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Encyclopedia > Pancreatic cancer

Pancreatic cancer
Classification and external resources
ICD-10 C25.
ICD-9 157
OMIM 260350
DiseasesDB 9510
MedlinePlus 000236
eMedicine med/1712 
MeSH D010190

Pancreatic cancer is a malignant tumor of the pancreas. Each year about 33,000 individuals in the United States are diagnosed with this condition, and more than 60,000 in Europe. Depending on the extent of the tumor at the time of diagnosis, the prognosis is generally regarded as poor, with few victims still alive five years after diagnosis, and complete remission still extremely rare.[1] About 95 percent of pancreatic tumors are adenocarcinomas (M8140/3). The remaining 5 percent include other tumors of the exocrine pancreas (e.g., serous cystadenomas), acinar cell cancers, and pancreatic neuroendocrine tumors (such as insulinomas, M8150/1, M8150/3). These tumors have a completely different diagnostic and therapeutic profile, and generally a more favorable prognosis.[1] Image File history File links Illu_pancrease. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // C00-D48 - Neoplasms (C00-C14) Malignant neoplasms, lip, oral cavity and pharynx (C00) Malignant neoplasm of lip (C01) Malignant neoplasm of base of tongue (C02) Malignant neoplasm of other and unspecified parts of tongue (C03) Malignant neoplasm of gum (C04) Malignant neoplasm of floor of mouth (C05) Malignant neoplasm of... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... The pancreas is a gland organ in the digestive and endocrine systems of vertebrates. ... For other uses, see Europe (disambiguation). ... Remission is the state of absence of disease activity in patients with known chronic illness. ... Adenocarcinoma is a form of carcinoma that originates in glandular tissue. ... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... Cystadenoma (or cystoma) refers to a type of cystic adenoma. ... Neuroendocrine tumors, or more properly gastro-entero-pancreatic or gastroenteropancreatic neuroendocrine tumors (GEP-NETs), are cancers of the interface between the endocrine (hormonal) system and the nervous system. ... An insulinoma is a tumour of the pancreas derived from the beta cells which while retaining the ability to synthesize and secrete insulin is autonomous of the normal feedback mechanisms. ... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ...

Contents

Signs and symptoms

Presentation

Early diagnosis of pancreatic cancer is difficult because the symptoms are so non-specific and varied. Common symptoms include pain in the upper abdomen that typically radiates to the back and is relieved by leaning forward (seen in carcinoma of the body or tail of the pancreas), loss of appetite, significant weight loss and painless jaundice related to bile duct obstruction (carcinoma of the head of the pancreas). All of these symptoms can have multiple other causes. Therefore, pancreatic cancer is often not diagnosed until it is advanced. Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. ... Anorexia (deriving from the Greek όρεξη (orexe) = appetite) is the decreased sensation of appetite. ... Weight loss, in the context of medicine or health or physical fitness, is a reduction of the total body weight, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue. ... Look up jaundice in Wiktionary, the free dictionary. ... A bile duct is any of a number of long tube-like structures that carry bile. ...


Jaundice occurs when the tumor grows and obstructs the common bile duct, which runs partially through the head of the pancreas. Tumors of the head of the pancreas (approximately 60% of cases) are more likely to cause jaundice by this mechanism. Look up jaundice in Wiktionary, the free dictionary. ... Bile, which is synthesized in the liver, is carried to the right and left hepatic ducts, which converge to form the common hepatic duct. ...


Trousseau sign, in which blood clots form spontaneously in the portal blood vessels, the deep veins of the extremities, or the superficial veins anywhere on the body, is sometimes associated with pancreatic cancer. Trousseaus sign of malignancy is a medical sign. ... This article discusses portal venous systems in general. ...


Clinical depression has been reported in association with pancreatic cancer, sometimes presenting before the cancer is diagnosed. However, the mechanism for this association is not known.[2] On the Threshold of Eternity. ...


