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FORUM FIXED on 1/4/03







Pancreatic Cancer

Cancer of the pancreas is abnormal cell growth in the tissue of the pancreas. The pancreas is about 6 inches long, and is located next to the small intestine, behind the stomach. This organ serves two main functions in the body. It produces juices and enzymes to help with digesting and absorbing food. It also produces several hormones, such as insulin, that regulate the way your body stores and processes food.

About 95% of all pancreatic cancers begin in the part of the pancreas that produces digestive fluids (the exocrine pancreas). The remaining 5% begin in the part that produces hormones (the endocrine pancreas). These different types of tumors are vastly different. It is extremely important that doctors confirm the type of cancer in the pancreas because of differences in treatment. Since the overwhelming majority of pancreatic cancers are tumors in the exocrine pancreas (adenocarcinomas), this article will focus on this type of cancer.

Unless pancreatic cancer is detected in its very early stages, it is hard to control. Pancreatic cancer tends to occur in older people, and the incidence of the disease is rising as people live longer. Health professionals estimate that 32,180 people in the United States will be diagnosed with pancreatic cancer in 2005 and 31,800 will die of the disease. Pancreatic cancer is expected to be the fourth leading cause of cancer death in men and the fifth leading causes of cancer death in women in 2005.

It's not clear what causes pancreatic cancer. However, cigarette smoking significantly raises the risk of developing pancreatic cancer. There is evidence that the risk of pancreatic cancer increases the more a person smokes and the longer he or she smokes. Smokers who quit have a lower risk of developing pancreatic cancer than those who continue smoking.

In most patients with pancreatic cancer, no cause can be found.

Symptoms

Someone with pancreatic cancer in the early stages of the disease may not have any symptoms. When symptoms occur, they can resemble many other ailments of the stomach, intestines, liver and gallbladder. As the tumor grows, there may be vague abdominal discomfort. Other symptoms are nausea, loss of appetite, weight loss, or pain in the upper or middle sections of the abdomen.

Yellowing of the whites of the eyes and the skin, called jaundice, is another key symptom. Most pancreatic tumors affect the head (upper portion) of the pancreas. When they grow larger, they can block the outflow of bile from the liver and the bile ducts into the intestine. This causes an orange-yellow pigment called bilirubin to build up in the body. In addition to jaundice, symptoms may include itching, brown urine and very light-colored bowel movements.

Diagnosis

There is no effective method of screening for cancers in the pancreas. Because the pancreas is hidden from view among many other organs, detecting cancer there is difficult.

If you have symptoms of pancreatic cancer, your doctor will ask you about your medical history, examine you and order diagnostic tests to look for other possible causes. These diagnostic tests include:

Expected Duration

The best hope for a cure exists when cancer is detected early, before it has spread. Unfortunately, by the time symptoms occur and diagnosis is made, cancer usually has spread outside the pancreas. How much symptoms can be controlled depends on how much the cancer has spread, your age and general health, and how well your body responds to treatment.

Even when a cure isn't possible, treatment can improve the length of survival and the quality of life by controlling symptoms and complications of the cancer.

Prevention

There is no way to prevent pancreatic cancer. There also is no method of screening for pancreatic cancer so that it can be caught and treated early. Because cigarette smoking is the most significant risk factor associated with pancreatic cancer, it's crucial to quit smoking or avoid starting. Eating a diet including fruits, vegetables and fiber is also recommended to avoid cancers in general.

Treatment

After your physician diagnoses pancreatic cancer, he or she will conduct more tests to determine how advanced the cancer has become, a process known as staging. The treatment depends on the cancer's stage.

Surgery may be done to remove part or all of the pancreas, and any surrounding tissue that has become cancerous. Your doctor also may use chemotherapy (treatment with tumor-killing drugs) and radiation therapy to kill tumor cells and control symptoms of the disease. In some cases, your doctor may offer you new treatments that are promising but are not yet approved as standard procedure. These treatments are called clinical trials.

Even if the chance for cure is small, treatment can help to prevent or control the development of symptoms.

