Pathophysiology Of Colon Cancer Pdf

ALKP Canine Liver Disease Foundation. A thorough approach is needed for a correct diagnosis of any liver problem. An organ like the liver thatis so intimately involved with other important organs will exhibit symptoms that mimic disease in these other organs. Liver function tests are laboratory blood tests meant to show details about the condition of the patients liver. Tests may be associated with functionality. Hemangiosarcomas of the spleen and liver are highly metastatic and malignant vascular neoplasms tumors in the blood vessels that arise from the endothelial cells. Overview of kidney disease, including most common causes, and associated tests. HematOnc/Gastrointestinal/CF_CRC_Fig2.gif' alt='Pathophysiology Of Colon Cancer Pdf' title='Pathophysiology Of Colon Cancer Pdf' />Also, what initially might appear as a diseased liver is in reality a disease elsewhere in thebody that is involved with the liver secondarily. This is why it is crucial to follow a thorough and methodical approach called the diagnostic process. Examination. Specifically noting signs which may indicate liver disease. Periodic ascites, intolerance of a high protein diet, icterus, chronic weight loss, abnormally colored feces or urine, bleeding disorders, chronic illness, and all that has been mentioned above. Sometimes urinary crystals formed from the improperly metabolized proteins and amino acids may indicate liver disease. Liver disease can occur in pets of any age. Get detailed information about liver cancer from the American Cancer Society. Pancreas definition, a gland, situated near the stomach, that secretes a digestive fluid into the intestine through one or more ducts and also secretes the hormone. If it occurs in young animals we tend to think more of toxicity, a liver shunt or a viral disease like adenovirus in dogs. In older pets we tend to think more of inflammation and cancer as the cause of the liver problem. Several canine breeds are prone to getting liver disease Bedlington terriers, Skye terriers, Doberman pinschers, and West Highland White terriers get aproblem with excessive copper accumulation that results from failure of normal biliary excretion of copper. Cocker spaniels have an increased incidence of chronic hepatitis. History. Early signs of liver disease are subtle, and might exhibit as some of the symptoms described above. It is important to remember that some pets do not show any symptoms early in the course of the disease. This is another reason for yearly exams, along with blood and urine samples in dogs and cats 8 years of age or more. Even though many cancers do not show up in a blood sample, we can sometimes get indirect evidence there is a problem, leading to additional diagnostic tests that might find cancer. The recent use of pesticides, insecticides, and drugs might give us a clue. Some Labradors are sensitive to the use of the arthritis medicine Rimadyl. These dogs should have a blood panel analyzed prior to initiating Rimadyl therapy. Every 6 months this panel should be repeated. A history of poorly controlled diabetes mellitus might also clue us in to liver problems. Pets withliver shunts might have stunted growth and become depressed right after eating. Physical Exam. Routine physical exam findings might include Distended abdomen due to enlargement of the liver hepatomegaly might be found. This can be palpated in some situations, especially in the smaller animals. This includes heart disease and Cushings Disease. Enlarged lymph nodes due to secondary bacterial infections or spread of a primary or metastaticliver tumor. Bruising hematoma might be observed under the skin, or when a blood sample is obtained. This isdue to the livers affects on the clotting mechanism. Fever a rectal temperature of greater than 1. F could accompany liver disease when inflammation or infection is present. Skin infections and wounds that do not heal, or recur after antibiotics are stopped. Yellowish discoloration icterus or jaundice of the ears, gums, or hairless areas of the skin. Anemia might be observed by checking the mucous membranes for a normal pink color. Extensive Blood Work and Diagnostic Testing. A complete blood count to check for anemia and blood cell abnormalities. A CBC complete bloodcount and BCP biochemistry panel should be run on every pet 8 years of age or more, especially if they have any of the symptoms of liver disease. The CBC might show a decrease in the number of red blood cells RBCs. This decrease in RBCs is called anemia. The white blood cell count WBC might be elevated leukocytosis, normal, or decreased leukopenia, mostly depending on the cause of the liver problem and how long it has been present. A change in the WBCs does not necessarily indicate there is a liver problem. A complete chemistry screen, including ALT, ALP, AST, bilirubin, glucose, urea, electrolyte levels,albumin, globulin and bile acid levels. The bile acid levels should be checked on an empty stomach and two hours after feeding. All these values, with the exception of the bile acids, usually are included ona standard Small Animal Data Base Screen. Important Liver Enzymes. Traditionally the medical practitioner has measured the relative concentration of several enzymes which may indicate alterations in liver health. The following enzymes typically change values in the face of liver failure. Alanine Aminotransferase ALT Liver specific. Cell damage will cause elevations of ALT due to leakage. The elevation of the enzyme correlates with the number of cells damaged. Falling levels of ALT may indicate recovery or may indicate a failing number of functional liver cells. Rapid increases in ALT may indicate an acute process, while slow increases may indicate bile duct obstruction. Normal Test Range 1. ULAspartate Aminotransferase AST an enzyme seen in the liver, heart, kidney, skeletal muscle and brain. The half life of the AST in the blood stream is much shorter than that of ALT, therefore the values of AST tend to drop more rapidly once liver function is resumed. AST elevations and ALT elevations should parallel each other in liver disease. Normal Test Range 5 5. ULlkaline Phosphatase ALKPALP This enzyme is present in many tissues, therefore it not very specific in liver disease, but it appears very early in the progress of liver