Predisposing factors

Risk factors for pancreatic cancer include:[3]

The cigarette is the most common method of smoking tobacco. ... For the disease characterized by excretion of large amounts of very dilute urine, see diabetes insipidus. ... Chronic pancreatitis can present as episodes of acute inflammation in a previously injured pancreas, or as chronic damage with persistent pain or malabsorption. ... Binomial name ((Marshall 1985) Goodwin 1989) ICD-9 code: 041. ... A pesticide is a substance or mixture of substances used for preventing, controlling, or lessening the damage caused by a pest. ... Look up dye in Wiktionary, the free dictionary. ... Petrol redirects here. ... In genetics, the term recessive gene refers to an allele that causes a phenotype (visible or detectable characteristic) that is only seen in a homozygous genotype (an organism that has two copies of the same allele). ... Ataxia-telangiectasia (AT) (Boder-Sedgwick syndrome or Louis-Bar syndrome) is a primary immunodeficiency disorder that occurs in an estimated incidence of 1 in 40,000 to 1 in 300,000 births (Lederman, 2000). ... BRCA2 refers to either a gene (BReast-CAncer susceptibility gene 2, located on human chromosome 13, 13q12-13) or the protein coded for by that gene. ... For other uses, see Gene (disambiguation). ... Peutz-Jeghers is an autosomal dominant genetic disease. ... Hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch syndrome, is characterized by an increased risk of colorectal cancer and other cancers of the endometrium, ovary, stomach, small intestine, hepatobiliary tract, upper urinary tract, brain, and skin. ...

Diagnosis

History — Most patients with pancreatic cancer experience pain, weight loss, or jaundice.[10] Look up jaundice in Wiktionary, the free dictionary. ...


Pain is present in 80 to 85 percent of patients with locally advanced or advanced metastic disease. The pain is usually felt in the upper abdomen as a dull ache that radiates straight through to the back. It may be intermittent and made worse by eating. Weight loss can be profound; it may be associated with anorexia, early satiety, diarrhea, or steatorrhea. Jaundice is often accompanied by pruritus and dark urine. Painful jaundice is present in approximately one-half of patients with locally unresectable disease, while painless jaundice is present in approximately one-half of patients with a potentially resectable and curable lesion. The initial presentation varies according to tumor location. Tumors in the pancreatic body or tail usually present with pain and weight loss, while those in the head of the gland typically present with steatorrhea, weight loss, and jaundice. The recent onset of atypical diabetes mellitus, a history of recent but unexplained thrombophlebitis, or a previous attack of pancreatitis are sometimes noted. Anorexia can refer to: Anorexia nervosa, an eating disorder in which people do not eat correctly due to the obsessive fear of weight gain Anorexia (symptom), the general symptom of decreased appetite Sexual anorexia, a term used to describe a lack of appetite for sex. ... Satiety, or the feeling of fullness and disappearance of appetite after a meal, is a process mediated by the ventromedial nucleus in the hypothalamus. ... Steatorrhoea is the formation of bulky, grey or pale faeces. ... Look up jaundice in Wiktionary, the free dictionary. ... For other uses, see Itch (disambiguation). ... It has been suggested that this article or section be merged into deep vein thrombosis. ... Pancreatitis is inflammation of the pancreas. ...


Courvoisier sign defines the presence of jaundice and a painlessly distended gallbladder as strongly indicative of pancreatic cancer, and may be used to distinguish pancreatic cancer from gallstones. Courvoisiers law states that in the presence of a palpable gall bladder, jaundice is unlikely to be caused by gall stones. ... The gallbladder (or cholecyst, sometimes gall bladder) is a pear-shaped organ that can accomodate up to 60 ml of bile (or gall) until the body needs it for digestion. ... This article does not cite any references or sources. ...


Pancreatic cancer is usually discovered during the course of the evaluation of aforementioned symptoms. Liver function tests may show a combination of results indicative of bile duct obstruction (raised conjugated bilirubin, γ-glutamyl transpeptidase and alkaline phosphatase levels). CA19-9 (carbohydrate antigen 19.9) is a tumor marker that is frequently elevated in pancreatic cancer. Liver function tests (LFTs or LFs), are groups of clinical biochemistry laboratory blood assays designed to give a doctor or other health professional information about the state of a patients liver. ... Bilirubin is a yellow breakdown product of normal heme catabolism. ... Gamma glutamyl transferase (GGT or GGTP, or Gamma-GT) (EC 2. ... Ball and stick model of alkaline phosphatase Alkaline phosphatase (ALP) (EC 3. ... CA19-9 or carbohydrate antigen 19-9 is a blood test from the tumor marker category. ... Tumor markers are substances found in the blood, urine or body tissues that can be elevated in cancer. ...


