PANCREATIC CARCINOMA
Overviews:
- Pancreatic Cancer: a comprehensive review - http://www.emedicine.com/med/topic1712.htm
- Medline Plus: Pancreatic carcinoma: a brief review - http://www.nlm.nih.gov/medlineplus/ency/article/000236.htm
- Pancreatic Cancer: radiological perspective - http://www.emedicine.com/radio/topic516.htm
- Neoplasms of the Endocrine Pancreas: a comprehensive review - http://www.emedicine.com/med/topic272.htm
- Ampullary Carcinoma: a comprehensive review - http://www.emedicine.com/med/topic123.htm
- Pancreatic Mucinous Cystic Neoplasm: radiological perspective - http://www.emedicine.com/radio/topic518.htm
- Chronic Pancreatitis: a comprehensive review - http://www.emedicine.com/med/topic1721.ht
- Society for Surgery of the Alimentary Tract (SSAT): Surgical Treatment of Pancreatic Cancer - http://www.guideline.gov/summary/summary.aspx?doc_id=5510&nbr=003753&string=ERCP
- NICE Guideline: Pancreatic Cancer and Gemcitabine - http://www.nice.org.uk/page.aspx?o=TA025guidance
Measures:
Lab Studies:
- American Association of Clinical Chemistry: Liver Function Tests (LFT's): An obstructive jaundice picture with elevated bilirubin, alkaline phosphatase and GGT may be seen. Aminotransferases may be minimally raised - http://www.labtestsonline.org/understanding/analytes/liver_panel/glance.html
- American Association of Clinical Chemistry: Gamma-glutamyl transferase (GGT): In case of raised alkaline phosphatase level, GGT level is asked to differentiate between the hepatic or bone origin of alkaline phosphatase - http://www.labtestsonline.org/understanding/analytes/ggt/glance.html
- American Association of Clinical Chemistry: Albumin: Hypoalbuminemia may be found indicative of malnourishment - http://www.labtestsonline.org/understanding/analytes/albumin/glance.html
- American Association of Clinical Chemistry: Total Cholesterol: Low cholesterol levels indicative of malnourishment may be found - http://www.labtestsonline.org/understanding/analytes/cholesterol/glance.html
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American Association of Clinical Chemistry:
Complete Blood Count (CBC): As with many chronic ailments, normochromic normocytic anaemia may be found - -
http://www.labtestsonline.org/understanding/analytes/cbc/glance.html - American Association of Clinical Chemistry:
Platelet Count: Thrombocytosis may be observed - http://www.labtestsonline.org/understanding/analytes/platelet/glance.html -
American Association of Clinical Chemistry:
Amylase: Usually 'not' raised unless patient develops acute pancreatitis secondary to pancreatic carcinoma - -
http://www.labtestsonline.org/understanding/analytes/amylase/glance.html -
American Association of Clinical Chemistry:
Lipase: Usually 'not' raised unless patient develops acute pancreatitis secondary to pancreatic carcinoma - -
http://www.labtestsonline.org/understanding/analytes/lipase/glance.html
Additional Lab Studies in a suspected case of neoplasm of the endocrine pancreas:
- American Association of Clinical Chemistry: Fasting blood sugar - http://labtestsonline.org/understanding/analytes/glucose/glance.html
- American Association of Clinical Chemistry:
Insulin - http://labtestsonline.org/understanding/analytes/insulin/glance.html - American Association of Clinical Chemistry: Insulin C-peptide - http://labtestsonline.org/understanding/analytes/c_peptide/glance.html
- Medline Plus: Gastrin - http://www.nlm.nih.gov/medlineplus/ency/article/003697.htm
- Medline Plus: Secretin stimulation test - http://www.nlm.nih.gov/medlineplus/ency/article/003892.htm
- Medline Plus: Vasoactive intestinal polypeptide (VIP) test - http://www.nlm.nih.gov/medlineplus/ency/article/003508.htm
- American Association of Clinical Chemistry:
Electrolytes - http://www.labtestsonline.org/understanding/analytes/electrolytes/glance.html - Medline Plus: Serum Glucagon Test - http://www.nlm.nih.gov/medlineplus/ency/article/003716.htm
Tumour Markers:
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American Association of Clinical Chemistry: Cancer Antigen 19-9 (CA 19-9): Chemically, it is a sialylated oligosaccharide. In cancer patients, it is most often found on circulating mucins. It is normally found in the biliary tract cells and thus its levels can be found raised in patients with acute or chronic biliary disease. If investigations confirm absence of biliary disease, a CA 19-9 value of >100U/mL is highly suggestive of pancreatic malignancy - http://www.labtestsonline.org/understanding/analytes/ca19_9/glance.html
