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Tests and procedures to stage pancreatic cancer are usually done at the same time as diagnosis.
There are three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
The following stages are used for pancreatic cancer:
Stage 0 (Carcinoma in Situ)
In stage 0, abnormal cells are found in the lining of the pancreas. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
In stage I, cancer has formed and is found in the pancreas only. Stage I is divided into stage IA and stage IB, based on the size of the tumor.
In stage II, cancer may have spread to nearby tissue and organs, and may have spread to lymph nodes near the pancreas. Stage II is divided into stage IIA and stage IIB, based on where the cancer has spread.
In stage III, cancer has spread to the major blood vessels near the pancreas and may have spread to nearby lymph nodes.
In stage IV, cancer may be of any size and has spread to distant organs, such as the liver, lung, and peritoneal cavity. It may have also spread to organs and tissues near the pancreas or to lymph nodes.
Republished by Blog Post Promoter
BY JANE HILL
Talking to children can help them deal with a family member’s cancer.
Susan Niebur did everything she could to ensure that her sons enjoyed life despite constraints brought on by her inflammatory breast cancer, she said. Now ages 5 and 7, the boys remember when their mom used to take them to a museum on the spur of the moment. Eventually, her illness confined family outings to the backyard, but it didn’t happen so suddenly that they noticed, she said in an interview last fall. When pain or medication confined Niebur to bed, she played board games with the boys or watched movies. When they asked her to wrestle, she reminded them that Dad is the wrestler, and Mom is the snuggler.
“They can choose a book by my bedside,” she said. “They have me at their disposal.”
Niebur, who died on Feb. 6, made a point to create new normals for her sons as her energy waned, including having friends bring her boys home from school. When the boys came in, she sat with them at the kitchen table and talked about their day until it was time for her to rest again. She called it their “welcome-home ritual.”
Children are resilient, far more so than most adults give them credit, says Kelly Gruber, LMSW, an oncology social worker. Though a family member’s cancer “can be emotionally challenging,” children can adjust to a “new normal” as long as they know what to expect. Keeping life structured and predictable is important, she says.
“From my experience, children want their parents to be honest,” she says. “When parents try to hide what’s going on, kids can imagine far worse scenarios.” Parents should sit down together and tell children in an age-appropriate manner what’s happening, provide reassurance that they will still be loved and cared for, and welcome questions. Social workers or counselors are available, either at a cancer center or in the community, to help facilitate these discussions if parents need help with how to do this, she says. By encouraging open communication, parents can help kids feel safe to ask questions.
From my experience, children want their parents to be honest. When parents try to hide what’s going on, kids can imagine far worse scenarios.
Gruber works with children ages 6 to 16 in “Kids Can Cope,” a twice-monthly program at Banner Thunderbird Medical Center in Glendale, Ariz., where they can get answers in a safe environment. The goal is to empower them and help them realize they are not alone, she explains. “The children get strength from each other, and it’s also a time to take a break, so their own needs as children can be met.”
An Unanticipated Toll
When a family member has cancer, parents often underestimate the emotional impact on their children, according to a landmark 1996 study. In 76 patient families, parents reported little or no evidence of emotional distress in their children, while the children themselves reported higher psychological stress. Parents did not appear to be aware of their children’s distress and rated their children as asymptomatic, even when children reported elevated levels of psychological symptoms.
A more recent study points to a pervasive need for child-centered support. Researchers analyzed data from 13,385 adults in America with a history of cancer and projected that an estimated 18 percent of newly diagnosed cancer survivors and 14 percent of all U.S. cancer survivors reside with one or more minor children Those numbers translate to 1.58 million survivors living with 2.85 million children, and an estimated 562,000 minor children living with a parent in the early phases of cancer treatment and recovery.
Get with a Program
In light of the research, programs such as CLIMB (Children’s Lives Include Moments of Bravery) provide emotional support to children who have a family member with cancer. Nan Bethmann, RN, OCN, an oncology nurse who co-facilitates CLIMB at Marshfield Clinic Cancer Care at Sacred Heart Hospital in Eau Claire, Wis., explains that each lesson is designed to teach healthy behaviors for coping with four emotions: happiness, anger, confusion and sadness. For young children, a special coloring book helps stimulate discussions on those themes.