disease, therefore it is considered quite sensitive. ALP tends to be slightly more specific in the cat, but not quite as sensitive. A similar enzyme or isoenzyme is secreted as a result of high levels of cortisone, therefore an effort must be made to separate Cortisole induced ALP or CALP and normal ALP. Liver ALP is released from the liver when many anticonvulsant drugs are administered to the dog. This must be taken into account when evaluating ALP levels. ALP levels typically are greatly elevated in the young, growing animal and therefore a veterinarian should not mistake any elevations as disease in a young animal. Normal Test Range 2. ULamma Glutamyltransferase GGT This enzyme is has its highest concentration in the kidneys and pancreas, but it is also found in the liver and other organs. The major proportion of GGT in the serum seems to come from the liver. Virtual Tabla For Pc. Elevations of GGT in disease seem to stem from new synthesis rather than leakage, therefore the changes seen due to disease are not spectacular. Large elevations of GGT are more commonly associated with pancreatitis and bile duct obstruction. Bile Acids. These series of organic acids circulate almost entirely in the localized blood flow between the intestinesand the liver a. Portal system. The flow is typically from the liver, into the bile duct system, then excretion into the intestines to aid digestion after a meal, to be re absorbed into the portal system and recycled by the liver. Very little of the bile acids escape from the portal circulation system into the rest of the body. Leakage is considered abnormal and is a sure sign of a liver abnormality. This is one of the most sensitive tests available to diagnose liver disease. While the liver does actually manufacture this product, it has tremendous reserve capacity and can easily meet the bodies demand for bile acids despite severe disease. Get Facts on Stages and Treatment. Treatment Option Overview. There are different types of treatment for patients with gallbladder cancer. Different types of treatments are available for patients with gallbladder cancer. Some treatments are standard the currently used treatment, and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team. Three types of standard treatment are used Surgery. Gallbladder cancer may be treated with a cholecystectomy, surgery to remove the gallbladder and some of the tissues around it. Nearby lymph nodes may be removed. A laparoscope is sometimes used to guide gallbladder surgery. The laparoscope is attached to a video camera and inserted through an incision port in the abdomen. Surgical instruments are inserted through other ports to perform the surgery. Because there is a risk that gallbladder cancer cells may spread to these ports, tissue surrounding the port sites may also be removed. If the cancer has spread and cannot be removed, the following types of palliative surgery may relieve symptoms Surgical biliary bypass If the tumor is blocking the small intestine and bile is building up in the gallbladder, a biliary bypass may be done. During this operation, the gallbladder or bile duct will be cut and sewn to the small intestine to create a new pathway around the blocked area. Endoscopic stent placement If the tumor is blocking the bile duct, surgery may be done to put in a stent a thin, flexible tube to drain bile that has built up in the area. The stent may be placed through a catheter that drains to the outside of the body or the stent may go around the blocked area and drain the bile into the small intestine. Percutaneous transhepatic biliary drainage A procedure done to drain bile when there is a blockage and endoscopic stent placement is not possible. An X ray of the liver and bile ducts is done to locate the blockage. Images made by ultrasound are used to guide placement of a stent, which is left in the liver to drain bile into the small intestine or a collection bag outside the body. This procedure may be done to relieve jaundice before surgery. Radiation therapy. Radiation therapy is a cancer treatment that uses high energy X rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. Chemotherapy. Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body systemic chemotherapy. When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas regional chemotherapy. The way the chemotherapy is given depends on the type and stage of the cancer being treated. New types of treatment are being tested in clinical trials. These include the following Radiosensitizers. Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more tumor cells. This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site. Treatment Options for Gallbladder Cancer. Localized Gallbladder Cancer. Treatment of localized gallbladder cancer may include the following Surgery to remove the gallbladder and some of the tissue around it. The liver and nearby lymph nodes may also be removed. Radiation therapy with or without chemotherapy may follow surgery. Radiation therapy with or without chemotherapy. A clinical trial of radiation therapy with radiosensitizers. This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site. Check for clinical trials from NCIs PDQ Cancer Clinical Trials Registry that are now accepting patients with localized gallbladder cancer. Unresectable Gallbladder Cancer. Treatment of unresectable gallbladder cancer may include the following Radiation therapy as palliative treatment, with or without surgery or the placement of stents, to relieve symptoms caused by blocked bile ducts. Surgery as palliative treatment to relieve symptoms caused by blocked bile ducts. Chemotherapy as palliative treatment to relieve symptoms caused by the cancer. A clinical trial of internal radiation therapy or radiosensitizers. A clinical trial of chemotherapy. This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site. Check for clinical trials from NCIs PDQ Cancer Clinical Trials Registry that are now accepting patients with unresectable gallbladder cancer. Recurrent Gallbladder Cancer. Treatment of recurrent gallbladder cancer depends on where the cancer has. It is usually done in a clinical trial. Information about ongoing clinical trials is available from the NCI Web site. Check for clinical trials from NCIs PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent gallbladder cancer.