- American Association of Clinical Chemistry: Carcinoembryonic Antigen (CEA): It is quite non-specific. Elevated levels can be found in many malignancies like colorectal, lung, breast, thyroid, pancreatic, liver, cervix, and bladder. Its levels are found raised in non-cancerous conditions as well like hepatitis, COPD, colitis, pancreatitis, and in cigarette smokers - http://www.labtestsonline.org/understanding/analytes/cea/glance.html
Imaging Studies:
Computed Tomography (CT) of the Abdomen and Pelvis:
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ACR Practice Guideline for the performance of Computed Tomography (CT) of the Abdomen and Computed Tomography (CT) of the Pelvis - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=12200&CID=547&VID=2&DOC=File.PDF
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ACR Technical Standard for Diagnostic Medical Physics Performance Monitoring of Computed Tomography (CT) Equipment - http://www.acr.org/s_acr/bin.asp?CID=1073&DID=12201&DOC=FILE.P
Transcutaneous Ultrasonography:
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ACR Practice Guideline for the Performance of an Ultrasound Examination of the Abdomen or Retroperitoneum - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=12175&CID=539&VID=2&DOC=File.PDF
Endoscopic Ultrasound:
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American Society for Gastrointestinal Endoscopy: Endoscopic Ultrasound - http://www.askasge.org/pages/procedures/eus/understanding.cfm
ERCP (Endoscopic Retrograde Cholangiopancreatography):
- American Society for Gastrointestinal Endoscopy (ASGE) Guidelines: Role of endoscopy in the evaluation and treatment of patients with pancreaticobiliary malignancy - http://www.guideline.gov/summary/summary.aspx?doc_id=5689&nbr=003827&string=ERCP
- National Institutes of Health (NIH) Consensus Development Panel on Endoscopic Retrograde Cholangiopancreatography (ERCP) for Diagnosis and Therapy - http://www.guideline.gov/summary/summary.aspx?doc_id=6110&nbr=003965&string=ERCP
- American Society for Gastrointestinal Endoscopy (ASGE) Guidelines: The role of ERCP in the diseases of the biliary tract and the pancreas - http://www.guideline.gov/summary/summary.aspx?doc_id=7781&nbr=004486&string=ERCP
Magnetic Resonance Imaging (MRI):
- ACR Practice Guideline for the Performance of Magnetic Resonance Imaging (MRI) of the Abdomen (excluding the Liver) - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=22489&CID=547&VID=2&DOC=File.PDF
- ACR Practice Guideline for the Performance of Magnetic Resonance Imaging (MRI) of the Liver - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=22487&CID=547&VID=2&DOC=File.PDF
FDG-PET Scintigraphy:
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ACR Practice Guideline for the Performance of FDG-PET Scintigraphy in Oncology - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=12222&CID=1074&VID=2&DOC=File.PDF
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ACR Practice Guideline for the Performance of Tumour Scintigraphy (with Gamma Cameras) - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=12297&CID=1074&VID=2&DOC=File.PDF
Bone Scan:
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ACR Practice Guideline for the Performance of Adult and Paediatric Skeletal Scintigraphy - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=12285&CID=1074&VID=2&DOC=File.PDF
Diagnostic Laparoscopy:
- Society of American Gastrointestinal Endoscopic Surgeons (SAGES) guidelines for diagnostic laparoscopy - http://www.guideline.gov/summary/summary.aspx?doc_id=4116&nbr=003161&string=laparoscopy
Pancreatic Cancer Screening:
- United States Preventive Services Task Force (USPSTF) - Independent Expert Panel: Screening for pancreatic cancer: recommendation statement - http://www.guideline.gov/summary/summary.aspx?doc_id=4790&nbr=003468&string=pancreatic+AND+cancer
Statistics:
- US National Cancer Institute: A snap shot of pancreatic cancer - http://planning.cancer.gov/disease/Pancreatic-Snapshot.pdf
Questionnaire:
- Harvard Centre for Cancer Prevention: Questionnaire for Pancreatic Cancer - http://www.yourdiseaserisk.harvard.edu/hccpquiz.pl?lang=english&func=home&quiz=pancreatic
Document Provenance and History
Document Author: Dr. Fazal Danish
Document Created: 8th May 2006
Document Edits: