Adv PET CT For metastasis and other organs involvement . Biopsy of suspicious distant lesions. Surgical intervention required if pt condition is fit for surgery.if fit go for surgical resection if not palliative therapy and chemotherapy + radiotherapy. Regular monitoring and constant evaluation required.
The current treatment options for pancreatic cancer are surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy. Your care plan also includes treatment for symptoms and side effects, an important part of cancer care.
This is an ideal case of Whipple 's Pancreatico- duodenectomy after a PET scan before further evaluation and ruling out any metastasis
Needs PET CT for possible mets. And biopsy of suspicious distant lesions, for starting palliative therapy In can no evidence of metastasis- stage disease on CECT, and check for resectability. And if resectable plz go ahead with surgery depending upon site of lesion. If not resectable, or patient is not operable need to check fitness for neoadjuvant therapy
Adv PET scan. Surgical intervention Chemoradiation further.
No image may be metastasis
Palliative treatment Chemotherapy + Radiotherapy
Refer vaidya balendu prakash
Surgery, radiotherapy, chemotherapy, immune therapy. PET scan..
SHOULD RADIOTHERAPY IT'S EFFICACIOUS ...
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Cancer in the Ovaries - Causes, Symptoms, Treatment & Prevention medindia.net Sep 20, 2017 12:00 PM What is Ovarian Cancer? ￼ Ovarian Cancer It refers to cancer of ovaries. It is called the "Silent killer", as it is difficult to detect this cancer in the early stages. Ovarian cancer starts when cells inside, near or on the outer layer of the ovaries grow abnormally out of control. Ovarian cancer is the 5th most common cancer in women and the most common cause of gynecologic cancer deaths. The lifetime risk for developing ovarian cancer in women is less than 2%; this risk is higher in women with a strong family history of ovarian and breast cancer. Cells are the basic units of all living organisms and form organs when they are grouped together. The term cancer indicates an uncontrollable division and growth of cells of a particular organ. The cancer cells thus produced are immature and non-functioning; they crowd out the normal functioning cells and cause disease of the body organ. What are Ovaries and What is their Function? The female reproductive system consists of internal organs such as the uterus, cervix, vagina, ovaries and fallopian tubes. The external structures include the breasts and labia. The ovaries are two small almond shaped organs that lie on either side of the uterus in a depression called the ovarian fossa. They are connected to the uterus by fallopian tubes which are hollow muscular tubes. The ovaries’ primary function is to store the ova (eggs) which a female child is born with; these ova reach maturity at puberty and every month one ovum is released during menstruation. The ova pass through the fallopian tubes into the uterus. The ovaries also produce estrogen and progesterone which are the female hormones. They regulate menstruation and development of sex organs. What are the Different Types of Ovarian Tumors? Ovaries contain 3 different types of cells: the epithelial cells, the germ cells and the stromal cells. Tumors can develop in any of these cells.Epithelial tumors: Epithelial tumors originate from the epithelial cells; this forms the outermost layer of the ovary. Epithelial cancers account for 90% of all ovarian cancers.Germ cell tumors: These tumors develop from the cells that produce the eggs.Stromal cell tumors: Ovarian stromal cells are structural tissue cells that hold the ovary together and produce the female hormones. Tumors arising from these stromal cells are called stromal tumors. Germ cell tumors and stromal tumors are quite rare. Other related cancers are - Primary peritoneal cancer is cancer that develops in cells from the peritoneum or abdominal lining. It is very similar in appearance, symptoms, and spread like the ovarian epithelial cancer as well as in treatment methods. Fallopian tube cancer is cancer that starts in the fallopian tubes and is also similar to the ovarian epithelial cancer in terms of symptoms and treatment methods. What are the Risk Factors for Ovarian Cancer? The exact