Imaging studies, such as ultrasound or abdominal CT may be used to identify tumors. Endoscopic ultrasound (EUS) is another procedure that can help visualize the tumor and obtain tissue to establish the diagnosis. Sonography redirects here. ... negron305 Cat scan redirects here. ... Endoscopic ultrasound is an ultrasound that is placed into the stomach and duodenum via the upper GI tract. ...


Treatment

Surgery

Treatment of pancreatic cancer depends on the stage of the cancer.[11] The Whipple procedure is the most common surgical treatment for cancers involving the head of the pancreas. It can only be performed if the patient is likely to survive major surgery, and if the tumor is localised without invading local structures or metastasizing. It can therefore only be performed in the minority of cases. Recent advances have made possible resection (surgical removal) of tumors that were previously unresectable due to blood vessel involvement.[citation needed] It has been suggested that this article or section be merged into Pancreaticoduodenectomy. ...


After surgery, adjuvant chemotherapy with gemcitabine may be offered to eliminate whatever tumor tissue may remain in the body. This has been shown to increase 5-year survival rates. Addition of radiation therapy is not recommended.[12] Gemcitabine is a nucleoside used as chemotherapy. ... Varian Clinac 2100C Linear Accelerator Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ...


Surgery may be performed for palliation, if the tumor is invading or compressing the duodenum or colon. In that case, bypass surgery may overcome the obstruction and improve quality of life, but it is not intended as a cure. In anatomy of the digestive system, the duodenum is a hollow jointed tube about 25-30 cm long connecting the stomach to the jejunum. ... It has been suggested that this article or section be merged with Large intestine. ...


Chemotherapy

In patients not suitable for resection with curative intent, palliative chemotherapy may be used to improve quality of life and gain a modest survival benefit. Gemcitabine was approved by the US FDA in 1998 after a clinical trial reported improvements in quality of life in patients with advanced pancreatic cancer. This marked the first FDA approval of a chemotherapy drug for a non-survival clinical trial endpoint. Gemcitabine is administered intravenously on a weekly basis. Addition of oxaliplatin (Gem/Ox) conferred benefit in small trials, but is not yet standard therapy.[13] Fluorouracil (5FU) may also be included. Chemotherapy, in its most general sense, refers to treatment of disease by chemicals that kill cells, specifically those of micro-organisms or cancer. ... Gemcitabine is a nucleoside used as chemotherapy. ... The United States Food and Drug Administration is the government agency responsible for regulating food, dietary supplements, drugs, cosmetics, medical devices, biologics and blood products in the United States. ... This article is about the economic and philosophical concept. ... This box:      In health care, a clinical trial is a comparison test of a medication or other medical treatment (such as a medical device), versus a placebo (inactive look-a-like), other medications or devices, or the standard medical treatment for a patients condition. ... Oxaliplatin is a platinum-based chemotherapy drug in the same family as cisplatin and carboplatin. ... Fluorouracil (5-FU) is a drug that is used in the treatment of cancer. ...


