May 21, 2022

1400H - 1500H
Health Disorder Empowerment Via Zoom
Course– objective - for
Fundamentals laypeople to have an
and understanding of the
Generalities in FUNDAMENTALS
Medical and GENERALITIES in
Management the MEDICAL
of PANCREATIC MANAGEMENT of
DISORDERS PANCREATIC
[OVERVIEW] DISORDERS.
Health Disorder Empowerment ROJoson PEP Talk
Course– objective - for
Fundamentals laypeople to have an I have a Patient
and Empowerment
understanding of the
Program in which I
Generalities in FUNDAMENTALS like to empower the
Medical and GENERALITIES in lay people or
Management the MEDICAL patients to take
of PANCREATIC MANAGEMENT of control in the
DISORDERS PANCREATIC management of
[OVERVIEW] their health.
DISORDERS.
 There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.
 From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer.
 My PEP TALK today
is entitled:
Health Disorder Empowerment
Fundamentals and
Course– objective - for
Generalities in
Fundamentals laypeople to have an Medical
and understanding of the Management of
Generalities in FUNDAMENTALS PANCREATIC
Medical and GENERALITIES in DISORDERS [AN
Management the MEDICAL OVERVIEW]. This is
of PANCREATIC MANAGEMENT of part of the Health
DISORDERS PANCREATIC Disorder Course.
[OVERVIEW] DISORDERS.
 Contents of PEP TALK on PANCREATIC DISORDERS
Fundamentals
• What is the pancreas?
and Generalities
• What is a pancreatic disorder?
in Medical
• What are the different types of pancreatic
Management of
disorder?
PANCREATIC
• What are the causes of pancreatic disorder?
DISORDERS
• How common is pancreatic disorder?
• Clinical diagnosis of pancreatic disorder
• Paraclinical diagnostic procedures for
pancreatic disorder
• Basic treatment modalities for pancreatic
disorder
• Overview on PANCREATIC CANCER
 • What is the pancreas?
Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
 • What is the pancreas?
Fundamentals
and Generalities The pancreas is an organ located deep in the
in Medical upper part of the abdomen or belly (behind
Management of stomach).
PANCREATIC
DISORDERS
 • What is the pancreas?
Fundamentals
and Generalities The pancreas can be divided into Head, Neck,
in Medical Body and Tail.
Management of
PANCREATIC
DISORDERS
 • What is the pancreas?
Fundamentals
and Generalities The pancreas is an organ of the digestive
in Medical system and endocrine system.
Management of
PANCREATIC As part of the digestive system, it plays an
DISORDERS essential role in converting the foods we eat into
fuels for the body's cells.

As part of the endocrine system, it plays an

essential role in regulating blood sugar.
 • What is the pancreas?
Fundamentals
and Generalities It has two main functions:
in Medical
Management of an exocrine function (99%) that helps in digestion
PANCREATIC and
DISORDERS
an endocrine function (1%) that regulates blood
sugar.
 • What is the pancreas?
Fundamentals
and Generalities One can live without a pancreas.
in Medical
Management of However, one will need to make a few
PANCREATIC adjustments though.
DISORDERS The pancreas makes substances that control
blood sugar and help the body digest foods.
After surgery with total removal, one will have to
take medicines to handle these functions.
 • What is a pancreatic disorder?
Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
 • What is a pancreatic disorder?
Fundamentals
and Generalities First, the meaning of DISORDER.
in Medical
Management of DISORDER is a definite disruption to regular
PANCREATIC bodily structure and function but the specific
DISORDERS cause is not yet determined. 

Once identified, the specific cause is called

the DISEASE.  
 • What is a pancreatic disorder?
Fundamentals
and Generalities A PANCREATIC DISORDER is a DISORDER OF THE
in Medical PANCREAS.
Management of
PANCREATIC - definite disruption to regular bodily structure
DISORDERS and function of the pancreas
- but the specific cause is NOT yet determined.
 • What are the different types of pancreatic
Fundamentals
disorder?
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
 • What are the different types of pancreatic
Fundamentals
disorder?
and Generalities
in Medical
Generally, 3 types:
Management of
PANCREATIC
DISORDERS • Pancreatic tumors (cancerous / non-
cancerous)
• Pancreatic inflammation / infection
(pancreatitis)
• Pancreatic endocrine disorder (diabetes
mellitus)
 • What are the causes of pancreatic disorder?
Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
 • What are the causes of pancreatic disorder?
Fundamentals
and Generalities Pancreatic Tumors
in Medical
Management of • Pancreatic newgrowth tumors (cancerous /
PANCREATIC non-cancerous)
DISORDERS • Gene mutations (exact mechanisms not yet
known)

