Join Oncology Explorers for an interactive overview of pancreatic cancer, including risk factors, diagnosis, workup, treatment, and more! Session will be geared towards the late medical student/early resident level, perfect for learners or any generalist interested in a refresher.
Pancreatic Cancer Slide Deck
Summary
Join seasoned professional Dr. Beatrice Preti as she dives deep into everything Pancreatic Cancer. This comprehensive session begins with the epidemiology and risk factors associated with this late-presenting, male-predominant disease which is a leading cause of cancer deaths worldwide. Dive into diagnosis methods such as bloodwork, tissue examination, and imaging. Learn and understand the intricacies of staging the disease, defining resectability, and planning a suitable treatment course for each resectability stage. Discuss the merits of various chemotherapies and their side effects. Understand the importance of early palliative care, germline testing, and sequencing. Finally, put your knowledge to the test through a set of interactive case studies on the topic. Awaiting your participation!
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Description
Learning objectives
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Interpret the results of diagnostic tests and imaging studies used in the diagnosis of pancreatic cancer.
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Evaluate the patient's health status and comorbid conditions to make appropriate recommendations for the management of pancreatic cancer.
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Explain the role of different therapeutic strategies in the management of pancreatic cancer, including surgery, chemotherapy, and radiation therapy.
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Discuss the implications of genetic testing and next generation sequencing in diagnosing and treating pancreatic cancer.
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Recognize the importance of early palliative care in the management of pancreatic cancer and describe when it should be initiated.
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Pancreatic Cancer: The Basics, and Beyond BEATRICE PRETI MD MMED AFAMEE FRCPC MEDALL EDUCATIONLearning Objectives By the end of this session, participants should be able to… 1. List five risk factors for developing pancreatic cancer. 2. Plan an appropriate workup for a patient with suspected pancreatic cancer. 3. Describe how to prognosticate pancreatic cancer by resectability (staging). 4. Describe an appropriate treatment plan for pancreatic cancer, by resectability.EpidemiologyPostintheChat! What comes to mind when you hear “pancreatic cancer”? Overview A leading causes of cancer deaths worldwide HIC highest incidence Older population Male-predominant Late-presentingRisk Factors Warning Flags New-onset diabetes Chronic pancreatitis Family/genetic syndromes BRCA, ATM, PALB2, CDKN2A, and MLH1Poll! Which of these patients is highest risk for pancreatic cancer?Diagnosis + orkupTissueWorkup Bloodwork Workup Bloodwork What bloodwork would you order? Post in the chat! Workup Bloodwork (including CA 19-9) Abdominal Imaging: ultrasound, CT scan, MRI Chest Imaging: CT scan ERCP/MRCP if biliary duct dilationStagingPoll: Which of these tumours is resectable?Treatment: LocalisedQuick Note on Histology Adenocarcinoma Neuroendocrine NeoplasmsResectable Disease Neoadjuvant or Adjuvant Chemotherapy? Borderline + Unresectable Disease Neoadjuvant chemotherapy FOLFIRINOX Gemcitabine-Abraxane Reassess after 3, 6 months Consider chemoradiation if still unresectable Risk Stratification CA 19-9 beyond modest elevation Poor performance status Symptoms beyond “expected” (i.e. severe pain) Tumour size 2 cmPostintheChat! What are some potential FOLFIRINOX side effects?PostintheChat! What are some potential Gemcitabine/ Abraxane side effects?Treatment: Metastatic First-Line FOLFIRINOX/ Gemcitabine/ Gemcitabine NALIRIFOX Abraxane Second-Line FOLFOX/ Gemcitabine/ Gemcitabine/ FOLFIRI/ XELOX Abraxane CapecitabineThird+ Line Clinical Trial Other Agent BSCEarly Palliative Care Germline Testing for All Metastatic Next Generation SequencingCasesCase 1 Mrs H is a 60-year-old woman who presents with painless jaundice. Ultrasound of the abdomen reveals a 4 cm mass in the body of the pancreas. Which of these workup steps would NOT be recommended?Case 2 Mr G is an 85-year-old gentleman with newly-diagnosed pancreatic adenocarcinoma. His tumour is 5 cm in size, with > 180 encasement around the SMA. His CA19-9 is 360. What is the resectability/stage of this tumour?Case 2, continued Mr G is an 85-year-old gentleman with newly-diagnosed unresectable pancreatic adenocarcinoma. He received one dose of gemcitabine, and ended up hospitalised due to side effect. Currently, he is ECOG 4. What course of treatment would be recommended at this point? Post in the chat!