AL-Turath University
Nursing department
Adult Nursing 1 /first semester 2024-2025
Assessment and Management of Patients
With cancer of Pancreas
Prepared by Dr. Bushra khairullah
Cancer of the pancreas
It is the fifth leading cause of cancer deaths in the United States and
occurs most frequently in the fifth to seventh decades of life
Cigarette smoking, exposure to industrial chemicals or toxins in the
environment, and a diet high in fat, meat, or both are associated with
pancreatic cancer, although their role is not completely clear.
The risk for pancreatic cancer increases as the extent of cigarette
smoking increases.
Diabetes mellitus, chronic pancreatitis, and hereditary pancreatitis
are also associated with pancreatic cancer. The pancreas can also be
the site of metastasis from other tumors.
clinical manifestations
vary depending on the location of the lesion and whether
functioning, insulin secreting pancreatic islet cells are involved.
Pain, jaundice, or both are present in more than 90% of patients and,
along with weight loss, are considered classic signs of pancreatic
carcinoma. However, they often do not appear until the disease is far
advanced. Other signs include rapid, profound, and progressive
weight loss as well as vague upper or mid abdominal pain or
discomfort that is unrelated to any gastrointestinal function and is
often difficult to describe.
Assessment and Diagnostic Findings
Magnetic resonance imaging and computed tomography are used to
identify the presence of pancreatic tumors.
ERCP ( Endoscopic retrograde cholangiopancreatography )is also
used in the diagnosis of pancreatic carcinoma.
Cells obtained during ERCP are sent to the laboratory for
examination.
Gastrointestinal x-ray findings may demonstrate deformities in
adjacent viscera caused by the impinging pancreatic mass.
Percutaneous fine-needle aspiration biopsy of the pancreas is used to
diagnose pancreatic tumors and confirm the diagnosis in patients
whose tumors are not resectable, eliminating the stress and
postoperative pain of ineffective surgery.
Medical Management
If the tumor is resectable and localized (typically tumors in the head
of the pancreas), the surgical procedure to remove it is usually
extensive
surgical treatment (ie, total excision of the lesion)
is often not possible because of the extensive growth when the
tumor is finally diagnosed and because of the probable widespread
metastases (especially to the liver, lungs, and bones).
More often, treatment is limited to palliative measures.
Nursing Managements
❖ Pain management and attention to nutritional requirements are
important nursing measures to improve the level of comfort.
❖ Skin care and nursing measures are directed toward relief of pain
and discomfort associated with jaundice, anorexia, and profound
weight loss.
❖ Because of the poor prognosis and likelihood of short survival,
end-of-life preferences are discussed and honored. If appropriate,
the nurse refers the patient to hospice care
Teaching Patients Self-Care: The specific patient and family
teaching indicated varies with the stage of disease and the treatment
choices made by the patient.
Continuing Care: A referral for home care is indicated to help the
patient and family deal with the physical problems and discomforts
associated with pancreatic cancer and the psychological impact of
the disease.