Pancreatic cancer is classified and treated according to the following stages:

Resectable cancer: The cancer has not spread outside the pancreas. It is rare for patients to be diagnosed with pancreatic cancer at this early stage. Treatment of cancers in this stage typically involves surgery, but may include any of the following:

Locally advanced cancer: The cancer has spread to neighboring organs, such as the duodenum (the first part of the small intestine), surrounding blood vessels and the intestine. Because of this spread, it generally is not possible to remove the pancreas surgically. Treatment of patients with this stage of pancreatic cancer may include:

Metastatic cancer: The cancer has spread to distant areas, such as the liver, pelvic organs, abdominal cavity and lungs. Treatment for patients with cancers in this stage may include any of the following:

Recurrent cancer: The cancer has reappeared (recurred) after it has been treated, either in the pancreas or another part of the body. In addition to any of the treatments listed above for metastatic pancreatic cancer, treatment may include external radiation therapy to reduce symptoms.

When To Call A Professional

See your doctor as soon as you notice any of the symptoms of pancreatic cancer. You doctor may refer you to a gastroenterologist (a digestive specialist) or an oncologist (a cancer specialist).

Prognosis

Pancreatic cancer is a serious illness, and its death rate is high. Your chances of recovery depend on your age, general health and the effectiveness of your treatment.

Approximately 19% of patients with pancreatic cancer survive at least 1 year after diagnosis, but only 1% to 2% of people with pancreatic cancer survive 5 years after diagnosis.











Esophageal Cancer

What Is It?

Esophageal cancer is the abnormal growth of cells in the esophagus, the tube that carries food and drink from your throat to your stomach. There are two types of esophageal cancer:

Esophageal cancer is common in Asia, Africa, and Latin America, but less common in the United States. However, the number of cases of adenocarcinoma of the esophagus is increasing faster than almost all other cancers in the United States. No one is certain what causes esophageal cancer, but risk factors include the following:

Symptoms

Early esophageal cancer may not cause any symptoms. As the cancer progresses, it usually causes one or more of the following symptoms:

Other conditions can cause these symptoms. If you experience any of these, you should see your doctor. If you have chest pain or vomit blood, seek medical attention immediately.

Diagnosis

In addition to examining you and reviewing your medical history, your doctor probably will order chest X-rays and other diagnostic tests. These may include the following:

People with squamous cell carcinoma of the esophagus are at higher risk of cancers of the mouth, throat, lungs, and stomach. For this reason, you probably also will have tests with endoscopes inside the throat and lungs as well as chest X-rays and chest CT scans.

Expected Duration

If it is not detected, esophageal cancer will continue to grow and can spread to almost any part of the body. The chance of survival increases greatly if the disease is detected early.

How long treatment lasts depends on such factors as your age and general health, how advanced the cancer is, and how well your body responds to treatment. Treatments can take several months to complete. If surgery is done, the recovery period typically lasts at least three to four weeks and can be longer.

Prevention

While some risk factors for esophageal cancer can't be avoided, you can take steps to decrease your risk:

If you suffer from chronic reflux or heartburn symptoms, an esophagoscopy may be done to look for Barrett's esophagus. If you have Barrett's esophagus, some doctors recommend periodic exams or biopsies to look for abnormalities before they develop into cancer.

Treatment

Treatment for esophageal cancer depends on the size and location of your tumor, your symptoms, and your general health. Many different treatments and combinations of treatments may be used. Your team of specialists may include a surgeon, a gastroenterologist (a specialist in diagnosing and treating disorders of the digestive system), a medical oncologist (a specialist in treating cancer), and a radiation oncologist (a specialist in using radiation to treat cancer). Other testing may also be required before treatments begin to determine how well your heart and kidneys are functioning.

Here are the key treatments for esophageal cancer:

In making a decision about what treatment to recommend, your cancer team will weigh the benefits of surgery against the risks of this serious operation, which has many potential complications. For many people, radiation therapy alone or in combination with chemotherapy may offer the same chance of survival as surgery. In addition, there are other options to improve symptoms, including:

When To Call A Professional

See your doctor if you experience any characteristic symptoms of esophageal cancer, such as difficulty swallowing, weight loss, or vomiting. If you have chest pain or vomit blood, seek medical attention immediately.

