Pancreatic Cancer

Pancreatic cancer is the tenth most common cancer in the UK and the fifth leading cause of cancer death (UK). According to the Office for National Statistics, there were 8085 new cases and 7781 deaths in 2008, highlighting its extremely poor prognosis. The average-size GP practice is likely to see at least one case of pancreatic cancer per year. Currently, only 13% of cases are diagnosed through the 2 week wait referral pathway, with 47% presenting as hospital emergencies. Delay in diagnosis can be multifactorial. Early symptoms tend to be non-specific and signs and symptoms such as painless jaundice and weight loss do not present until late stages. Early recognition by the GP is crucial as surgical resection offers the best chance of survival. GPs also play a crucial role in providing palliative care in patients who have unresectable disease.

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Pancreatic cancer

InnovAiT Education and inspiration for general practice ◽

10.1177/1755738019855101 ◽

2019 ◽

Vol 12 (9) ◽

pp. 492-496

Author(s):

Matthew C M Mortimer ◽

Jessica L Ovens

Keyword(s):

Pancreatic Cancer ◽

Palliative Care ◽

Early Recognition ◽

Early Stage ◽

Survival Rates ◽

Cancer Death ◽

Common Cause ◽

Common Cancer ◽

The Uk

Pancreatic cancer is the eleventh most common cancer in the UK, yet it is the fifth most common cause of cancer death. In the UK, the age-standardised incidence has risen by 11% over the last decade. The symptoms are often vague, and as a result, it rarely presents at an early stage. Prognosis is determined by stage at presentation, therefore prompt recognition and referral of suspicious symptoms is vital. Survival rates remain poor, with just a 3% rate of 5-year survival. GPs therefore have an important role in both the early recognition and palliative care of patients with pancreatic cancer.

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Haemophagocytic Lymphohistiocytosis: A Case Report and Short Overview

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v10i1.38905 ◽

2018 ◽

Vol 10 (1) ◽

pp. 51-58

Author(s):

Md Amzad Hossain ◽

Tahmina Akther ◽

Md Amran Sarker ◽

Arunava Paul ◽

Tanzina Zannat ◽

...

Keyword(s):

T Lymphocytes ◽

Early Recognition ◽

Age Groups ◽

Signs And Symptoms ◽

Organ Damage ◽

Clinical Syndrome ◽

Laboratory Findings ◽

Delay In Diagnosis ◽

Clinical Presentations ◽

Clinical Conditions

Haemophogocyticlymphohistiocytosis (HLH) is a rare but potentially fatal disease, which describes a clinical syndrome of hyper-inflammation resulting in uncontrolled and ineffective immune response. It appears commonly in infancy, although it has been seen in all age groups. A vast majority of cases are acquired due to secondary causes (infections, autoimmune, malignancy, metabolic disorders) but primary HLH (genetic) is also not uncommon which also gets triggered by infection as suggested by recent studies. “Hypercytokinemia” which is the hallmark of HLH can result in end organ damage and even death in some cases if there is delay in diagnosis. The pathological hallmark of this syndrome is uncontrolled activation of T lymphocytes and macrophages, together with an impaired cytotoxic function of NK cells and CD8+T lymphocytes resulting into massive cytokine release (e.g. interferon-ã, TNF-á, Interleukin-6, 8, 10, 12, 18) from this cells and overwhelming inflammation. Lymphocytes and macrophages sometimes with haemophagocytic activity accumulate in bone marrow, spleen, liver or lymph nodes. This disorder is characterized by fever, hepatosplenomegaly, lymphadenopathy, skin rash, cytopenias, hepatitis, coagulopathy, and neurological symptoms. We report a case of 55 yr. old male presenting with fever and high colored urine who developed clinical and laboratory findings consistent with diagnosis of HLH according to HLH-2004 guidelines. Unfortunately the patient died despite receiving chemotherapy. HLH has multifaceted clinical presentations with often non-specific signs and symptoms that are often found in other clinical conditions. Early recognition of HLH is critical in initiating therapy early and preventing high mortality resulting from multi-organ failure.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 51-58

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Kawasaki Shock Syndrome with Initial Presentation as Neck lymphadenitis: A Case Report

Children ◽

10.3390/children9010056 ◽

2022 ◽

Vol 9 (1) ◽

pp. 56

Author(s):

Yi-Ting Cheng ◽

Yu-Shin Lee ◽

Jainn-Jim Lin ◽

Hung-Tao Chung ◽

Yhu-Chering Huang ◽

...

