Chemotherapy Can Extend a Patient's Life Who Has Rare Pancreatic Cancer

When a patient has pancreatic cancer most will do what it take to extend their life.  There is a rare pancreatic  cancer called periampullary adenocarcinoma in which chemotherapy will increase the patient's life span.

Ampullary cancer is a malignant tumor that arises from the Ampulla of Vater, the last centimeter of the common bile duct as it passes through the duodenum, the first section of the intestine. All pancreatic and biliary secretions enter the duodenum through the Ampulla of Vater.

A tumor blocking  the Ampulla of Vater will interfere with drainage of the pancreatic and biliary secretions into the intestine. Jaundice results when the drainage of bile into the duodenum is blocked causing it to accumulate in in the bloodstream. Jaundice, the yellowing of the skin, is typically one of the first symptoms present with Ampullary cancer.

The diagnostic tests used to for ampullary cancer  are similar to those for pancreatic cancer; endoscopy or endoscopic retrograde cholangiopancreatography (ERCP) are frequently used to make the diagnosis. 

                        Histology of Periampullay adenocarcinoma

Patients with periampullary cancer who received chemotherapy and surgery lived longer than patients who did not receive the chemotherapy.

This is the finding of a large multi-center research effort that was published in the July 11 issue of JAMA (Journal of the American Medical Association).

This an important large international multi-center study showing the benefit of chemotherapy after surgical resection of a specific type ofperiampullary cancer," James Farrell, MD, director of the University of California Los Angeles Medical Center Endoscopic Ultrasound Division of Digestive Diseases, told dailyRx in an email,

"It supports the use of adjuvant treatment with gemcitabine for this group of patients," Dr. Farrell said.

Additional study is needed to learn more about this treatment option. "There were different survival outcomes by tumor type, although age, poorly differentiated tumor grade, and lymph node involvement were also independent survival factors,” the authors write.

What to Expect During Chemotherapy Treatments

The following video does an excellent job of explaining your journey as a patient with cancer that requires chemotherapy treatment. Watching this tutorial will greatly reduce the anxiety of a patient's first infusion.

                                            Chemotherapy at Norris Memorial Cancer Center

Please share this article with anyone you know that has been diagnosed with cancer and has been prescribed chemotherapy for treatment of killing cancer cells.

When Does A Patient Need A Stem Cell Transplant?

Let's first give a definition of a stem cell.
Stem cells have the remarkable potential to develop into many different cell types in the body during early life and growth. In addition, in many tissues they serve as a sort of internal repair system, dividing essentially without limit to replenish other cells as long as the person or animal is still alive. When a stem cell divides, each new cell has the potential either to remain a stem cell or become another type of cell with a more specialized function, such as a muscle cell, a red blood cell, or a brain cell.
Stem cells are distinguished from other cell types by two important characteristics. First, they are unspecialized cells capable of renewing themselves through cell division, sometimes after long periods of inactivity. Second, under certain physiologic or experimental conditions, they can be induced to become tissue- or organ-specific cells with special functions. In some organs, such as the gut and bone marrow, stem cells regularly divide to repair and replace worn out or damaged tissues. In other organs, however, such as the pancreas and the heart, stem cells only divide under special conditions.

 
A stem cell transplant is the infusion of healthy stem cells into your body. A stem cell transplant may be necessary if your bone marrow stops working and doesn't produce enough healthy stem cells. A stem cell transplant can help your body make enough healthy white blood cells, red blood cells or platelets, and reduce your risk of life-threatening infections, anemia and bleeding.
Although the procedure to replenish your body's supply of healthy blood-forming cells is generally called a stem cell transplant, it's also known as a bone marrow transplant or an umbilical cord blood transplant, depending on the source of the stem cells. Stem cell transplants can use cells from your own body (autologous stem cell transplant), or they can use stem cells from donors (allogenic stem cell transplant).

• Bone marrow transplantation and peripheral blood stem cell transplantation are procedures that restore stem cells that were destroyed by high doses of chemotherapy and/or radiation therapy.
• After being treated with high-dose anticancer drugs and/or radiation, the patient receives the harvested stem cells, which travel to the bone marrow and begin to produce new blood cells.
• A “mini-transplant” uses lower, less toxic doses of chemotherapy and/or radiation to prepare the patient for transplant.
• A “tandem transplant” involves two sequential courses of high-dose chemotherapy and stem cell transplant.
• The National Marrow Donor Program® maintains an international registry of volunteer stem cell donors.

