Which type of cancer has the poorest prognosis?
A- Squamous cell carcinoma
B- Breast cancer
C- Pancreatic cancer
D- Gastric cancer
Correct Response: C
Of all of the above types of cancer, it is pancreatic cancer that has the poorest prognosis. This is based on the fact that pancreatic cancer is not symptomatic, and therefore, it is diagnosed after the point when a surgical removal can be performed. It has a rapid course and it is characterized with a high degree of mortality.
Signs and symptoms of pancreatic cancer:
Often, pancreatic cancers in early stages do not cause any signs or symptoms. Often, pancreatic cancers have grown a lot or have already spread outside the pancreas by the time they cause symptoms.
Having one or more of the symptoms presented below does not mean that you have pancreatic cancer. In fact, many of these symptoms are more likely to be caused by other conditions. However, if you have any of these symptoms, it is important that a doctor do an exam to find out the cause of your symptoms and receive treatment if necessary.
- Jaundice and related symptoms:
Jaundice manifests through the skin and eyes that turn yellowish. It presents as one of the first symptoms in most people with pancreatic cancer (and almost all people with ampullary cancer).
Jaundice is caused by the accumulation of bilirubin, a dark green substance produced in the liver. Normally, the liver releases a fluid called bile that contains bilirubin. Bile passes through the bile duct into the intestines, where it helps to break down fats. Finally it leaves the body in the stool. When the bile duct becomes blocked, bile cannot reach the intestines and the amount of bilirubin in the body accumulates.
Cancers that begin in the head of the pancreas are near the bile duct. These cancers can press the duct and cause jaundice when they are still quite small, which sometimes results in these tumors being found at an early stage. But cancers that originate from either the body or the tail of the pancreas do not exert pressure on the duct until they are spread throughout the organ. By that time, cancer has often also spread outside the pancreas.
When pancreatic cancer spreads, it usually goes first to the liver. This can also cause jaundice.
In addition to the yellowing of the eyes and skin, other signs of jaundice are:
- Dark urine:
Sometimes, urine with a darker color is the first sign of jaundice. As bilirubin levels increase in the blood, the urine turns a brown color.
- Pale or fatty stools:
Bilirubin normally helps give stool its brown color. If the bile duct is blocked, the stool may look gray or light in color. Also, if bile and pancreatic enzymes cannot reach the intestines to help disintegrate fats, feces can become fatty and can float on the toilet.
- Itchy skin:
When bilirubin accumulates in the skin, it turns yellow and begins to itch.
Pancreatic cancer is not the most common cause of jaundice. Other causes, such as gallstones, hepatitis and other diseases of the liver and bile duct are much more common causes.
- Abdomen or back pain:
Abdominal (belly) or back pain is common in pancreatic cancer. Cancers that originate in the body or tail of the pancreas can grow significantly and can begin to compress other nearby organs causing pain. Cancer may also spread to nerves near the pancreas, which often causes back pain. Pain in the abdomen or back is quite common and is more often caused by conditions other than pancreatic cancer.
- Weight loss and lack of appetite:
It is very common for people who have pancreatic cancer to lose weight without trying. Often, these people have little or no appetite.
- Nausea and vomiting:
If the cancer presses the distal end of the stomach, this can partially block it, making it difficult for food to pass through. This can cause nausea, vomiting and pain that tends to intensify after eating.
- Enlargement of the gallbladder or liver:
If the cancer blocks the bile duct, bile can accumulate in the gallbladder, causing it to increase in size. Sometimes, a doctor can feel this enlargement during a physical exam (such as a large bump under the right side of the rib). It can also be seen in imaging studies.
Occasionally, pancreatic cancer can also cause an increase in liver size, especially if the cancer has spread there. It is possible that the doctor can realize this by palpating the edge of the liver under the right rib, or it is possible that the enlarged liver can be seen in imaging studies.
A- Squamous cell carcinoma
B- Breast cancer
C- Pancreatic cancer
D- Gastric cancer
Correct Response: C
Of all of the above types of cancer, it is pancreatic cancer that has the poorest prognosis. This is based on the fact that pancreatic cancer is not symptomatic, and therefore, it is diagnosed after the point when a surgical removal can be performed. It has a rapid course and it is characterized with a high degree of mortality.