Keyword(s):

Coronary Artery ◽

Early Recognition ◽

Systemic Vasculitis ◽

Pediatric Population ◽

Signs And Symptoms ◽

Initial Presentation ◽

Small Subset ◽

Cervical Lymphadenitis ◽

Initial Manifestation ◽

Delay In Diagnosis

Kawasaki disease (KD) is an acute systemic vasculitis of unknown cause that mainly affects infants and children and can result in coronary artery complications if left untreated. A small subset of KD patients with fever and cervical lymphadenitis has been reported as node-first-presenting KD (NFKD). This type of KD commonly affects the older pediatric population with a more intense inflammatory process. Considering its unusual initial presentation, a delay in diagnosis and treatment increases the risk of coronary artery complications. Herein, we report the case of a 9-year-old female with fever and neck mass that rapidly deteriorated to shock status. A diagnosis of KD was made after the signs and symptoms fulfilled the principal diagnostic criteria. The patient’s heart failure and blood pressure improved dramatically after a single dose of intravenous immunoglobulin. This case reminds us that NFKD could be the initial manifestation of KDSS, which is a potentially fatal condition. We review the literature to identify the overlapping characteristics of NFKD and KDSS, and to highlight the importance of early recognition of atypical KD regardless of age. We conclude that unusually high C-reactive protein, neutrophilia, and thrombocytopenia serve as supplemental laboratory indicators for early identification of KDSS in patients with NFKD.

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Bridging clinic: The initial medical management of patients with newly diagnosed pancreatic cancer

Frontline Gastroenterology ◽

10.1136/flgastro-2018-101002 ◽

2018 ◽

Vol 10 (3) ◽

pp. 261-268 ◽

Cited By ~ 1

Author(s):

Loveena Sreedharan ◽

Bhaskar Kumar ◽

Anna Jewell ◽

Paul Banim ◽

Andreas Koulouris ◽

...

Keyword(s):

Pancreatic Cancer ◽

Nurse Practitioners ◽

Healthcare Professionals ◽

Well Being ◽

Cancer Treatments ◽

Common Cancer ◽

Time Period ◽

Management Of Complications ◽

Poor Nutritional Status ◽

The Uk

Pancreatic cancer is the 11th most common cancer in the UK and has the worst prognosis of any tumour with minimal improvements in survival over recent decades. As most patients are either ineligible for surgery or may decline chemotherapy, the emphasis is on control of symptoms and management of complications such as poor nutritional status. The time period between informing the patient of their diagnosis and commencing cancer treatments presents a valuable opportunity to proactively identify and treat symptoms to optimise patients’ overall well-being. The ‘bridging clinic’, delivered by a range of healthcare professionals from gastroenterologists to nurse practitioners, can provide this interface where patients are first informed of their diagnosis and second supportive therapies offered. In this article, we provide a structure for instituting such supportive therapies at the bridging clinic. The components of the clinic are summarised using the mnemonic INDASH (Information/Nutrition/Diabetes and Depression/Analgesia/Stenting/Hereditary) and each is discussed in detail below.

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The Revolutionary Roads to Study Cell–Cell Interactions in 3D In Vitro Pancreatic Cancer Models

Cancers ◽

10.3390/cancers13040930 ◽

2021 ◽

Vol 13 (4) ◽

pp. 930

Author(s):

Donatella Delle Cave ◽

Riccardo Rizzo ◽

Bruno Sainz ◽

Giuseppe Gigli ◽

Loretta L. del Mercato ◽

...

Keyword(s):

Pancreatic Cancer ◽

Therapeutic Response ◽

Three Dimensional ◽

Cellular Models ◽

Common Cancer ◽

Cancer Models ◽

Anti Cancer ◽

Tumor Environment

Pancreatic cancer, the fourth most common cancer worldwide, shows a highly unsuccessful therapeutic response. In the last 10 years, neither important advancements nor new therapeutic strategies have significantly impacted patient survival, highlighting the need to pursue new avenues for drug development discovery and design. Advanced cellular models, resembling as much as possible the original in vivo tumor environment, may be more successful in predicting the efficacy of future anti-cancer candidates in clinical trials. In this review, we discuss novel bioengineered platforms for anticancer drug discovery in pancreatic cancer, from traditional two-dimensional models to innovative three-dimensional ones.