On the back of the results of a Canadian led Phase III Randomised Controlled trial involving 569 patients with advanced pancreatic cancer, the US FDA has licensed the use of erlotinib (Tarceva) in combination with gemcitabine as a palliative regimen for pancreatic cancer. This trial compared the action of gemcitabine/erlotinib vs gemcitabine/placebo and demonstrated improved survival rates, improved tumor response and improved progression-free survival rates. The survival improvement with the combination is on the order of less than four weeks, leading some cancer experts to question the incremental value of adding erlotinib to gemcitabine treatment. New trials are now investigating the effect of the above combination in the adjuvant and neoadjuvant setting.[14] A trial of anti-angiogenesis agent bevacizumab (Avastin) as an addition to chemotherapy has shown no improvement in survival of patients with advanced pancreatic cancer. It may cause higher rates of high blood pressure, bleeding in the stomach and intestine, and intestinal perforations. Erlotinib hydrochloride (trade name Tarceva, Genentech/OSIP, originally coded as OSI-774) is a drug used to treat non-small cell lung cancer, pancreatic cancer and several other types of cancer. ... Gemcitabine is a nucleoside used as chemotherapy. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... Erlotinib hydrochloride (trade name Tarceva, Genentech/OSIP, originally coded as OSI-774) is a drug used to treat non-small cell lung cancer, pancreatic cancer and several other types of cancer. ... Gemcitabine is a nucleoside used as chemotherapy. ... Bevacizumab (trade name Avastin) is a monoclonal antibody against vascular endothelial growth factor. ...


Ukrain is a semisynthetic combination of the herb greater celandine and the classic cancer drug ThioTepa. It was recently licensed as an orphan drug for the treatment of pancreatic cancer in the US and Australia after positive results in two small studies.[15][16] Ukraine (Україна, Ukrayina in Ukrainian; Украина in Russian) is a republic in eastern Europe which borders Russia to the east, Belarus to the north, Poland, Slovakia and Hungary to the west, Romania and Moldova to the southwest and the Black Sea to the south. ... Binomial name Chelidonium majus L. The greater celandine (Chelidonium majus) is a yellow-flowering poppy, native to Europe and the Mediterranean basin. ... The granting of the orphan drug status is designed to encourage the development of drugs which are necessary but would be prohibitively expensive/un-profitable to develop under normal circumstances. ...


Prognosis

Patients diagnosed with pancreatic cancer typically have a poor prognosis partly because the cancer usually causes no symptoms early on, leading to locally advanced or metastatic disease at time of diagnosis. Median survival from diagnosis is around 3 to 6 months; 5-year survival is much less than 5%.[17] With 37,170 cases diagnosed in the United States in 2007, and 33,700 deaths, pancreatic cancer has the highest fatality rate of all cancers and is the fourth highest cancer killer in the United States among both men and women.[18] Although it accounts for only 2.5% of new cases, pancreatic cancer is responsible for 6% of cancer deaths each year.[19] Prognosis (older Greek πρόγνωσις, modern Greek πρόγνωση - literally fore-knowing, foreseeing) is a medical term denoting the doctors prediction of how a patients disease will progress, and whether there is chance of recovery. ... Metastasis (Greek: change of the state) is the spread of cancer from its primary site to other places in the body. ...


Pancreatic cancer may occasionally result in diabetes. Insulin production is hampered and it has been suggested that the cancer can also prompt the onset of diabetes and vice versa.[20] For the disease characterized by excretion of large amounts of very dilute urine, see diabetes insipidus. ...


Prevention

According to the American Cancer Society, there are no established guidelines for preventing pancreatic cancer, although cigarette smoking is responsible for 20-30% of pancreatic cancers.[21] The American Cancer Society (ACS) is the nationwide community-based voluntary health organization dedicated to eliminating cancer as a major health problem by preventing cancer, saving lives, and diminishing suffering from cancer, through research, education, advocacy and service. ... The cigarette is the most common method of smoking tobacco. ...


The ACS recommends keeping a healthy weight, and increasing consumption of fruits, vegetables, and whole grains while decreasing red meat intake, although there is no consistent evidence that this will prevent or reduce pancratic cancer specifically.[22][23] In 2006 a large prospective cohort study of over 80,000 subjects failed to prove a definite association.[24] The evidence in support of this lies mostly in small case-control studies.


In September 2006, a long-term study concluded that taking Vitamin D can substantially cut the risk of pancreatic cancer (as well as other cancers) by up to 50%.[25][26][27] More studies of this have been called for. Vitamin D is a fat soluble vitamin that contributes to the maintenance of normal levels of calcium and phosphorus in the bloodstream. ...