• Grave concern – pancreatic cancers

(adenocarcinomas)

• Pancreatic non-newgrowth tumors (e.g. cystic

degeneration)
 • What are the causes of pancreatic disorder?
Fundamentals
and Generalities • Pancreatic inflammation / infection
in Medical (pancreatitis)
Management of • Common causes:
PANCREATIC • gallbladder stones in the common bile
DISORDERS duct obstructing the pancreatic duct
• alcohol intake
 • What are the causes of pancreatic disorder?
Fundamentals
and Generalities • Pancreatic endocrine disorder
in Medical • Most common disease – diabetes mellitus
Management of
PANCREATIC
DISORDERS
 • How common is pancreatic disorder?
Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
 • How common is pancreatic disorder?
Fundamentals
and Generalities • Common - not rare
in Medical
Management of • Pancreatic inflammation / infection
PANCREATIC (pancreatitis) – more common than pancreatic
DISORDERS tumors
• Pancreatic endocrine disorder (diabetes
mellitus) – most common
 • Clinical diagnosis of pancreatic disorder
Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
 • Clinical diagnosis of pancreatic disorder
Fundamentals
and Generalities
Focus:
in Medical
Management of • Acute pancreatitis
PANCREATIC • Pancreatic tumors
DISORDERS
 • Clinical diagnosis of pancreatic disorder
Fundamentals
and Generalities
Acute pancreatitis
in Medical
Management of • Pattern Recognition Cues:
PANCREATIC • pain in the upper abdomen that
DISORDERS radiates to the back.
• abdominal pain worsens after eating,
especially foods high in fat.
• abdomen is tender to touch.
• May or may not have fever.
 • Clinical diagnosis of pancreatic disorder
Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
 • Clinical diagnosis of pancreatic disorder
Fundamentals Pancreatic tumors
and Generalities Pancreatic tumors and cancers and cancers are
in Medical usually not
Management of Because of its deep location, most tumors of the diagnosed clinically
PANCREATIC but with imaging
pancreas cannot be felt when pressing on the
DISORDERS procedures like
abdomen.
ultrasound and CT
This leads to late detection, as symptoms of scan and MRI.
pancreatic cancer usually do not appear until the
tumor begins to interfere with the function of the
pancreas or other nearby organs such as the
stomach, duodenum, liver, or gallbladder.
 • Clinical diagnosis of pancreatic disorder Patients with
Fundamentals pancreatic tumors
and Generalities Pancreatic cancers can be
in Medical asymptomatic and
Management of Because of its deep location, most tumors of the symptomatic.
PANCREATIC If symptomatic, they
pancreas cannot be felt when pressing on the
DISORDERS usually starts with
abdomen.
vague abdominal
This leads to late detection, as symptoms of pain at the epigastric
pancreatic cancer usually do not appear until the area.
tumor begins to interfere with the function of the
pancreas or other nearby organs such as the
stomach, duodenum, liver, or gallbladder.
 • Clinical diagnosis of pancreatic disorder Patients with
Fundamentals pancreatic HEAD
and Generalities tumors usually
in Medical present with
Management of JAUNDICE because
PANCREATIC of the common bile
DISORDERS duct obstruction
they cause.
 • Clinical diagnosis of pancreatic disorder Patients with
Fundamentals pancreatic HEAD
and Generalities tumors can cause
in Medical gastric outlet
Management of obstruction if they
PANCREATIC grow into the
DISORDERS duodenum or small
intestine.
 • Paraclinical diagnostic procedures for
Fundamentals
pancreatic disorder
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
 • Paraclinical diagnostic procedures for
Fundamentals ERCP – Endoscopic
pancreatic disorder
and Generalities Retrograde
in Medical Common instrumental and laboratory diagnostic Cholangio-
Management of procedures for PANCREATIC DISORDER: Pancreaticography
PANCREATIC
DISORDERS • Imaging procedures (ultrasound; CT scan; MRI; EUS – Endoscopic
PET scan; etc.) ultrasound
• Endoscopy (upper endoscopy) – ERCP, EUS
• Blood tests (pancreatic enzymes, tumor
markers; etc.)
• Biopsy
 • Paraclinical diagnostic procedures for
Fundamentals
pancreatic disorder
and Generalities
in Medical
Competencies required of physicians managing
Management of
pancreatic disorders:
PANCREATIC
DISORDERS • Know the uses and indications of all known
instrumental and laboratory diagnostic
procedures for pancreatic disorders.
• Use as needed and indicated.
• Select the most cost-effective one using the
BRCA process.
• Know how to interpret the results.
 • Paraclinical diagnostic procedures for
Fundamentals
pancreatic disorder
and Generalities
in Medical
BRCA Process in selecting diagnostic procedures
Management of
PANCREATIC Procedures Benefit Risk Cost Availability
DISORDERS (goal – to
be more
definite on
the
diagnosis)

Option1        
Option2        
Option3        
 • Paraclinical diagnostic procedures for
Fundamentals
pancreatic disorder
and Generalities
in Medical
Usually, an ultrasound is initially done for patients
Management of
suspected to have a pancreatic disorder.
PANCREATIC
DISORDERS
After the ultrasound, other paraclinical diagnostic
procedures may be done as indicated such as
pancreatic enzyme determinations like serum
amylase and lipase.
 • Basic treatment modalities for pancreatic
Fundamentals
disorder
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
 • Basic treatment modalities for pancreatic
Fundamentals
disorder
and Generalities
in Medical SPECIFIC DISEASE SURGICAL / POTENTIALLY SURGICAL / NON-SURGICAL
Management of
PANCREATIC W
DISORDERS X
Y
Z

• Surgical – outright surgical

• Non-surgical – non-surgical at all times (no OPERATION)
• Potentially surgical – surgical only when needed
 • Basic treatment modalities for pancreatic Surgical Treatment:
Fundamentals
disorder • Remove or
and Generalities
extirpate
in Medical Examples of OUTRIGHT SURGICAL TREATMENT • By-pass or detour
Management of • Resectable pancreatic cancers procedure
PANCREATIC • Necrotizing pancreatitis (with severe • Debridement
DISORDERS inflammation) • Drainage

• Surgical – outright surgical

• Non-surgical – non-surgical at all times (no OPERATION)
• Potentially surgical – surgical only when needed
 • Basic treatment modalities for pancreatic
Fundamentals
disorder
and Generalities
in Medical Illustration of extirpation of pancreatic head cancer - pancreaticoduodenectomy
Management of
PANCREATIC
DISORDERS
 • Basic treatment modalities for pancreatic Surgical Treatment:
Fundamentals
disorder • Remove or
and Generalities
extirpate
in Medical Examples of POTENTIALLY SURGICAL TREATMENT
• By-pass or detour
Management of in which a WATCH & WAIT stance is a better
procedure
PANCREATIC option and in which a medical management can
• Debridement
DISORDERS be tried
• Drainage
• Acute pancreatitis
• Pancreatic abscess (small)
• Pancreatic pseudocyst
• Benign pancreatic tumors
• Surgical – outright surgical
• Non-surgical – non-surgical at all times (no OPERATION)
• Potentially surgical – surgical only when needed
 • Basic treatment modalities for pancreatic Non-Surgical
Fundamentals
disorder Treatment:
and Generalities
in Medical Examples of OUTRIGHT NON-SURGICAL • Medicines
Management of TREATMENT • NO medicines
PANCREATIC • Mild acute pancreatitis (watchful waiting;
DISORDERS • Chronic pancreatitis natural support
• Unresectable pancreatic cancer – just palliative management;
treatment etc.)

• Surgical – outright surgical

• Non-surgical – non-surgical at all times (no OPERATION)
• Potentially surgical – surgical only when needed
 • Basic treatment modalities for pancreatic
Fundamentals
disorder
and Generalities
in Medical
BRCA Process in selecting cost-effective treatment
Management of
modality.
PANCREATIC
DISORDERS
 • Overview on Pancreatic Cancers
Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
 • Overview on Pancreatic Cancers
Fundamentals
and Generalities Pancreatic cancer statistics in the Philippines
in Medical
(Globocan 2020)
Management of
PANCREATIC
DISORDERS No. 14 in incidence rank
No. 8 in mortality or death rank
Prevalence: 3 / 100,000 population
 • Overview on Pancreatic Cancers
Fundamentals
and Generalities USUALLY LATE DETECTION Late detection
in Medical
Management of Because of its deep location, most tumors of the
PANCREATIC pancreas cannot be felt when pressing on the Advanced stage of
DISORDERS abdomen. cancer
This leads to late detection, as symptoms of
pancreatic cancer usually do not appear until the
tumor begins to interfere with the function of the Poor prognosis
pancreas or other nearby organs such as the
stomach, duodenum, liver, or gallbladder.
 • Overview on Pancreatic Cancers
Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
 • Overview on Pancreatic Cancers
Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
 • Overview on Pancreatic Cancers
Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
 • Overview on Pancreatic Cancer
Fundamentals
and Generalities
in Medical
Management of
PANCREATIC
DISORDERS
 • Overview on Pancreatic Cancer
Fundamentals
and Generalities USUALLY LATE DETECTION
in Medical
Management of Early symptoms are usually non-specific, a vague
PANCREATIC and dull upper abdominal pain at the epigastric
DISORDERS are o sikmura.
Usually, loss of appetite and weight follow. 
 • Overview on Pancreatic Cancer
Fundamentals
and Generalities Causes NOT exactly known.
in Medical
Management of About 10% of pancreatic cancers are hereditary.
PANCREATIC The rest are acquired – due to gene mutation –
DISORDERS with no known exact cause.

Anybody can be afflicted with pancreatic cancer,

when and how, nobody exactly knows.
 • Overview on Pancreatic Cancer
Fundamentals
and Generalities 2 general types of pancreatic cancers:
in Medical
Management of • Adenocarcinoma (more common)
PANCREATIC • Neuroendocrine Tumors
DISORDERS
 • Overview on Pancreatic Cancer
Fundamentals
and Generalities In general, pancreatic neuroendocrine tumors
in Medical
grow at a much, much slower rate than pancreatic
Management of
adenocarcinomas.
PANCREATIC
DISORDERS While each type of tumor can spread
(metastasize) from the pancreas to other organs,
pancreatic neuroendocrine tumors usually spread
over a period of years.
 • Overview on Pancreatic Cancer
Fundamentals
and Generalities Screening for Pancreatic Cancers
in Medical
Management of For pancreatic cancer, no major professional
PANCREATIC groups currently recommend routine screening in
DISORDERS people who are at average risk.

This is because no screening test has been shown

to lower the risk of dying from this cancer.
 • Overview on Pancreatic Cancer
Fundamentals
and Generalities Screening for Pancreatic Cancers
in Medical
Management of There is no single diagnostic test that can tell you
PANCREATIC if you have pancreatic cancer.
DISORDERS
Definitive diagnosis requires a series of imaging
scans, blood tests and biopsy—and those tests are
typically only done only if you have symptoms.
 • Overview on Pancreatic Cancer
Fundamentals
and Generalities Paraclinical diagnostic procedures
in Medical
Management of • Ultrasound of the abdomen
PANCREATIC • CT scan
DISORDERS • MRI
• CA-19-9
• Biopsy
 • Overview on Pancreatic Cancer
Fundamentals
and Generalities Treatment
in Medical
Management of Early stage, resectable, with no evidence of
PANCREATIC distant spread - SURGERY is the treatment of
DISORDERS choice.

Otherwise – chemotherapy or no more

conventional medical treatment (palliative and
Hospice care)
 Contents of PEP TALK on PANCREATIC DISORDERS
Fundamentals Summary
• What is the pancreas?
and Generalities
• What is a pancreatic disorder? Take Away
in Medical
• What are the different types of pancreatic
Management of
disorder?
PANCREATIC
• What are the causes of pancreatic disorder?
DISORDERS
• How common is pancreatic disorder?
• Clinical diagnosis of pancreatic disorder
• Paraclinical diagnostic procedures for
pancreatic disorder
• Basic treatment modalities for pancreatic
disorder
• Overview on PANCREATIC CANCER
 Fundamentals Be always in touch with reliable medical Take Away in
and Generalities information on fundamentals and relation to
in Medical generalities in medical management of Patient
Management of PANCREATIC DISORDERS. Empowerment
PANCREATIC
DISORDERS Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions in
medical management of PANCREATIC
DISORDERS.
 My PEP TALK today
is entitled:
Health Disorder Empowerment
Fundamentals and
Course– objective - for
Generalities in
Fundamentals laypeople to have an Medical
and understanding of the Management of
Generalities in FUNDAMENTALS PANCREATIC
Medical and GENERALITIES in DISORDERS [AN
Management the MEDICAL OVERVIEW]. This is
of PANCREATIC MANAGEMENT of part of the Health
DISORDERS PANCREATIC Disorder Course.
[OVERVIEW] DISORDERS.