Getting children to talk about how they’re feeling is important because left to their own imaginations, children, as naturally egocentric beings, believe they are somehow at fault, she says. That’s why she urges adults to talk to an oncology social worker about other resources for children if no formal program is available.
When it comes to adolescents who are anxious or sad, Paula Rauch, MD, advises parents to assume that they are probably experiencing normal reactions to a life crisis. “It is not a fact of a family member’s illness that kids will become depressed and need medication or a therapist.” Many will benefit instead from participating in virtual or actual group meetings, and especially weekend camps with other peers in similar circumstances, says Rauch, who founded and directs the Marjorie E. Korff Parenting At a Challenging Time (PACT) Program at Massachusetts General Hospital in Boston.
Kathleen McCue, CCLS, a licensed social worker and head of the child life program at the Cleveland Clinic Foundation, says arming adolescents with strategies to help themselves cope is most effective when you get them to agree first that they want to be able to pick themselves up when feeling down. Then help them identify music in advance that makes them want “to dance around the room” or name a friend to call who will talk while kicking a soccer ball back and forth, which is preferable to just sitting and talking, she suggests.
If the parent is depressed or exhausted, find someone who can step in, McCue says. “When you have no energy to parent, it’s hard to care, but kids need someone to care about them.”
Katie Wangelin, MSW, a licensed clinical social worker in Greensboro, N.C., encourages adults to set up safety nets for children. For example, identify someone at school with whom children can connect if they are having a hard day.
“When children are overcome by sadness or anger, they can give a signal to the teacher and it’s understood that they need a break,” Wangelin says. “It gives them a sense of control.”
Older children have the additional burden of peer pressure. They worry about what their friends might think or say, or fear their friends will avoid them because they don’t know what to say or don’t understand what’s going on, Wangelin says. She suggests bringing in one or two of the child’s closest friends so they can “see behind the scenes” of what is going on at home. Then the child will have an ally to turn to who has some understanding of the circumstances.
“I think what they all want to hear is reassurance, that they are not alone, that a lot of people are here to take care of them and that we will prepare them as much as possible.”
Results from two phase III randomized clinical trials suggest that, at least for some patients with ovarian cancer, adding the antiangiogenesis agent bevacizumab to chemotherapy increases the time to disease progression and may improve survival.
Side effects of treatment for pancreatic cancer vary depending on the type of treatment. For example, radiation treatment (which is a local treatment) side effects tend to accumulate throughout the course of radiation therapy and include fatigue, nausea, and diarrhea. Chemotherapy side effects depend on the type of chemotherapy given (less aggressive chemotherapy treatments typically cause fewer side effects whereas more aggressive combination regimens are more toxic) and can include fatigue, loss of appetite, change in taste, hair loss (although not usually), and lowering of the immune system with risk for infections (immunosuppression). While these lists of side effects may seem worrisome, recognize that radiation doctors (radiation oncologists) and medical oncologists have much better supportive medications than they did in years past to control any nausea, pain, diarrhea, or immunosuppression related to treatment. The risks associated with pancreatic cancer treatment must be weighed against the inevitable and devastating risks associated with uncontrolled pancreatic cancer and, if the treatments control progression of the cancer, most patients feel better on treatment that they otherwise would.
If you’re diagnosed with a rare or unusual cancer, it’s not easy to figure out how you fit in to the mainstream of cancer care.
Hearing that you’ve been diagnosed with cancer is hard enough, but when your doctor tells you that your cancer’s rare, it’s not easy to feel comfortable about your next steps.
You may find that doctors, nurses and other cancer patients have never heard of your type of cancer. It may be difficult to find information and resources to guide your treatment choices. This is when it’s important to ask questions and take steps to find a cancer specialist who understands your cancer type and others who can help support you along the way.