Several studies, including one published June 1, 2007, indicate that B vitamins such as B12, B6, and folate, can reduce the risk of pancreatic cancer when consumed in food, but not when ingested in vitamin tablet form.[28][29] The B vitamins are eight water-soluble vitamins that play important roles in cell metabolism. ... Cobalamin or vitamin B12 is a chemical compound that is also known as cyanocobalamine. ... Pyridoxine Pyridoxal phosphate Vitamin B6 is a water-soluble vitamin. ... Folic acid (the anion form is called folate) is a B-complex vitamin (once called vitamin M) that is important in preventing neural tube defects (NTDs) in the developing human fetus. ...


Awareness

  • November is Pancreatic Cancer Awareness Month
  • Purple is the traditional color chosen to represent pancreatic cancer awareness.
  • The National Cancer Institute’s cancer research budget was $4.824 billion in 2004, an estimated $52.7 million of which was devoted to pancreatic cancer.[30]
  • Research spending per pancreatic cancer patient is $1145, the lowest of any leading cancer.[31]
  • For a list of celebrities who have succumbed to this disease, see Category:Pancreatic cancer deaths. For a list of survivors see Category:Pancreatic cancer survivors.
  • The Pancreatic Cancer Action Network (PanCAN) was created as an advocacy group for pancreatic cancer.

Awareness ribbons are short pieces of ribbon folded into a loop, or representations of such, which are used in the United States, Canada, Australia, UK and other parts of the world as a way for the wearer to make a subtle statement of support for a cause or issue. ... PanCAN is the Pancreatic Cancer Action Network. ...