cause of development of ovarian cancer is still unknown. Risk factors have been found for epithelial ovarian cancers which are mentioned below; these do not apply for the other types of ovarian cancer. ￼ Age: Ovarian cancer is mainly seen in post-menopausal women, usually over 50 years of age.Reproductive history: Women who have never been pregnant or who have had their first full term pregnancy after 35 years of age are at a higher risk.Obesity: Women who are obese, with a BMI of > 30 are at an increased risk.Endometriosis is a condition when tissue that usually lines the inside of the uterus grows outside it, like in the ovaries or fallopian tubes.Drugs: Some studies have found that taking clomiphene citrate (a drug used in infertility treatment) for more than a year; taking male hormonal drugs (e.g. danazol) or post-menopausal women taking estrogen only hormonal replacement therapy (HRT) for more than 5 years increased risk of developing ovarian cancer.Assisted reproductive technologies like in-vitro fertilizationFamily history of ovarian cancer: The risk of developing ovarian cancer increases if the woman’s first degree relative has had ovarian cancer. The risk increases with the number of relatives affected (both on the maternal and paternal side of family).Family cancer syndromes: There is a link between developing ovarian cancer and family history of other cancers such as breast cancer, colorectal cancer, prostate cancer, pancreatic cancer and other cancers. This is due to change (mutation) in the gene causing cancers; this gene is inherited among family members. Hereditary ovarian and breast cancer syndrome are caused by inherited mutations mainly in BRCA1 and BRCA2 genes; these mutated genes are also responsible for fallopian tube, pancreatic and peritoneal cancers. The lifetime ovarian cancer risk with BRCA1 mutation is between 35-70% and with BRCA2 mutation is 10-30%.Talcum powder: Using talcum powder over the genital area or on sanitary napkins (maybe due to the asbestos that used to be added to talcum powder prior to 1970s) has been shown to cause a slight increased risk of developing ovarian cancer.Smoking has been related to increased risk of developing mucinous ovarian cancer.Some of the ways to lower your risk factors are as follows:Women who have had their first full term pregnancy before 26 years of age or who had multiple full term pregnancies are at a lower risk to develop ovarian cancer.Breastfeeding helps to lower ovarian cancer risk as it prevents ovulation.Using birth control pills or depot injection also lowers ovarian cancer risk as it inhibits ovulation.Research has shown that women who had tubal ligation or a hysterectomy with conservation of ovaries are at a lower risk to develop ovarian cancer. Further studies are still needed to corroborate this fact. ￼ What are the Different Stages of Ovarian Cancer? Staging is the process of finding the extent of spread of cancer and is important as it will guide the diagnosis, treatment and the prognosis of the disease. Staging is done with the help of imaging and during surgery.Stage 1: The cancer is within the ovary/ovaries and/or the fallopian tube/tubes.Stage 2: The cancer is in one or both ovaries and/or fallopian tubes and has spread to other organs in the pelvis (uterus, urinary bladder, sigmoid colon or rectum).Stage 3: The cancer has spread beyond the pelvis to the lining of the abdomen or has spread to the lymph nodes in the back of the abdomen.Stage 4: The cancer has spread to distant organs like liver, spleen, lungs, brain or skin. What are the Signs and Symptoms of Ovarian Cancer? Ovarian cancer usually causes symptoms when the cancer has spread beyond the ovaries, although in some patients even early stage cancer can cause symptoms. They include:Abdominal bloatingUpper or lower abdominal painFeeling full despite eating smaller amounts of foodLoss of appetiteLoss of weightAcid refluxNausea, vomitingUrinary frequency or urgencyFatigueVaginal bleeding after menopauseMenstrual changesLow back painPainful sexual intercourseDiarrhea or constipationAbdominal swelling due to fluidAbdominal or pelvic mass (not fibroids) ￼ How is Ovarian Cancer Diagnosed? If any of the symptoms are severe and occur frequently (more than 12 times/month), and is a change from a woman’s normal