013;31(1):51–6.PubMedCrossRefGoogle Scholar
  3. 3.
    Jemal A, et al. Cancer statistics, 2010. CA Cancer J Clin. 2010;60(5):277–300.PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Lowenfels AB, Maisonneuve P. Epidemiology and risk factors for pancreatic cancer. Best Pract Res Clin Gastroenterol. 2006;20(2):197–209.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Stathis A, Moore MJ. Advanced pancreatic carcinoma: current treatment and future challenges. Nat Rev Clin Oncol. 2010;7(3):163–72.PubMedCrossRefGoogle Scholar
  6. 6.
    Maisonneuve P, Lowenfels AB. Risk factors for pancreatic cancer: a summary review of meta-analytical studies. Int J Epidemiol. 2015;44(1):186–98.CrossRefGoogle Scholar
  7. 7.
    Sun V. Update on pancreatic cancer treatment. Nurse Pract. 2010;35(8):16–22. Quiz 22–23.PubMedCrossRefGoogle Scholar
  8. 8.
    Butcher HK, Bulechek GM, McCloskey Dochterman JM, Wagner CM. Nursing interventions classification (NIC). 7th ed. St. Louis: Elsevier; 2018.Google Scholar
  9. 9.
    Moorhead S, Swanson E, Johnson M, Maas ML. Nursing Outcomes Classification (NOC): measurement of health outcomes. 6th ed. St. Louis: Elsevier; 2018.Google Scholar
  10. 10.
    Laquente B, et al. Supportive care in pancreatic ductal adenocarcinoma. Clin Transl Oncol. 2017;19(11):1293–302.PubMedCrossRefGoogle Scholar
  11. 11.
    Li D, et al. Pancreatic cancer. Lancet. 2004;363(9414):1049–57.PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Ballehaninna UK, Chamberlain RS. The clinical utility of serum CA 19-9 in the diagnosis, prognosis and management of pancreatic adenocarcinoma: An evidence based appraisal. J Gastrointest Oncol. 2012;3(2):105–19.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Dabizzi E, Assef MS, Raimondo M. Diagnostic management of pancreatic cancer. Cancers. 2011;3(1):494–509.PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Treadwell JR, et al. Imaging tests for the diagnosis and staging of pancreatic adenocarcinoma: a meta-analysis. Pancreas. 2016;45(6):789–95.PubMedCrossRefGoogle Scholar
  15. 15.
    Chen J, et al. Diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration for solid pancreatic lesion: a systematic review. J Cancer Res Clin Oncol. 2012;138(9):1433–41.PubMedCrossRefGoogle Scholar
  16. 16.
    Dabizzi E, Assef MS, Raimondo M. Diagnostic management of pancreatic cancer. Cancers (Basel). 2011;3(1):494–509.CrossRefGoogle Scholar
  17. 17.
    van der Gaag NA, et al. Preoperative biliary drainage for cancer of the head of the pancreas. N Engl J Med. 2010;362(2):129–37.PubMedCrossRefGoogle Scholar
  18. 18.
    Strom TJ, et al. Comparative long-term outcomes of upfront resected pancreatic cancer after preoperative biliary drainage. Surg Endosc. 2015;29(11):3273–81.PubMedPubMedCentralCrossRefGoogle Scholar
  19. 19.
    Pek CJ, et al. A national survey on peri-interventional management of percutaneous transhepatic biliary drainage. Surg Laparosc Endosc Percutan Tech. 2017;27(4):253–6.PubMedCrossRefGoogle Scholar
  20. 20.
    Itoi T, Dhir V, Moon JH. EUS-guided biliary drainage: moving into a new era of biliary drainage. Gastrointest Endosc. 2017;85(5):915–7.PubMedCrossRefGoogle Scholar
  21. 21.
    Ryan JE, et al. Predicting pathological complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a systematic review. Color Dis. 2016;18(3):234–46.CrossRefGoogle Scholar
  22. 22.