Other Reasons For Bone Marrow Transplants

• Replace dysfunctional bone marrow. For instance, in aplastic anemia, a noncancerous condition, your bone marrow doesn't make enough new blood cells. A stem cell transplant procedure first destroys the dysfunctional marrow with powerful drugs or radiation, and then healthy stem cells are infused. If all goes well, the new stem cells migrate to the marrow and begin working normally.
• Destroy unhealthy bone marrow that may contain cancer cells. In the case of cancer, such as leukemia, a stem cell transplant procedure may first help rid the bone marrow of cancer cells. When healthy stem cells are then transplanted, normal cell production can resume. In addition, immune factors in the transplanted cells may help destroy any cancer cells that remain in your bone marrow.
•  For more information about stem cells :  www.mayoclinic.com 

http://stemcells.nih.gov  or  http://www.cancer.gov/cancertopics/factsheet/Therapy/bone-marrow-transplant

Pancreatic Cancer Chemotherapy

John Chabot, MD, chief, division of GI/Endocrine Surgery, executive director, Pancreas Center at New York-Presbyterian Hospital, Columbia University Medical Center, New York, NY, discusses the current chemotherapy options available to treat pancreatic cancer. The main drug available is gemcitabine
and is currently used in combination therapies.

There are currently trials underway that are demonstrating improved survival with aggressive chemotherapy. Nongemcitabine regiment was identified that proved to be a better treatment option for stage IV pancreatic cancer than gemcitabine. Chabot expects that drugs that are used in other types of cancer will show the most significant improvement in the future.

Chemotherapy and Lab Testing

During a patient's chemotherapy treatments routine blood draws for lab testing are important. Chemotherapy drugs can affect your blood cell counts and organs of your body .  This can be monitored through the results of the lab test that are ordered.  A Complete Blood Count is very important as to monitor low white cell counts, platelet counts, red cell counts and low hemoglobin. When a CBC is ordered before a next chemo treatment they are looking for changes in all blood counts. The nurse will look at the ANC which stand for the Absolute Neutrophil Count.

Since chemotherapy attacks the fast growing cells, the normal tissues with high growth rate suffer the major brunt of attack of the chemotherapy drugs. These include the fast growing cells of the bone marrow, oral mucus membrane and lining of the stomach and intestine. This may subsequently lead to low blood counts, mouth soars, diarrhea, and abdominal upset. White blood cells are the guardian defense system of your body, and when the white cell count decrease due to the chemotherapy; you may be at great risk of an infection. Also when your body defense system is low due to low white cell count, once you get an infection it could be overwhelming.

Physicians usually calculate the absolute neutrophil count (ANC) from your regular blood count to determine the risk of infection. ANC is calculated by multiplying the total white cell count by the percentage of neutrophils and then dividing by 100. For example if your total white cell count is 4,000 and neutrophil percentage is 50 then your ANC is 2000 x 50 divided by 100 and equals 1000. If your white cell count is 8000 but neutrophil percentage is 25 then the ANC is again 1000. If your ANC is 500 to 1000 you have slightly increased risk of getting infections. If ANC is 300 to 500 you are at moderate risk of getting infections. If the ANC is less than 300 then you are at high risk of getting infections. Infection can come from out side or from your own body (example gut).

Some other blood tests that the physician may order during cycles of chemotherapy are a Complete Metabolic Panel and a Magnesium level.
A typical CMP-16 will specifically measure the levels of Glucose, Waste Products ( Blood Urea Nitrogen, Creatinine, Uric Acid, & the Glom Filtration Rate), Electrolytes (Sodium & Potassium Chloride), Minerals (Calcium & Phosphorus), Blood Fats (Cholesterol & Triglycerides), Proteins (Albumin, Globulin, & Total Protein), Enzymes (Total Bilirubin, Alkaline Phosphatase, GGTP, LDH, & SGOT (AST)).
cThe glucose checks your pancreas function.  Blood Urea Nitrogen and creatinine levels relate to kidney function.  Protein levels are important in liver and kidney damage.  Finally bilirubin and the enzyme testing is very important in determining liver damage. Magnesium is another electrolyte.  The magnesium can be low during chemo and may cause kidney damage. 

It is vitally important that you have your pre-chemotherapy  lab testing done the day before your chemo appointment.  When you do not have the labs performed then they have to order the tests stat and then wait and hour or two to begin your infusion.  As a result, this makes your nurse behind in her infusion schedule and other patients have to wait.

If you are experience weakness, shortness of breath, bleeding or muscle pain before your next blood draw for your chemotherapy then you need to contact the oncologist.

For more information :  http://www.labtestsonline.org ; http://www.medicineworld.org/cancer