GI diseases

what is the largest internal organ

liver

which quadrant is the liver located in

RUQ

protected by ribs

underneath diaphragm

what % of bloody supply does the lvier hold at any given moment

13%

what cells are the liver mainly made up of

hepatocytes

what 2 sources supply blood to the liver

hepatic artery: deliver oxygenated blood from general circualtion

hepativ portal vein: delivering deoxygenated blood from small intestine containing nutrients

key functions of liver

produce bile to break down fats

make protein for blood plasma

produce cholesterol and proteins to transport fats

converts glucose to glycogen for energy storage

regulates blood amino acids

sotres iron from hemoglobin

converts ammonia to urea

clears drugs anbd toxins from blood

regulates blood clotting

supports immune response and removes bacteria

clears bilirubin to prevent jaundice

liver cancer RF

chronic Hep B and C infections

alcohol consumption

non-alcoholic fatty liver disease

cirrhosis

certain env exposures

obesity and diabetes

how many cases of liver cancer are expected to be diagnosed in US

21,210

is liver cancer more common in men or women

men

what age range are the liver cancer rates highest

60-70 years

causes of liver cancer

aflatoxins: poisonous and cancer causing chemicals produced in certain molds which grow in soil, hay

hepatitis: inflammation of liver caused by viral infection or liver damage from alcohol

what sites mets to liver

GI TRACT

BREAST

LUNG

PANCREAS

Common liver cancer screenings

US: every 6 months for those with chronic liver disease

alpha-fetoprotein blood test: measures protein that may be elevated in ppl with liver cancer

common sx/presentation

jaundice

unexplained weight loss

upper abdominal pain

fatigue

nauseadark-colored urine

liver cancer staging

TNM

cirrhosis staging: assess progress of chronic disease

surgery treatments

partial hepatectomy or liver transplant

SBRT fx for liver cancer

1000 cGy x 5 EOD—>50Gy

800 cGy x 5 EOD—>40 Gy

IMRT fx for liver cancer

250 cGy x 15 daily—>37.5 Gy

300 cGy x 15 daily—>45 Gy

pancreas function

produces hormones (insulin, glucagon, pancreatic polypeptide)

digestive organ, secretes pancreatic juice to enutralize acidity of chyme moving in from stomach—>help further break down carbs, proteins, lipids

whipple-pancreaticduodenectomy

remove the head of the pancreas and first part of the small intestine, portion of common bile duct, gallbladder, and sometimes part of stomach

what is the 5-year prognosis of pancreatic cancer

6% of patients are alive 5 years after diagnosis

very poor prognosis

histopathology for pancreatic cancer

>90% of adenocarcinomas are duct cell adenocarcinoams

standard fx for pancreatic cancer

preop or postop

45-50.4 Gy x 25-28 fx

pts with resectable pancreatic cancer, aiming to shrink tumor before surgery or eliminate remaining cancer cells after surgery

SBRT pancreatic cancer

25-40 Gy in 5 or fewer fx

for unresectable cancer

conventional rt pancreatic cancer fx

45-54 Gy in 1.8-2 Gy per fx

when SBRT is not possible