“To diagnose pancreatitis and find its causes, doctors use your medical history, a physical exam, lab and imaging. tests. Health care professionals may use lab or imaging tests to diagnose pancreatitis and find its causes. Diagnosing chronic pancreatitis can be hard in the early stages. Your doctor will also test for other conditions that have similar symptoms, such as peptic ulcers or pancreatic cancer.”.
MAYO CLINIC
The top of pancreas attaches to the gall bile duct (allowing it into the head of the pancreas) and than there is the mesenteric artery. Blood supply to the liver, pancreas and gallbladder is via the celiac artery (or celiac axis or celiac trunk). The celiac artery also supplies the duodenum, stomach and esophagus (the foregut and its derviatives). The pancreas is also supplied to some extent by the superior mesenteric artery that goes through the head of the pancreas. This is how metastasis occurs (spreading) of pancreatic cancer can occur. These arteries allow cancerous cells thorough the head into the bile duct into the blood stream and metastasis can now happen. This can’t occur in the tail of the pancreas, its not attached to anything; which is the best place for it to occur & be diagnosed versus the head of the pancreas due to location.
Pancreatic cancer is hard to find early. The pancreas is deep inside the body, so early tumors can’t be seen or felt by health care providers during routine physical exams. People usually have no symptoms until the cancer has become very large or has already spread to other organs.
For certain types of cancer, screening tests or exams are used to look for cancer in people who have no symptoms (and who have not had that cancer before). But for pancreatic cancer, no major professional groups currently recommend routine screening in people who are at average risk. This is because no screening test has been shown to lower the risk of dying from this cancer, unfortunately.
Genetic History is one of the most common risk factors in getting most cancers, including Pancreatic. Some people might be at increased risk of pancreatic cancer because of a family history of the disease (or a family history of certain other cancers). Sometimes this increased risk is due to a specific genetic syndrome.
Genetic testing looks for the gene changes that cause these inherited conditions and increase pancreatic cancer risk. The tests look for these inherited conditions, not pancreatic cancer itself. Your risk may be increased if you have one of these conditions, but it doesn’t mean that you have (or definitely will get) pancreatic cancer.
Knowing if you are at increased risk can help you and your doctor decide if you should have tests to look for pancreatic cancer early, when it might be easier to treat. But determining whether you might be at increased risk is not simple. The American Cancer Society strongly recommends that anyone thinking about genetic testing talk with a genetic counselor, nurse, or doctor (qualified to interpret and explain the test results) before getting tested. It’s important to understand what the tests can − and can’t − tell you, and what any results might mean, before deciding to be tested.
For people in families at high risk of pancreatic cancer, newer tests for detecting pancreatic cancer early may help. The two most common tests used are an endoscopic ultrasound or MRI. These tests are not used to screen the general public, but might be used for someone with a strong family history of pancreatic cancer or with a known genetic syndrome that increases their risk. Doctors have been able to find early, treatable pancreatic cancers in some members of high-risk families with these tests.
The M.D. is usually the first thing done and the M.D. will ask about your medical history to learn more about your symptoms. The doctor might also ask about possible risk factors, including smoking and your family history. Your doctor will also do a physical examine you to look for signs of pancreatic cancer or other health problems.
Doctors are also studying other new tests to try to find pancreatic cancer early. Interested families at high risk may wish to take part in studies of these new screening tests.
1.) CT Scan-detailed cross-sectional images of the body/pancreas. Their are special types of CT known as a multiphase CT scan or a pancreatic protocol CT scan. During this test, different sets of CT scans are taken over several minutes after you get an injection of an intravenous (IV) contrast. CT-guided needle biopsy: CT scans can also be used to guide a biopsy needle into a suspected pancreatic tumor.
2.) MRI(magnetic resonance imagery)-uses radio waves and strong magnets instead of x-rays to make detailed images of parts of your body. Most doctors prefer to look at the pancreas with CT scans, but an MRI might also be done. Special types of MRI scans that can also be used are:
-MR cholangiopancreatography (MRCP), which can be used to look at the pancreatic and bile ducts, is described below in the section on cholangiopancreatography.
-MR angiography (MRA), which looks at blood vessels, is mentioned below in the section on angiography.