References

  1. ^ a b c Ghaneh P, Costello E, Neoptolemos JP (2007). "Biology and management of pancreatic cancer". Gut 56 (8): 1134-52. doi:10.1136/gut.2006.103333. PMID 17625148. 
  2. ^ Carney CP, Jones L, Woolson RF, Noyes R Jr, Doebbeling BN. Relationship between depression and pancreatic cancer in the general population. Psychosom Med 2003;65:884-8. PMID 14508036.
  3. ^ ACS :: What Are the Risk Factors for Cancer of the Pancreas?. Retrieved on 2007-12-13.
  4. ^ What You Need To Know About Cancer of the Pancreas - National Cancer Institute. Retrieved on 2007-12-22.
  5. ^ Iodice S, Gandini S, Maisonneuve P, Lowenfels AB (2008). "Tobacco and the risk of pancreatic cancer: a review and meta-analysis". Langenbecks Arch Surg. doi:10.1007/s00423-007-0266-2. PMID 18193270. 
  6. ^ Red Meat May Be Linked to Pancreatic Cancer. Journal of the National Cancer Institute. WebMD (2005-10-05). Retrieved on 2008-03-05.
  7. ^ Obesity Linked to Pancreatic Cancer. American Cancer Society. Cancer Epidemiology, Biomarkers & Prevention (Vol. 14, No. 2: 459-466) (2005-03-06). Retrieved on 2008-03-05.
  8. ^ Efthimiou E, Crnogorac-Jurcevic T, Lemoine NR, Brentnall TA (Feb 2001). "Inherited predisposition to pancreatic cancer". Gut 48 (2): 143-7. doi:10.1136/gut.48.2.143. PMID 11156628. 
  9. ^ Michaud DS, Joshipura K, Giovannucci E, Fuchs CS (2007). "A prospective study of periodontal disease and pancreatic cancer in US male health professionals". J. Natl. Cancer Inst. 99 (2): 171-5. doi:10.1093/jnci/djk021. PMID 17228001. 
  10. ^ Bakkevold KE, Arnesjø B, Kambestad B (1992). "Carcinoma of the pancreas and papilla of Vater: presenting symptoms, signs, and diagnosis related to stage and tumour site. A prospective multicentre trial in 472 patients. Norwegian Pancreatic Cancer Trial". Scand. J. Gastroenterol. 27 (4): 317-25. doi:10.3109/00365529209000081. PMID 1589710. 
  11. ^ Pancreas (Pancreatic) Cancer
  12. ^ Neoptolemos JP, Stocken DD, Friess H, et al (2004). "A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer". N. Engl. J. Med. 350 (12): 1200-10. doi:10.1056/NEJMoa032295. PMID 15028824. 
  13. ^ Demols A, Peeters M, Polus M, et al (2006). "Gemcitabine and oxaliplatin (GEMOX) in gemcitabine refractory advanced pancreatic adenocarcinoma: a phase II study". Br. J. Cancer 94 (4): 481-5. doi:10.1038/sj.bjc.6602966. PMID 16434988. 
  14. ^ FDA approval briefing
  15. ^ Zemskov V, Prokopchuk O, Susak Y, et al (2002). "Efficacy of ukrain in the treatment of pancreatic cancer". Langenbecks Arch Surg 387 (2): 84-9. doi:10.1007/s00423-002-0293-y. PMID 12111260. 
  16. ^ Gansauge F, Ramadani M, Schwarz M, Beger HG, Lotspeich E, Poch B (2007). "The clinical efficacy of adjuvant systemic chemotherapy with gemcitabine and NSC-631570 in advanced pancreatic cancer". Hepatogastroenterology 54 (75): 917-20. PMID 17591092. 
  17. ^ WHO | Cancer
  18. ^ PanCAN - Working Together for a Cure™
  19. ^ Cancer Statistics, 2007 - Jemal et al. 57 (1): 43 - CA: A Cancer Journal for Clinicians
  20. ^ Molecular Cancer | Full text | The relationship between diabetes and pancreatic cancer
  21. ^ ACS :: Can Cancer of the Pancreas be Prevented?. Retrieved on 2007-12-13.
  22. ^ Coughlin, SS; Calle EE, Patel AV, Thun MJ. (2000 Dec). "Predictors of pancreatic cancer mortality among a large cohort of United States adults.". Cancer Causes Control. 11 (10): 915-23.. PMID 11142526. Retrieved on 2007-02-27. 
  23. ^ Zheng, W; et al (1993 Sep). "A cohort study of smoking, alcohol consumption, and dietary factors for pancreatic cancer (United States).". Cancer Causes Control. 4 (5): 477-82.. PMID 8218880. Retrieved on 2007-02-27. 
  24. ^ Larsson, Susanna; Niclas Håkansson, Ingmar Näslund, Leif Bergkvist and Alicja Wolk (February 2006). "Fruit and vegetable consumption in relation to pancreatic cancer risk: a prospective study.". Cancer Epidemiology Biomarkers & Prevention 15: 301-305. PMID 16492919. Retrieved on 2007-02-27. 
  25. ^ BBC NEWS | Health | Vitamin D 'slashes cancer risk'
  26. ^ Vitamin D May Cut Pancreatic Cancer
  27. ^ http://www.forbes.com/forbeslife/health/feeds/hscout/2006/09/14/hscout534925.html
  28. ^ Plasma Folate, Vitamin B6, Vitamin B12, and Homocysteine and Pancreatic Cancer Risk in Four Large Cohorts -- Schernhammer et al. 67 (11): 5553 -- Cancer Research. Retrieved on 2007-06-04.
  29. ^ United Press International - Consumer Health Daily - Briefing. Retrieved on 2007-06-04.
  30. ^ PanCAN - Working Together for a Cure™
  31. ^ PanCAN - Working Together for a Cure™