    Russo S, et al. The role of neoadjuvant therapy in pancreatic cancer: a review. Future Oncol. 2016;12(5):669–85.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Ronde-Schoone LJM, Pek CJ, Swijnenburg R-J, Pieterse AH. What questions are most important to pancreatic cancer patients soon after diagnosis? A multicenter survey. Appl Cancer Res. 2017;37:32.CrossRefGoogle Scholar
  24. 24.
    Barbas AS, et al. Comparison of outcomes and the use of multimodality therapy in young and elderly people undergoing surgical resection of pancreatic cancer. J Am Geriatr Soc. 2012;60(2):344–50.PubMedCrossRefGoogle Scholar
  25. 25.
    Tran TC, et al. Pancreatic fibrosis correlates with exocrine pancreatic insufficiency after pancreatoduodenectomy. Dig Surg. 2008;25(4):311–8.PubMedCrossRefGoogle Scholar
  26. 26.
    Neoptolemos JP, et al. Adjuvant 5-fluorouracil and folinic acid vs observation for pancreatic cancer: composite data from the ESPAC-1 and -3(v1) trials. Br J Cancer. 2009;100(2):246–50.PubMedPubMedCentralCrossRefGoogle Scholar
  27. 27.
    Sohn TA, et al. Resected adenocarcinoma of the pancreas-616 patients: results, outcomes, and prognostic indicators. J Gastrointest Surg. 2000;4(6):567–79.PubMedCrossRefGoogle Scholar
  28. 28.
    Neoptolemos JP, et al. Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): a multicentre, open-label, randomised, phase 3 trial. Lancet. 2017;389(10073):1011–24.PubMedPubMedCentralCrossRefGoogle Scholar
  29. 29.
    Seufferlein T, et al. Ductal pancreatic adenocarcinoma. Dtsch Arztebl Int. 2014;111(22):396–402.PubMedPubMedCentralGoogle Scholar
  30. 30.
    Conroy T, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011;364(19):1817–25.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Conroy T, et al. Current standards and new innovative approaches for treatment of pancreatic cancer. Eur J Cancer. 2016;57:10–22.PubMedCrossRefGoogle Scholar
  32. 32.
    Lederle FA. Terminal. Ann Intern Med. 2017;167(11):826–7.PubMedCrossRefGoogle Scholar
  33. 33.
    Rahma OE, et al. Second-line treatment in advanced pancreatic cancer: a comprehensive analysis of published clinical trials. Ann Oncol. 2013;24(8):1972–9.PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Agarwal R, Epstein AS. Palliative care and advance care planning for pancreas and other cancers. Chin Clin Oncol. 2017;6(3):32.PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Jeurnink SM, et al. Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review. BMC Gastroenterol. 2007;7:18.PubMedPubMedCentralCrossRefGoogle Scholar
  36. 36.
    Fazal S, Saif MW. Supportive and palliative care of pancreatic cancer. JOP. 2007;8(2):240–53.PubMedGoogle Scholar
  37. 37.
    Smith EM, Jayson GC. The current and future management of malignant ascites. Clin Oncol (R Coll Radiol). 2003;15(2):59–72.CrossRefGoogle Scholar
  38. 38.
    Gooden HM, White KJ. Pancreatic cancer and supportive care – pancreatic exocrine insufficiency negatively impacts on quality of life. Support Care Cancer. 2013;21(7):1835–41.PubMedCrossRefGoogle Scholar
  39. 39.
    Gartner S, et al. Nutrition in pancreatic cancer: a review. Gastrointest Tumors. 2016;2(4):195–202.PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Ripamonti CI, et al. Management of cancer pain: ESMO Clinical Practice Guidelines. Ann Oncol. 2012;23(Suppl 7):vii139–54.PubMedCrossRefGoogle Scholar
  41. 41.
    Jia L, et al. Investigation of the incidence of pancreatic cancer-related depression and its relationship with the quality of life of patients. Digestion. 2010;82(1):4–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.HPB SurgeryErasmus University HospitalRotterdamThe Netherlands

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