Prognosis

Once cancer has been diagnosed, your doctor will conduct tests to determine what stage your cancer has reached. The stages are labeled 0 to IV. The higher the stage number, the further the cancer has spread. For example, in stage 0, the cancer is confined to the superficial lining of the esophagus. In stage I, the cancer has not invaded the outer muscle layer of the esophagus.

Surgery to remove the tumor offers the best chance for cure. If the disease is caught early, the five-year survival rate is much higher — 75% for patients diagnosed in stage 0 and 50% for those diagnosed in stage I. Most esophageal cancer is diagnosed at the more advanced stages when the five-year survival is only about 15% to 20%. With or without surgery, chemotherapy and radiation therapy can help to improve the quality of life and prolong survival, even in advanced stages.






More on Reflux

Bile reflux

Bile is a digestive fluid produced by the liver. Some of the elements that make up bile are cholesterol, bile salts, bile pigments and water. The bile is found in the gallbladder and released in the gut when you eat, where the bile helps digestion of fats. Bile reflux is the result of bile that runs up from the small intestine, stomach and esophagus BR sometimes be confused with acid reflux, because a person can experience some of the same symptoms, and bile (such as GERD) is irritating to the finish ‘ esophagus, which may increase the risk of esophageal cancer.

One thing that makes it different from bile reflux is acid reflux cannot be treated with lifestyle changes, little power, it should be treated with prescription medications or, in severe cases, surgery. IES Medical Group offers a variety of highly advanced treatments for an ever-growing list of conditions. Another thing that makes this condition of BR is irritating to the stomach, causing gnawing or burning sensation in the upper abdomen. Due to the fact that acid reflux and BR are somewhat alike, can sometimes be quite a task at times to distinguish the basic symptoms. Thus among the symptoms of bile reflux, there is vomiting bile, hoarseness, unintentional weight loss and nausea.

The causes of this condition are a gastric ulcer and gallbladder removal. Prevent peptic pyloric valve. When this happens, the valve does not open enough to empty the stomach faster as it should. The causes of this condition are a gastric ulcer and gallbladder removal. Prevent peptic pyloric valve. During that time, the valve does not open enough to empty the stomach faster as it should. As food and drink will result in an increase in gastric pressure, that causes the bile acid reflux up the esophagus and stomach. If you had gallbladder out so there’s a good chance that the body produces more bile to those who have their gallbladder removed. BR diagnosis is more difficult to manage than acid reflux, and requires further testing. The doctor will also check for damage of the esophagus and premalignant changes.

Bile reflux disease was apparently forgotten and unknown to many who unknowingly qualify it with acid reflux. The symptoms are very similar to heartburn, but there are some key differences. Process it is necessary because it is also possible to contact another disease. Many of these questions are difficult to heal, making it necessary to eliminate this disorder at source and treatment of bile reflux as soon as possible.

Some popular options include bile acid inhibitors, proton pump. Its basic function is simply to reduce acid production. Many people find it useful since it reduces and attacks most of the symptoms of bile reflux, and provides temporary relief and welfare. They can be very expensive, and often, if you stop using the medication before your condition has improved, the above symptoms may return. However, there are other more simple and natural remedies for stomach ailments. If you take the medication does not or there are precancerous changes of the esophagus, then the next option is to try surgery.






The Members of A.W.A.K.E. have been diagnosed with Sleep Apnea, and have come together to provide support for one another. Our discussions range from solutions to common problems to insurance questions. Representives from Gateway Health Services, Apria Healthcare, Lincare, Family Medical, are usually in attendance, and are a valuable source of information. If you live in the St. Louis Metro area, and would like information on our meetings, just Email Us!

Our support group exists because 74% of stroke victims have apnea. Sleep Apnea affects over 10% of the population. Our support group can make life a little easier for people with apnea, because of our common experiences and helpful advice. We are trying to make this page as simple as possible so everyone can find information easily.







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Dr. Oscar Schwartz has volunteered to answer some questions from anyone suffering from sleep disorders. Dr. Schwartz is a highly qualified Pulmonogist and Sleep Specialist. Dr. Schwartz is on staff at numerous hospitals in St. Louis area, and has years of experience in the sleep field. His practice is called Advantage Pulmonary, but he also specializes in Post-Polio syndrome.













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