self, ovarian cancer needs to be ruled out.Medical history: A detailed history of symptoms, risk factors and family history should be taken.Physical examination: A detailed physical examination of the abdomen and pelvis helps to identify any tumorous growths or fluid in the abdomen.Imaging studies: A transvaginal ultrasound and an ultrasound of the abdomen are performed to identify pelvic or abdominal masses. MRI or CT scan of the abdomen and pelvis is performed to identify the extent and spread of the disease. A CT scan of the chest and/or positron emission tomography (PET) scan are performed to check if the cancer has spread to chest and other parts of the body.Tumor markers: Tumor markers or biomarkers are proteins found in abundance in cancer cells when compared to healthy cells. CA 125 (Cancer Antigen 125) is a protein found in ovarian cancer cells and is measured by a blood test. Some germ cell tumors cause increased levels of tumor markers such as Alpha fetoprotein (AFP), Beta HCG (human chorionic gonadotrophin) and /or LDH (Lactate Dehydrogenase).Some stromal cell cancers can increase the levels of estrogen, progesterone and a substance called inhibin.Blood tests include complete blood picture, liver function tests, kidney function tests and ESR.Laparoscopy: This is a procedure in which a doctor can look at the insides of the abdominal cavity. This is useful to confirm the diagnosis and the spread of the cancer.Colonoscopy: If the cancer has been found to spread to the large bowel, a colonoscopy is done to confirm the diagnosis and remove it.Tissue biopsy: A definitive diagnosis of cancer can be made by taking a small tissue sample from the tumor during surgery and studying it under the microscope. In rare cases (when the woman cannot have surgery due to ill health or in advanced cancer) the biopsy can be obtained during laparoscopy (or colonoscopy) and also from an ultrasound or CT scan guided percutaneous biopsy procedure. There are some concerns that cancer cells can spread through this type of tissue biopsy.Paracentesis: In patients with ascites, a small sample of fluid is aspirated through a needle attached to a syringe and studied for cancer cells.Genetic tests to identify inherited mutations in genes such as BRCA1 and BRCA 2 can be offered to women with a strong family history of breast and ovarian cancer. How is Ovarian Cancer Treated? Most of the ovarian tumors are benign tumors, which are non-cancerous and do not spread beyond the ovaries. These are usually treated by removing a part or the full ovary. Tumors that are cancerous are called malignant tumors and can spread beyond the ovaries to distant parts of the body. These are usually fatal if not treated appropriately. There are various types of treatments; the choice of treatment depends on the type and staging of cancer. Surgery: Surgery is the main treatment for majority of ovarian cancers. The affected ovary/ovaries along with the fallopian tubes, uterus, cervix and omentum are removed. ￼ Chemotherapy: Chemotherapy is treatment of cancer by using two or more drugs. These are given intravenously or orally. Chemotherapy is often given after surgery to destroy any remnant cancer cells, to shrink the tumor or to relieve the patient of their symptoms. Gemcitabine, capecitabine, melphalan and other similar drugs are usually used. Targeted therapy: The metabolism of cancer cells is different from surrounding healthy cells. In targeted therapy, injected drugs attack only the cancer cells without destroying the healthy cells. Bevacizumab, olaparib, and rucaparib are commonly used. Radiation therapy: Radiation therapy refers to destroying cancer cells by using high energy X-rays / particles. Radiotherapy is now not so commonly used and is usually given to women who are in advanced stages of cancer, who cannot undergo surgery, who have cancer recurrence after surgery or to relieve symptoms. Hormone therapy: Hormone therapy is use of hormones or hormone blocking drugs to destroy cancer cells. Commonly used drugs are anastrazole, exemestane, tamoxifen and goserelin. Newer therapies involving use of cytokines, chromatin remodeling proteins and immunomodulators are being tested as treatment options. Once the treatment is completed, patients should see their doctor every 3 months; this is done to identify recurrence of ovarian cancer or development of a new cancer (breast cancer, colorectal cancer, or leukemia) early on. The patient is examined and investigations such as tumor markers and imaging studies are performed as necessary. Health Tips Eating a well-balanced diet rich in vegetables, fruits, whole grain products and limiting red meat intake has been shown to prevent various types of cancers.Stopping smoking is beneficial for a healthy life.Exercise helps to improve physical and mental health.Practicing relaxation therapies or meditation helps to control stress and anxiety. Report a problemDr. Tapan Kumar Sau4 Likes7 Answers
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Dear Doctors please guide me the line of treatment in AyurvedaDr. Vishwanath Kumar K0 Like7 Answers
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Health Benefits of Kundur, B. Name. Boswellia serrata Arabic Name : Lubaan, Kundur Bengali Name : Luban, Salai Dhoop English Name : Boswellia, Indian Frankincense, Indian Olibanum German Name : Weihrauch, Indischer Weihrauchbaum, Olibanum Gujarati Name : Shaledum, Saleda, Saladi Hindi Name : Kundur, Salai, Salai-guggul, Laban Marathi Name : Salai Cha Deek Persian Name : Kundur Punjabi Name : Salai Gond Sanskrit Name : Shallaki, Kunduru Urdu Name : Kundur, Loban Uses of Kundur/ Boswellia serrata Studies show that boswellia may reduce inflammation and may be useful in treating the following conditions: Rheumatoid arthritis and osteoarthritis The anti-inflammatory actions of boswellia have been shown in several studies to ease pain, reduce swelling, and improve mobility in people with arthritis or osteoarthritis. Some research shows a profound effect, including a reduction in arthritis symptoms by 45 to 67 percent, which is comparable to prescription medications, and a 35 percent reduction in inflammation. It appears to be especially helpful in osteoarthritis of the knee; several studies have found significant reductions in knee pain, knee jerking, swelling, and pain while walking, and improvements in flexion in test subjects who took boswellia. Unlike some herbs, which may take weeks to be effective, boswellia works quickly: in one study, boswellia extract reduced pain and considerably improved knee-joint functions, in some cases providing relief even within seven days. Inflammatory bowel disease Because of its powerful anti-inflammatory effects, boswellia may be effective in treating inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis. Studies also suggest boswellia can improve gastrointestinal health by maintaining immune activity in the lining of the digestive tract and offering antioxidant protection. In one study comparing boswellia extract with an anti-inflammatory prescription drug, the herb performed as well as the drug in managing Crohn’s disease. Another study found boswellia was effective in treating ulcerative colitis as well, and older studies show up to 82 percent of ulcerative colitis patients who took boswellia went into remission. Asthma Frankincense, derived from boswellia, has traditionally been used to treat respiratory system ailments, including coughs, bronchitis, and breathing disorders; now, modern studies show boswellic acids in frankincense modulate the inflammatory process that drives asthma, and can dramatically improve asthma symptoms. In one study of patients with asthma, 70 percent of those who took 300 mg of boswellia three times daily showed significant improvement, including disappearance of physical symptoms and signs of asthma, such as difficulty in breathing and the number of attacks. In another study, asthma patients who took a combination of boswellia, curcumin, and licorice root showed a significant decline in levels of inflammatory compounds and markers of oxidative stress. Cancer AKBA and other boswellic acids appear to act in several ways that can inhibit cancer growth. They may prevent changes to DNA, and studies show boswellic acids can induce apoptosis (cell death) of cancer cells. Other compounds called triterpenoids in various Boswellia species have demonstrated antitumor properties. A number of studies show boswellia can: Slow even aggressive tumor growth in breast cancer cells.Halt the spread of malignant leukemia and brain tumor cells.Suppress pancreatic cancer progression and metastasis.Inhibit prostate tumor growth.Stop cancer cell viability and induce bladder cancer cell death.Reduce cerebral edema in patients with brain tumors following radiotherapy. Unani Formulation: Majoon KundurDr. Anurudh Gaur4 Likes7 Answers