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Traditional and Novel Adiposity Indicators and Pancreatic Cancer Risk: Findings from the UK Women’s Cohort Study

Cancers ◽

10.3390/cancers13051036 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1036

Author(s):

Sangeetha Shyam ◽

Darren Greenwood ◽

Chun-Wai Mai ◽

Seok Shin Tan ◽

Barakatun Nisak Mohd Yusof ◽

...

Keyword(s):

Pancreatic Cancer ◽

Cohort Study ◽

Cancer Risk ◽

Reverse Causality ◽

Hip Circumference ◽

Primary Analysis ◽

Pancreatic Cancer Risk ◽

Obesity Indices ◽

The Uk

(1) Background: We studied the association of both conventional (BMI, waist and hip circumference and waist–hip ratio) and novel (UK clothing sizes) obesity indices with pancreatic cancer risk in the UK women’s cohort study (UKWCS). (2) Methods: The UKWCS recruited 35,792 women from England, Wales and Scotland from 1995 to 1998. Cancer diagnosis and death information were obtained from the National Health Service (NHS) Central Register. Cox’s proportional hazards regression was used to evaluate the association between baseline obesity indicators and pancreatic cancer risk. (3) Results: This analysis included 35,364 participants with a median follow-up of 19.3 years. During the 654,566 person-years follow up, there were 136 incident pancreatic cancer cases. After adjustments for age, smoking, education and physical activity, each centimetre increase in hip circumference (HR: 1.03, 95% CI: 1.01–1.05, p = 0.009) and each size increase in skirt size (HR: 1.12, 95% CI: 1.02–1.23, p = 0.041) at baseline increased pancreatic cancer risk. Baseline BMI became a significant predictor of pancreatic cancer risk (HR: 1.04, 95% CI: 1.00–1.08, p = 0.050) when latent pancreatic cancer cases were removed. Only baseline hip circumference was associated with pancreatic cancer risk (HR: 1.03, 95% CI: 1.00–1.05, p = 0.017) when participants with diabetes at baseline were excluded to control for reverse causality. (4) Conclusion: Hip circumference and skirt size were significant predictors of pancreatic cancer risk in the primary analysis. Thus, hip circumference is useful to assess body shape relationships. Additionally, standard skirt sizes offer an economical and objective alternative to conventional obesity indices for evaluating pancreatic cancer risk in women.

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Laryngeal cancer

InnovAiT Education and inspiration for general practice ◽

10.1177/17557380211010564 ◽

2021 ◽

pp. 175573802110105

Author(s):

Kelvin Miu

Keyword(s):

Head And Neck Cancer ◽

Early Diagnosis ◽

Head And Neck ◽

Patient Outcomes ◽

Laryngeal Cancer ◽

Neck Cancer ◽

Early Recognition ◽

Signs And Symptoms ◽

Diagnosis And Treatment

Laryngeal cancer is a common head and neck cancer and typically presents with voice hoarseness in patients older than 60 years. Early recognition of signs and symptoms of laryngeal cancer can lead to early diagnosis and treatment, therefore improving patient outcomes. This article aims to provide an overview of the anatomy of the larynx, presentation and management of laryngeal cancer, and common follow-up problems.

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Recognition and management of neonatal sepsis

British Journal of Nursing ◽

10.12968/bjon.2021.30.7.410 ◽

2021 ◽

Vol 30 (7) ◽

pp. 410-415

Author(s):

Luke William Crocker ◽

Ayesha White ◽

Paul Anthony Heaton ◽

Débora Pascoal Horta ◽

Siba Prosad Paul

Keyword(s):

Neonatal Sepsis ◽

Early Recognition ◽

Signs And Symptoms ◽

Evidence Based ◽

Suspected Sepsis ◽

Serious Illness ◽

Prompt Treatment ◽

Serious Infection ◽

Common Causes ◽

Red Flag

Neonatal sepsis results from acute bacterial or viral infection occurring in the first 28 days of life. It causes significant morbidity and mortality, although the outcome can be improved by early recognition and prompt treatment by health professionals. This article describes the most common causes of sepsis, and explains why neonates are particularly vulnerable to infection. It highlights the non-specific way in which an infant with a serious infection may present, indicating the crucial features to elicit during history taking and examination, and emphasising the ‘red-flag’ signs and symptoms that should increase suspicion of a serious illness. The authors have adapted National Institute for Health and Care Excellence guidelines to produce an evidence-based approach to the management of an infant with suspected sepsis, and describe the roles of nurses in ensuring effective treatment and best outcomes for these babies.

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