Here are a few ideas on what you can do:
Cancer survivors find great support from each other by sharing experiences, thoughts and feelings. Many times, the most value is in finding someone else to talk to who’s experienced a similar situation. Reach out to others through social networks and general support groups.
Look for opportunities to volunteer or be an advocate for other cancer survivors. In doing this, you may find the people you meet along the way become your personal support group, regardless of cancer type.
Women who are large around the middle at particular risk for most lethal forms of disease, including bowel and pancreatic cancer.
Official NHS figures show that 44% of women in England have a waist circumference of more than the 80cm (31.5in), that is recommended for health reasons. Some 32% of men have a waist measuring more than the suggested 94cm (37in).
The World Cancer Research Fund (WCRF) is urging women who are large around the middle to lose weight in order to minimise their risk of getting the disease.
Excess body fat increases an individual’s general cancer risk and having a large waistline is a particular risk for bowel and pancreatic cancer, breast cancer in women who have been through the menopause, and for cancer of the womb lining.
“We tend to think that men are more likely to put weight on their stomach. But these statistics show that actually women in England are more likely to have a raised waist circumference than men,” said Dr Rachel Thompson, WCRF’s deputy head of science. “It is important to alert women to this, particularly as breast and womb lining (endometrial) cancers account for about a third of the 300,000 new cases of the disease diagnosed in the UK every year,” added Thompson.
Initiatives are needed to educate both sexes about the extra risk they are at if they are dangerously large around the middle, she said. “We need to raise awareness among both men and women that being overweight and having a large waistline are cancer risk factors.”
Prof Martin Wiseman, the WCRF’s medical and scientific adviser, called on ministers to do more to help educate the public. “We all need to play a part in raising awareness of cancer risk factors, and that includes us in the charity sector. But the government also has as much a role in increasing awareness of cancer risk factors as much as for heart disease risk factors, and we would like to see them do more in this,” said Wiseman.
But Thompson also voiced concern that many people do not know the right way to measure their waist, and thus may not know their actual size. Everyone should measure both their waist and body mass index, she recommended. The percentage of adults in England classed as obese rose between 1993 and 2009 from 16% to 24% of women and from 13% to 22% of men.
The National Obesity Forum, which represents doctors, nurses and dieticians involved in weight-related illness, said it shared the WCRF’s concerns. Women whose waist goes beyond 31.5in should consult a doctor, it said.
“Doctors have known for a long time that a high waist measurement is a proven indicator of co-morbidity and is a measure that any woman can easily take in front of the bathroom mirror,” said spokesman Tam Fry.
“It is, however, vital that she always positions the tape in the correct position and makes a precautionary visit to her GP if the reading creeps up to more than the recommended80cm/31.5in.”
Ed Yong, Cancer Research UK’s head of health information, said: “Keeping a healthy body weight is one of the most important ways of reducing the risk of cancer, and this applies to both men and women. Fat around the middle is surprisingly active, releasing hormones and other chemicals that can make cells in the body divide far more often than usual, which can increase the risk of cancer.
If you have not yet had the opportunity to do so, please remember that you can still submit your tax-deductible year-end donation to the Pancreatic Cancer Action Network until December 31, 2010 at midnight.
If you would like to make a donation by check, please make checks payable to Pancreatic Cancer Action Network, include a copy of this form and send to:
2010 Year-End Campaign
Pancreatic Cancer Action Network
1500 Rosecrans Ave., Suite 200
Manhattan Beach, CA 90266
To donate by phone, please call Pancreatic Cancer Action Network at 877-272-6226.
You can’t change the fact that you have had cancer. What you can change is how you live the rest of your life — making choices to help you stay healthy and feel as well as you can. This can be a time to look at your life in new ways. Maybe you are thinking about how to improve your health over the long term. Some people even start during cancer treatment.
For many people, a diagnosis of cancer helps them focus on their health in ways they may not have thought much about in the past. Are there things you could do that might make you healthier? Maybe you could try to eat better or get more exercise. Maybe you could cut down on the alcohol, or give up tobacco. Even things like keeping your stress level under control may help. Now is a good time to think about making changes that can have positive effects for the rest of your life. You will feel better and you will also be healthier.