These tests use sound waves to create images of organs such as the pancreas. The two most commonly used types for pancreatic cancer:
A-Abdominal ultrasound – If it’s not clear what might be causing a person’s abdominal symptoms, this might be the first test done because it is easy to do and it doesn’t expose a person to radiation. But if signs and symptoms are more likely to be caused by pancreatic cancer, a CT scan is often more useful.
B-Endoscopic ultrasound (EUS): This test is more accurate than abdominal US and can be very helpful in diagnosing pancreatic cancer. This test is done with a small US probe on the tip of an endoscope, which is a thin, flexible tube that doctors use to look inside the digestive tract and to get biopsy samples of a tumor (more invasive but more detailed in results of the pancreas).
Abdominal This is an imaging test that looks at the pancreatic ducts and bile ducts to see if they are blocked, narrowed, or dilated. These tests can help show if someone might have a pancreatic tumor that is blocking a duct. They can also be used to help plan surgery. If signs and symptoms are more likely to be caused by pancreatic cancer, a CT scan is often more useful.
A – Endoscopic ultrasound (EUS): This test is more accurate than abdominal US and can be very helpful in diagnosing pancreatic cancer. This test is done with a small US probe on the tip of an endoscope, which is a thin, flexible tube that doctors use to look inside the digestive tract and to get biopsy samples of a tumor.
SPYGLASS. This novel technology provides a direct view of the bile duct system, enabling our doctors to visualize lesions and narrowed areas (strictures) in the ducts and to biopsy them to see if they are cancerous. This approach ensures highly accurate sampling of the area in question. It is an excellent tool to use with confocal endomicroscopy.
B – Magnetic resonance cholangiopancreatography (MRCP):This is a non-invasive way to look at the pancreatic and bile ducts using the same type of machine used for standard MRI scans. Unlike ERCP, it does not require an infusion of a contrast dye. Because this test is non-invasive, doctors often use MRCP if the purpose is just to look at the pancreatic and bile ducts. But this test can’t be used to get biopsy samples of tumors or to place stents in ducts; like ERCP. can do also.
5.) Percutaneous transhepatic cholangiography (PTC): In this procedure, the doctor puts a thin, hollow needle through the skin of the belly and into a bile duct within the liver. A contrast dye is then injected through the needle, and x-rays are taken as it passes through the bile and pancreatic ducts. As with ERCP, this approach can also be used to take fluid or tissue samples or to place a stent into a duct to help keep it open. Because it is more invasive (and might cause more pain), PTC is not usually used unless ERCP has already been tried or can’t be done for some reason.
5.) Positron emission tomography (PET) scan
For a PET scan, you are injected with a slightly radioactive form of sugar, which collects mainly in cancer cells. A special camera is then used to create a picture of areas of radioactivity in the body.
This test is sometimes used to look for spread from exocrine pancreatic cancers.
PET/CT scan: Special machines can do both a PET and CT scan at the same time.
Pancreatoscopy. Here what is used is a small camera to visualize the pancreatic duct.
This test can help determine the stage (extent) of the cancer. It might be able to detect metastasis (spreading beyond the pancreas). See the top anatomy picture provided to understand this better by knowing the location of the organ to other parts of the body, if needed.
“November is a month of empowerment, education and inspiration for communities far and wide who have been touched by pancreatic cancer. In 2021 in the U.S., there will be an estimated 1,898,160 new cancer cases. Smoking is one of the most important risk factors for pancreatic cancer. The risk of getting pancreatic cancer is about twice as high among people who smoke compared to those who have never smoked. About 25% of pancreatic cancers are thought to be caused by cigarette smoking. Cigar smoking and the use of smokeless tobacco products also increase the risk. However, the risk of pancreatic cancer starts to drop once a person stops smoking .”
American Cancer Society
Pancreatic cancer is one of the few types of cancer that haven’t improved in terms of survival rates over the years, according to the Hirshberg Foundation for Pancreatic Cancer Research. In fact, the foundation said the mortality rate is 93-percent within 5-years of diagnosis. And 71-percent will die in first year. Usually people diagnosed with this disease are told they have 6 months to 1 year survival rate. There are the few for the many that live longer but know this the major depending factor is also the stage level of cancer your in (I, II, III & IV). The higher the worse the metastasis.
These stats point to why it’s important to raise awareness about this killer cancer, and to outline some facts and figures. In honor of Pancreatic Cancer Awareness Month in November, here are six things to know, thanks to Jeff Hayward on November 1 informed the world of this information on his blog with facts…
The American Cancer Society says that the average lifetime risk of developing cancer of the pancreas in both men and women is 1 in 65. However, there are certain factors that might make you more likely to face the disease.
Cancer Treatment Centers of America notes that these risk factors include age (most pancreatic cancers form at age-55 or older), gender (males are slightly more likely to develop it), obesity, diabetes, smoking, and more.
Cancer Treatment Centers of America also notes that about 10-percent of pancreatic cancer cases are thought to be genetic, or passed down from a parent.
These genetic mutations include hereditary breast and ovarian cancer syndrome (BRCA2), familial melanoma (p16), familial pancreatitis (PRSS1), and neurofibromatosis type-1 (NF1), adds the source. Other “inherited syndromes” can raise risks including Lynch syndrome (hereditary nonpolyposis colorectal cancer), Peutz-Jeghers Syndrome, and Von Hippel-Lindau Syndrome.
The American Cancer Society estimates death rates are proportionate for both, according to additional statistics from the cancer society.
The American Cancer Society’s estimates for pancreatic cancer in the United States for 2021 are:
Pancreatic cancer accounts for about 3% of all cancers in the US and about 7% of all cancer deaths.
It is slightly more common in men than in women.
The World Cancer Research Fund International notes that pancreatic cancer shares 10th-place in global prevalence with kidney cancer. Worldwide, there were 338,000 cases of pancreatic cancers diagnosed in 2012 alone, notes the source.
Looking at a breakdown of the disease’s age-standardized rates by country, the U.S. comes in 20th at 7.5-cases per 100,000. The top two countries in the world for cancer of the pancreas are Czech Republic (9.7-per 100,000) and Slovakia (9.4-per 100,000).
Scientific American talks about why this type of cancer is so deadly in a 2011 article making reference to Apple founder Steve Jobs, who died from the cancer.
It notes that patients sometimes don’t seek treatment right away, because symptoms including weight loss, jaundice and abdominal pain don’t begin until the later stages. “They usually start after the tumor is a significant size. By then, chances are, it has metastasized (that is, spread to other parts of the body),” explains the article.
The American Cancer Society explains the overwhelmingly common form of this cancer is pancreatic adenocarcinoma, which makes up 95-percent of all cases. These begin in the ducts of the pancreas and sometimes develop from the cells that form pancreatic enzymes, according to the source.
The “other” type of cancer of the pancreas is pancreatic endocrine tumors, otherwise known as neuroendocrine tumors, explains the cancer society. These tumors can be cancerous or benign, and are subdivided into other categories including “functioning NETs” (including gastrinomas, insulinomas and glucagonomas), and “non-functioning NETs” which are actually more likely to cause cancer because they can grow larger before they’re discovered.
Know how it works you have a pancreas medically noted in Anatomy and Physiology as having a head, neck, body and tail. The location of the cancer can play a major role especially if diagnosed earlier, depending on the location for some.
The head is the widest part of the pancreas. The head of the pancreas is found in the right side of abdomen, nestled in the curve of the duodenum body and tail. Worse place for pancreas since this allows metastasis faster than other areas of the pancreas. Know this in some cases caught early can make a major change in a longer life for some.
The neck is the thin section of the gland between the head and the body of the pancreas.
The body is the middle part of the pancreas between the neck and the tail. The superior mesenteric artery and vein run behind this part of the pancreas. This is not connected like the head and if caught early results can be better.
The tail is the thin tip of the pancreas in the left side of the abdomen, in close proximity with the spleen. This is the end of the pancreas connected to nothing, no ducts or other tissues nearby or connected to it compared to other parts of the pancreas and best place for area of the cancer especially if it is only in the tail, in most cases.
“This year’s flu season will be particularly brutal, experts say. Usually, flu seasons are easier to handle when some portion of the population has a natural immunity, due to getting infected the previous year. But since many Americans spent last fall and winter relentlessly washing hands and socially distancing, fewer people than normal got the flu. That means an above-average number of people are at risk now, especially as more Americans have let down their guard against Covid in recent months. The best way to prevent getting the flu is to get the flu vaccine,”.
CNBC Make It (https://www.cnbc.com)
“Autumn is here, the coronavirus pandemic is dragging on and — if that wasn’t enough — peak season for yet another infectious disease looms just around the corner: influenza, a viral infection that attacks the nose, throat and lungs.”.