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BLOOD TEST FOR PANCREATIC CANCER SHOWS EARLY PROMISE. May 24, 2017 by Amy Norton, Healthday Reporter. SCIENTISTS say they've DEVELOPED a NEW BLOOD TEST FOR IDENTIFYING PANCREATIC CANCER —a step that might eventually ALLOW EARLIER DIAGNOSIS. PANCREATIC CANCER is a particularly DEADLY type of TUMOR BECAUSE it's often DETECTED TOO LATE for effective treatment. The STILL-EXPERIMENTAL TEST DETECTS a bundle of proteins churned out by PANCREATIC TUMORS. And it appears to be MORE ACCURATE THAN a CURRENTLY AVAILABLE TEST for a protein CALLED CA19-9, according to the study findings. That CA 19-9 TEST is "VERY IMPERFECT," said Dr. Cesar Castro, one of the researchers on the new study. For one, levels of CA 19-9 OFTEN RISE only in the LATER STAGES of pancreatic cancer, according to Castro, an oncologist at Massachusetts General Hospital in Boston. PLUS, A SPIKE IN THE PROTEIN IS NOT SPECIFIC TO the CANCER. It can GO UP WHEN the PANCREAS IS INFLAMED, for example, OR when there is a BLOCKAGE IN the BILE DUCTS. MEASURING CA 19-9 can be USEFUL TO TRACK PATIENTS' PROGRESS DURING TREATMENT, Castro said. BUT IT'S A "TERRIBLE DIAGNOSTIC MARKER," he added. It's estimated that almost 53,700 AMERICANS will be DIAGNOSED with PANCREATIC CANCER THIS YEAR, according to the U.S. National Cancer Institute. MORE THAN 80 PERCENT DEVELOP a form called PANCREATIC DUCTAL ADENOCARCINOMA (PDAC). FEW people SURVIVE the disease BECAUSE IT'S RARELY CAUGHT EARLY, when it can be treated with surgery. The SYMPTOMS, which include WEIGHT LOSS AND JAUNDICE, usually arise ONLY AFTER THE DISEASE HAS SPREAD. Of all Americans DIAGNOSED with PANCREATIC CANCER, ONLY 8 PERCENT are STILL ALIVE FIVE YEARS LATER, the cancer institute says. SCIENTISTS have been WORKING TO FIND MARKERS, or indicators, of early pancreatic cancer—such as proteins in the blood that consistently and SPECIFICALLY SIGNAL THE PRESENCE OF THE DISEASE. The ultimate GOAL IS TO FIND A TEST that can screen people for pancreatic cancer, CATCHING it BEFORE SYMPTOMS ARISE, said Dr. Peter Kingham. Kingham, who was not involved in the new study, specializes in treating pancreatic cancer at Memorial Sloan Kettering Cancer Center in New York City. "UNLIKE with some other cancers, we have NO SCREENING TEST FOR PANCREATIC CANCER," Kingham said. "We'd love to have some test that's used like mammography for breast cancer, or colonoscopy for colon cancer." He said the results with the NEW BLOOD TEST RESULTS ARE "IMPRESSIVE IN COMPARISON WITH CA 19-9." But, Kingham cautioned, it NEEDS TO BE STUDIED IN LARGER GROUPS of patients to get a better gauge of its accuracy. The TEST USES a CHIP TECHNOLOGY that ANALYZES structures called EXTRACELLULAR VESICLES, or EVs, which are churned out by cells into the bloodstream. EVs can COME FROM BOTH NORMAL cells AND CANCER CELLS. BUT Castro's team found that THOSE CONTAINING a "SIGNATURE" OF FIVE SPECIFIC PROTEINS were a GOOD MARKER of pancreatic cancer. In one phase of the study, the researchers used blood samples from 43 patients who'd undergone surgery for either PDAC or noncancerous conditions, including pancreatitis (where the organ becomes inflamed). The scientists found that TESTING for the five proteins DETECTED 86 PERCENT of the PANCREATIC CANCER cases. The test also had a "SPECIFICITY" of 81 PERCENT. That suggests it would accurately give a negative result to 81 percent of people who do not have pancreatic cancer. HOWEVER, Castro agreed that the STUDY GROUP WAS TOO SMALL to draw any conclusions. Some aspects of the testing have been AUTOMATED, Castro said. Right now, it could be DONE in about 10 MINUTES, at a COST of $60 a patient, the researchers said. The big LONGER-TERM QUESTION is WHETHER the TEST could be GOOD ENOUGH and PRACTICAL ENOUGH TO be USED FOR SCREENING. To get answers, Castro said, STUDIES COULD FIRST LOOK AT PATIENTS at high-risk of pancreatic cancer because of a strong family history of the disease. But ultimately, he said, the HOPE is to develop a screening