You can start by working on those things that worry you most. Get help with those that are harder for you. For instance, if you are thinking about quitting smoking and need help, call the American Cancer Society at 1-800-227-2345.
Eating right can be hard for anyone, but it can get even tougher during and after cancer treatment. Treatment may change your sense of taste. Nausea can be a problem. You may not feel like eating and lose weight when you don’t want to. Or you may have gained weight that you can’t seem to lose. All of these things can be very frustrating.
If treatment caused weight changes or eating or taste problems, do the best you can and keep in mind that these problems usually get better over time. You may find it helps to eat small portions every 2 to 3 hours until you feel better. You may also want to ask your cancer team about seeing a dietitian, an expert in nutrition who can give you ideas on how to deal with these treatment side effects.
One of the best things you can do after cancer treatment is put healthy eating habits into place. You may be surprised at the long-term benefits of some simple changes, like increasing the variety of healthy foods you eat. Try to eat 5 or more servings of vegetables and fruits each day. Choose whole grain foods instead of those made with white flour and sugars. Try to limit meats that are high in fat. Cut back on processed meats like hot dogs, bologna, and bacon. Better yet, don’t eat any of these, if you can. If you drink alcohol, limit yourself to 1 or 2 drinks a day at the most.
Extreme tiredness, called fatigue, is very common in people treated for cancer. This is not a normal tiredness, but a “bone-weary” exhaustion that doesn’t get better with rest. For some people, fatigue lasts a long time after treatment, and can make it hard for them to exercise and do other things they want to do. But exercise can help reduce fatigue. Studies have shown that patients who follow an exercise program tailored to their personal needs feel better physically and emotionally and can cope better, too.
If you were sick and not very active during treatment, it is normal for your fitness, endurance, and muscle strength to decline. Any plan for physical activity should fit your own situation. An older person who has never exercised will not be able to take on the same amount of exercise as a 20-year-old who plays tennis twice a week. If you haven’t exercised in a few years, you will have to start slowly — maybe just by taking short walks.
Talk with your health care team before starting anything. Get their opinion about your exercise plans. Then, try to find an exercise buddy so you’re not doing it alone. Having family or friends involved when starting a new exercise program can give you that extra boost of support to keep you going when the push just isn’t there.
If you are very tired, you will need to balance activity with rest. It is OK to rest when you need to. Sometimes it’s really hard for people to allow themselves to rest when they are used to working all day or taking care of a household, but this is not the time to push yourself too hard. Listen to your body and rest when you need to. (For more information about fatigue, please see our publications, Fatigue in People With Cancer and Anemia in People With Cancer.)
Keep in mind exercise can improve your physical and emotional health.
And long term, we know that exercise plays a role in helping to lower the risk of some cancers. In the American Cancer Society guidelines on physical activity for cancer prevention, we recommend that adults take part in at least 30 minutes of moderate to vigorous physical activity, above usual activities, on 5 or more days of the week; 45 to 60 minutes of intentional physical activity are even better.
Patricia Griecci Pancreatic Cancer Foundation
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Healthy eating helps cancer survivors heal on the path to recovery.
When Christopher Columbus “discovered” red chili peppers in the New World during the 15th century, the pungent fruit already had a long and distinguished history.
University of Missouri-Columbia and Smithsonian Institute researchers found fossil evidence in 2007 suggesting that people were eating chili peppers as long as 6,000 years ago, making chili peppers one of the oldest domesticated food sources in the Americas. As Columbus found, chili peppers were already being used as remedies for diarrhea, cramps, flatulence, seasickness, malarial fevers and blood clotting reduction.
In addition to pleasing ancient and modern palates, chili peppers are a good source of vitamins A, C and E, rich in folic acid and potassium, low in calories and sodium, and contain no carbohydrates, according to Chemical & Engineering News Magazine.
Given its history, it’s easy to understand why modern researchers are fired up about this ancient food’s health benefits. While the jury is still out—to date, researchers have only scratched the surface — there seems to be good news associated with eating chili peppers or chili-pepper-based sauces for your overall health.
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