Cleveland Clinic (https://health.clevelandclinic.org/how-to-prepare-for-flu-season-in-the-time-of-covid-19)
“Classifying the type of seizure a patient has helps the healthcare team choose the right therapy for that patient. Seizure types are divided into two major groups that are called 1.) Generalized-Seizures produced by widespread abnormal electrical impulses present throughout the entire brain. and 2.) Partial-Seizures produced by electrical impulses that generate from a relatively small or “localized” part of the brain (referred to as the focus).”.
Cleveland Clinic (https://my.clevelandclinic.org)
“The average incidence of epilepsy each year in the U. S is estimated at 150,000 or 48 for every 100,000 people. Another way of saying this- each year, 150,000 or 48 out of 100,000 people will develop epilepsy. The incidence of epilepsy is higher in young children and older adults. This means that epilepsy starts more often in these age groups.”.
Epilepsy Foundation (www.epilepsy.com)
“When identifiable, the causes of epilepsy usually involve some form of injury to the brain. For most people, though, epilepsy’s causes aren’t known. A seizure occurs when a burst of electrical impulses in the brain escape their normal limits. They spread to neighboring areas and create an uncontrolled storm of electrical activity. The electrical impulses can be transmitted to the muscles, causing twitches or convulsions.”
WebMD (Dr. Matthew Hoffman)
Most people with epilepsy are otherwise healthy; as long seizure occurs there is a decrease in oxygen since the brain isn’t capable to send messages during the seizure. If the seizure continues to repeat one right after another the person is in status epilepticus and if the seizures do not stop the person can lead to a neuronal death; like John Travolta’s son who died of this for example.
The term seizure disorder may refer to any number of conditions that result in such a paroxysmal electrical discharge. These conditions could be metabolic or structural in nature.
For example, if the cause is metabolic this could be “Canavan disease” which is primarily a disease of demyelination. Your myelin sheath that protects and insulates the nerves is being destroyed and can cause a seizure as one of the symptoms.
*Another example of epilepsy being caused by a metabolic reason is thought to be caused by brain acetate deficiency resulting from a defect of N–acetylaspartic acid (NAA) catabolism (meaning breakdown is occurring). Accumulation of NAA, a compound thought to be responsible for maintaining cerebral fluid balance, can lead to cerebral edema and neurological injury, like a seizure as one symptoms of the disease.
*A structural condition to cause a seizure could be a tumor in the brain. Than there is just idiopathic, unknown cause for the epilepsy which if starts in childhood can resolve by the child growing out it, like in petite mal seizures but it not it goes into motor/focal or grand mal that is permanent the individual needs Rx for life.
Remember, etiology (the cause) of Epilepsy can be generally a sign of underlying pathology involving the brain–knowing the cause. To find this out diagnostic tooling be a neurologist who specializes in epilepsy is the best resource to go to. The epilepsy may be the first sign of a nervous system disease (ex. Brain tumor), or it may be a sign of a systemic or metabolic derangement. Where the treatment may be able to resolve the seizure symptom completely where this wasn’t a seizure disorder or epilepsy but just a symptom due to another disorder that may be 100% cured, like a operable tumor removed surgically from the brain.
Metabolic and Systemic Causes of Seizures:
a.) Electrolyte Imbalance=In the blood having acidosis, heavy metal poisoning, Hypocalcemia (low Ca+) , Hypocapnea (low carbon dioxide), Hypoglycemia (low glucose), Hypoxia (low oxygen), Sodium-Potassium imbalance, and than Systemic diseases (liver, renal failure, etc…). Then their is also toxemia of pregnancy, and water intoxication.
b.) Infections like meningitis, encephalitis, brain abcess.
c.) Withdrawal of sedative-hypnotic drugs=Alcohol, Antiepileptic drugs, Barbiturates, Benzodiazepines.
d.) Iatrogenic drug overdose=Theopylline, Penicillin.
Other causes of epilepsy can be Trauma, Heredity.
Structural causes of epilepsy:
Head trauma/Degenerative Disease like Alzheimer’s or Creutfeldz-Jacob or Huntington’s Chorea or Multiple Sclerosis or Pick’s Disease. There is also tumors or genetic disease or Stroke or Infections or Febrile seizures.
Come back tomorrow for Epilepsy going further on etiology factors for the disease of occur.