test that CAN BE USED FOR the GENERAL POPULATION. Castro and some of his colleagues on the study are inventors on a patent application covering technology used in the research. Two researchers are consultants to Exosome Diagnostics, Inc., which licensed the patent application. THE STUDY WAS PUBLISHED MAY 24 IN SCIENCE TRANSLATIONAL MEDICINE. *********************************************************** MORE INFORMATION: K.S. Yang el al., "Multiparametric plasma EV profiling facilitates diagnosis of pancreatic malignancy," Science Translational Medicine (2017). stm.sciencemag.org/lookup/doi/10.1126/scitranslmed.aal3226 ____________________________________ IMAGE : NANOSECOND IMAGE OF the surface of a new sensor CHIP that can DIAGNOSE PANCREATIC CANCER FROM small circulating MARKERS isolated FROM PATIENT SERUM (SMALL SPHERES shown in RIGHT PANEL). CREDIT: K.S. Yang et al., Science Translational Medicine (2017) ****************************+******************************Dr. Puranjoy Saha14 Likes6 Answers
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RESEARCHERS DISCOVER BRCA1 GENE IS KEY FOR BLOOD FORMING STEM CELLS. January 24, 2017. The study is published in CELL Reports. _______________________________________ Researchers at from the Harold C. Simmons Comprehensive Cancer Center have found that the BRCA1 GENE IS REQUIRED FOR THE SURVIVAL OF BLOOD FORMING STEM CELLS, WHICH COULD EXPLAIN WHY PATIENTS WITH BRCA1 MUTATIONS DO NOT HAVE AN ELEVATED RISK FOR LEUKEMIA. The stem cells die before they have an opportunity to transform into a blood cancer. " One of the great MYSTERIES IN CANCER RESEARCH is why inherited mutations, such as those in BRCA1, cause cancer only in specific tissues such as the breast and ovaries, rather than in all tissues. Our data suggest a 'DIE OR TRANSFORM' HYPOTHESIS, which could explain this tissue specificity," said Dr. Theodora Ross, Professor of Internal Medicine and Director of the Cancer Genetics Program at UT Southwestern. Additional data from this study suggest these patients may have a tougher time with the side effects of chemotherapy. "Patients with certain BRCA1 mutations may be at a higher than expected risk for serious complications during chemotherapy treatment," said Dr. Ross, who holds the Jeanne Ann Plitt Professorship in Breast Cancer Research and the H. Ben and Isabelle T. Decherd Chair in Internal Medicine in Honor of Henry M. Winans, Sr., M.D. "If we confirm these clinical findings in upcoming studies, giving patients preventative antibiotics or growth factors may be necessary to lower this increased risk of treatment side effects." THE STUDY IS PUBLISHED IN CELL REPORTS. According to the National Cancer Institute, more than 246,660 women will be diagnosed with BREAST CANCER and 22,280 women will be diagnosed with OVARIAN CANCER this year. Of these, about 10-15 percent are ESTIMATED TO BE AFFECTED BY BRCA1 AND BRCA2 GENETIC MUTATIONS, Dr. Ross said. "Our data also illustrate why rare variations in the BRCA1 gene are not always mutations that put women and men at high risk for specific cancers. We and others have learned that most rare 'spellings' of the BRCA1 gene, spellings we call variations of undetermined significance, are not harmful," said Dr. Ross, a member of the Simmons Cancer Center. Dr. Ross' laboratory investigates how cells transform from normal cells to cancer cells, and how some cancer cells are able to withstand specifically targeted cancer drugs. Among her main avenues of research is the BRCA1 gene, which - when abnormal - predisposes women to breast and ovarian cancer. WHAT IS BRCA? BRCA1 and BRCA2 are human GENES THAT PRODUCE TUMOR SUPPRESSOR PROTEINS which help repair damaged DNA. WHEN EITHER of these genes is MUTATED, or ALTERED, DNA damage may not be repaired properly. BRCA gene mutations can RAISE THE RISK FOR SEVERAL CANCERS, INCLUDING BREAST, OVARIAN, PROSTATE, and PANCREATIC cancer. _______________________________________ PROVIDED BY: UT Southwestern Medical Center. _______________________________________ LEAD CO-AUTHOR Dr. VICTORIA E. Mgbemena at work in her lab studying the BRCA1 gene in the Hematology-Oncology Division of Internal Medicine at UT Southwestern. CREDIT: UT Southwestern Medical Center =============================================Dr. Puranjoy Saha10 Likes4 Answers