Signs and symptoms of pancreatic cancer:
Often, pancreatic cancers in early stages do not cause any signs or symptoms. Often, pancreatic cancers have grown a lot or have already spread outside the pancreas by the time they cause symptoms.
Having one or more of the symptoms presented below does not mean that you have pancreatic cancer. In fact, many of these symptoms are more likely to be caused by other conditions. However, if you have any of these symptoms, it is important that a doctor do an exam to find out the cause of your symptoms and receive treatment if necessary.
- Jaundice and related symptoms:
Jaundice manifests through the skin and eyes that turn yellowish. It presents as one of the first symptoms in most people with pancreatic cancer (and almost all people with ampullary cancer).
Jaundice is caused by the accumulation of bilirubin, a dark green substance produced in the liver. Normally, the liver releases a fluid called bile that contains bilirubin. Bile passes through the bile duct into the intestines, where it helps to break down fats. Finally it leaves the body in the stool. When the bile duct becomes blocked, bile cannot reach the intestines and the amount of bilirubin in the body accumulates.
Cancers that begin in the head of the pancreas are near the bile duct. These cancers can press the duct and cause jaundice when they are still quite small, which sometimes results in these tumors being found at an early stage. But cancers that originate from either the body or the tail of the pancreas do not exert pressure on the duct until they are spread throughout the organ. By that time, cancer has often also spread outside the pancreas.
When pancreatic cancer spreads, it usually goes first to the liver. This can also cause jaundice.
In addition to the yellowing of the eyes and skin, other signs of jaundice are:
- Dark urine:
Sometimes, urine with a darker color is the first sign of jaundice. As bilirubin levels increase in the blood, the urine turns a brown color.
- Pale or fatty stools:
Bilirubin normally helps give stool its brown color. If the bile duct is blocked, the stool may look gray or light in color. Also, if bile and pancreatic enzymes cannot reach the intestines to help disintegrate fats, feces can become fatty and can float on the toilet.
- Itchy skin:
When bilirubin accumulates in the skin, it turns yellow and begins to itch.
Pancreatic cancer is not the most common cause of jaundice. Other causes, such as gallstones, hepatitis and other diseases of the liver and bile duct are much more common causes.
- Abdomen or back pain:
Abdominal (belly) or back pain is common in pancreatic cancer. Cancers that originate in the body or tail of the pancreas can grow significantly and can begin to compress other nearby organs causing pain. Cancer may also spread to nerves near the pancreas, which often causes back pain. Pain in the abdomen or back is quite common and is more often caused by conditions other than pancreatic cancer.
- Weight loss and lack of appetite:
It is very common for people who have pancreatic cancer to lose weight without trying. Often, these people have little or no appetite.
- Nausea and vomiting:
If the cancer presses the distal end of the stomach, this can partially block it, making it difficult for food to pass through. This can cause nausea, vomiting and pain that tends to intensify after eating.
- Enlargement of the gallbladder or liver:
If the cancer blocks the bile duct, bile can accumulate in the gallbladder, causing it to increase in size. Sometimes, a doctor can feel this enlargement during a physical exam (such as a large bump under the right side of the rib). It can also be seen in imaging studies.
Occasionally, pancreatic cancer can also cause an increase in liver size, especially if the cancer has spread there. It is possible that the doctor can realize this by palpating the edge of the liver under the right rib, or it is possible that the enlarged liver can be seen in imaging studies.
Blood clots:
Occasionally, the first sign that a person has pancreatic cancer is a blood clot in a large vein, often in a leg. This is called deep phlebothrombosis (DVT). Symptoms may include pain, swelling, redness and heat in the affected leg. Occasionally, a clot fragment may break off and move to the lungs, which could make breathing difficult and cause chest pain. A blood clot in the lungs is called pulmonary embolism (PE).
Even so, having a blood clot usually does not mean that you have cancer. Most blood clots are due to other causes.
Diabetes:
Rarely, pancreatic cancer destroys insulin-producing cells causing diabetes (high blood sugar). Symptoms may include feeling thirsty and hungry, as well as having to urinate frequently. More frequently, cancer can lead to small changes in blood sugar levels that do not cause symptoms of diabetes, but can still be detected by blood tests.
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