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Biliary tree (Cholangitis, Cholestasis/Mirizzi's syndrome, PSC, Biliary fistula, Ascending cholangitis) what was here was sick and improperly spelled. ... Gastroenterology (MeSH heading[2] ) is the branch of medicine where the digestive system and its disorders are studied. ... The esophagus or oesophagus (see American and British English spelling differences), sometimes known as the gullet, is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. ... Esophagitis (or Oesophagitis) is inflammation of the esophagus. ... Gastroesophageal Reflux Disease (GERD or GORD using the British Å“sophageal) is defined as chronic symptoms or mucosal damage produced by the abnormal reflux in the esophagus[1]. This is commonly due to transient or permanent changes in the barrier between the esophagus and the stomach. ... Achalasia, also known as esophageal achalasia, achalasia cardiae, cardiospasm, dyssynergia esophagus, and esophageal aperistalsis, is an esophageal motility disorder. ... Boerhaave syndrome (also called Boerhaaves syndrome) is rupture of the esophagus. ... Time space graph of normal peristalsis. ... In anatomy, Zenkers diverticulum is a diverticulum of the mucous membrane of the oesophagus through a defect in the wall of oesophagus. ... Mallory-Weiss Syndrome refers to bleeding from tears in the mucosa at the junction of the stomach and esophagus, usually caused by severe retching, coughing, or vomiting. ... Barretts esophagus (sometimes called Barretts syndrome, CELLO, columnar epithelium lined lower (o)esophagus or colloquially as Barretts) refers to an abnormal change (metaplasia) in the cells of the lower end of the esophagus thought to be caused by damage from chronic acid exposure, or reflux esophagitis. ... In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... In anatomy of the digestive system, the duodenum is a hollow jointed tube about 25-30 cm long connecting the stomach to the jejunum. ... A benign gastric ulcer (from the antrum) of a gastrectomy specimen. ... Gastritis is inflammation of the gastric mucosa. ... See also Bacterial gastroenteritis and Diarrhea Gastroenteritis is a general term referring to inflammation or infection of the gastrointestinal tract, primarily the stomach and intestines. ... Duodenitis is inflammation of the duodenum. ... Infantile pyloric stenosis is a pediatric condition where there is a congenital narrowing of the pylorus (the opening at the lower end of the stomach). ... Achlorhydria or hypochlorhydria is decreased production of gastric acid by the stomach. ... Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. ... In medicine, gastroptosis is the abnormal downward displacement of the stomach. ... Look up hernia in Wiktionary, the free dictionary. ... Inguinal hernias are protrusions of abdominal cavity contents through an area of the abdominal wall, commonly referred to as the groin, and known in anatomic language as the inguinal area or the myopectineal orifice. ... An indirect inguinal hernia a inguinal hernia which results from the failure of embryonic closure of the internal inguinal ring after the testicle has passed through it. ... Inguinal hernias are the most common abdominal hernias (about 90%) and are seen most often in men. ... Femoral hernias occur just below the inguinal ligament, when abdominal contents pass into the weak area at the posterior wall of the femoral canal. ... Umbilical hernia is a congenital malformation, especially common in infants of African descent, and more frequent in boys. ... This article or section is in need of attention from an expert on the subject. ... Congenital diaphragmatic hernia (CDH) is a term applied to a variety of congenital birth defects that involve abnormal development of the diaphragm. ... A hiatus hernia or hiatal hernia is the protrusion (or herniation) of the upper part of the stomach into the thorax through a tear or weakness in the diaphragm. ... Enteritis is the inflammation of the small intestine (inflammation of the large intestine is termed colitis). ... Colitis is a digestive disease characterized by inflammation of the colon. ... In medicine, inflammatory bowel disease (IBD) is a group of inflammatory conditions of the large intestine and, in some cases, the small intestine. ... Crohns disease (also known as regional enteritis) is a chronic, episodic, inflammatory bowel disease (IBD) and is generally classified as an autoimmune disease. ... Ulcerative colitis (Colitis ulcerosa, UC) is a form of inflammatory bowel disease (IBD). ... See also Bacterial gastroenteritis and Diarrhea Gastroenteritis is a general term referring to inflammation or infection of the gastrointestinal tract, primarily the stomach and intestines. ... Abdominal angina (a. ... This page may meet Wikipedias criteria for speedy deletion. ... Ischemic colitis is inflammation of the intestine (colitis) caused by inadequate blood supply (ischemia) to meet the metabolic demands. ... An angiodysplasia in the colon being treated with argon plasma coagulation administered via probe through the colonoscope. ... Ileus, formerly called iliac passion, refers to limited or absent intestinal passage. ... Bowel obstruction is a mechanical blockage of the intestines, preventing the normal transit of the products of digestion. ... An intussusception is a situation in which a part of the intestine has prolapsed into another section of intestine, similar to the way in which the parts of a collapsible telescope slide into one another. ... A volvulus is a loop of the bowel whose nose has twisted on itself. ... Diverticulitis is a common digestive disorder particularly found in the large intestine. ... Diverticulosis, otherwise known as diverticular disease, is the condition of having diverticula in the large colon which are outpocketings of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall. ... Constipation or irregularity, is a condition of the digestive system where a person (or animal) experiences hard feces that are difficult to egest; it may be extremely painful, and in severe cases (fecal impaction) lead to symptoms of bowel obstruction. ... In medicine, diarrhea, also spelled diarrhoea (see spelling differences), refers to frequent loose or liquid bowel movements. ... Megacolon is an abnormal dilatation of the colon (a part of the large intestines) that is not caused by mechanical obstruction. ... Toxic megacolon (megacolon toxicum) is a life-threatening complication of other intestinal conditions. ... The term Proctalgia fugax refers to fleeting rectal pain. ... An anal fissure is an unnatural crack or tear in the anus skin. ... An anal fistula is an abnormal infection that grows a second head between the epithelialised surface of the anal canal and (usually) the perianal skin. ... An anal abscess is a abscess adjacent to the anus, characterized by extremely painful bowel movements. ... Rectal prolapse normally describes a medical condition wherein the walls of the rectum protrude through the anus and hence become visible outside the body. ... Proctitis (Noun) Inflammation of the rectum. ... Radiation proctitis (and the related radiation colitis) is inflammation and damage to the lower parts of the colon after exposure to x-rays or other ionizing radiation as a part of radiation therapy. ... The liver is the largest internal organ in the human body, and is an organ present in vertebrates and some other animals. ... Hepatitis (plural hepatitides) implies injury to liver characterised by presence of inflammatory cells in the liver tissue. ... Liver failure is the final stage of liver disease. ... Acute liver failure is the appearance of severe complications rapidly after the first signs of liver disease (such as jaundice), and indicates that the liver has sustained severe damage (loss of function of 80-90% of liver cells). ... Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ... This article or section does not cite its references or sources. ... In medicine (gastroenterology), hepatitis is any disease featuring inflammation of the liver. ... Non-alcoholic fatty liver disease (NAFLD) is fatty inflammation of the liver when this is not due to excessive alcohol use. ... Different stages of liver damage Fatty liver (also known as steatorrhoeic hepatosis or steatosis hepatis) is a reversible condition where large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis. ... Peliosis Hepatis is an uncommon vascular condition characterised by randomly distributed multiple blood-filled cavities throughout liver. ... In medicine, portal hypertension is hypertension (high blood pressure) in the portal vein and its branches. ... Hepatorenal syndrome (HRS), also called hepatorenal failure, refers to acute renal failure that occurs in the setting of cirrhosis or fulminant liver failure associated with portal hypertension, usually in the absence of other disease of the kidney. ... The gallbladder (or cholecyst, sometimes gall bladder) is a pear-shaped organ that can accomodate up to 60 ml of bile (or gall) until the body needs it for digestion. ... This article does not cite any references or sources. ... Choledocholithiasis is the presence of a gallstone in the common bile duct. ... Cholecystitis is inflammation of the gall bladder. ... In surgical pathology, strawberry gallbladder, more formally cholesterolosis of the gallbladder and gallbladder cholesterolosis, is a change in the gallbladder wall due to excess cholesterol/cholesterol gallstones. ... Rokitansky-Aschoff sinuses are diverticula or pockets of the gallbladder They are not of themselves considered abnormal, but they can be associated with cholecystitis. ... A bile duct is any of a number of long tube-like structures that carry bile. ... Cholangitis is one of a number of problems associated with the bile duct. ... In medicine, cholestasis is a condition where bile cannot flow from the liver to the duodenum. ... Mirizzis syndrome is a rare cause of acquired jaundice. ... Primary sclerosing cholangitis (PSC) is a form of cholangitis due to an autoimmune reaction. ... A biliary fistula, a type of fistula where bile leaks from the bile ducts into outside areas, can occur as a complication following biliary trauma, either iatrogenic or a result of a penetrating injury. ... Cholangitis redirects here. ...

Pancreas (Acute pancreatitis, Chronic pancreatitis, Pancreatic pseudocyst, Hereditary pancreatitis)
Other/general