The goal of the Life After Whipple Project is to begin to research, collect and disseminate information that may be helpful for pancreatic cancer survivors. This project is for patients who have had, or will have, the Whipple Procedure and are interested in learning how this surgery will affect their lives afterward. Our goal is to help patients learn how to live a successful life, after Whipple.
Greg Adams, a pancreatic cancer survivor and team leader of the “Life After Whipple” project, introduces the project providing helpful information for those undergoing or considering the Whipple procedure for pancreatic cancer. Dr. Kwon discusses the anatomy of the pancreas and types of pancreatic operations, focusing on the Whipple procedure and its implications, such as encasement around blood vessels leading to unresectable tumors. The Whipple procedure is a complex six-step operation that involves removing and reconnecting the bile duct, stomach, and pancreas head. Although there are controversies surrounding pylorus preservation, both techniques have comparable long-term effects.
The discussion also highlights complications like Type 3 diabetes, exocrine pancreas insufficiency, delayed gastric emptying, and leakages from pancreatic connections. Medical treatments for weakly squeezing stomachs involve Reglan or Redline. Following the procedure, patients require lifelong acid reduction medication and may face complications like bile reflux and potential hiatal hernias. Foreign patients considering treatment are advised to research and contact international patient services offered by specialized medical centers for the best possible outcome.
HIGHLIGHTS
00:00:00 Introduction of the “Life After Whipple” project and the purpose of this series aiming to disseminate helpful information for pancreatic cancer survivors.
00:05:00 Dr. Kwon explains the anatomy of the pancreas and the types of pancreas operations one may undergo for cancer, focusing on the Whipple procedure and its consequences.
00:10:00 Various stages of pancreatic cancer and whether they are respectable via surgery or not.
00:15:00 The concept of “encasement” in pancreatic cancer, using a CT scan image as an example.
00:20:00 The complex nature of the Whipple procedure, a six-step operation used to remove tumors in the pancreas.
00:25:00 The importance of early detection and symptoms of pancreas cancer and the development in early detection tests on the horizon.
00:30:00 Three components of pancreas reconstruction after the Whipple procedure, focusing on the technical challenges of connecting the pancreas, bile duct, and stomach.
00:35:00 The challenges and techniques used during surgery to secure the pancreatic in place.
00:40:00 Health complications that can arise after undergoing pancreas surgery, specifically Type 3 diabetes and exocrine pancreas insufficiency.
00:45:00 The debate surrounding pylorus preservation during the procedure.
00:50:00 The complications of delayed gastric emptying after the procedure.
00:55:00 Questions answered in regard to surgery in foreign countries.
Dr. Kathleen Estrada discusses the functions of the pancreas, focusing on its endocrine role in glucose regulation. The pancreas contains islets of Langerhans, which secrete insulin, glucagon, and somatostatin. Insulin lowers blood sugar levels, while glucagon raises it. Type 3C diabetes, a subtype of diabetes, results from damages to the pancreas and affects exocrine function, leading to insulin and glucagon deficiency, causing blood sugar fluctuations. She also talks about the relationship between insulin production and pancreatectomy locations, with distal pancreatectomy having a higher risk of Type 3C diabetes. The video covers various insulin types and management, the importance of good blood sugar control, the effects of low blood sugar, and recent advancements in technology, such as Continuous Glucose Monitors and insulin pumps. Lastly, Kathleen touches on the experiences and insights of a Whipple procedure survivor regarding blood sugar regulation post-surgery.
HIGHLIGHTS
00:00:00 Discussion on the endocrine functions of the pancreas, specifically focusing on glucose regulation.
00:05:00 Type 3C diabetes, a subtype of diabetes that belongs to Type 3 and beyond, which includes conditions affecting the exocrine pancreas.
00:10:00 The relationship between the location of pancreatic resection and the development of Type 3C diabetes.
00:15:00 Different types of insulin used by people with diabetes.
00:20:00 The importance of good blood sugar control for individuals with diabetes.
00:25:00 The insulin pen, a device used for insulin injection, and its side effects & primary functions, specifically low blood sugar.
00:30:00 Recent advancements in diabetes technology, specifically Continuous Glucose Monitors (CGMs).
00:35:00 Advancements in insulin pumps and continuous glucose monitoring systems (CGMs) for managing diabetes.
00:40:00 The Bionic Pancreas, a new device designed to help manage blood sugar levels for people with diabetes.
00:45:00 A survivor discusses the cyclical nature of their blood sugar levels, which alternate between insulin resistance and carbohydrate resistance.
00:50:00 A survivor of pancreatic cancer shares her experiences and offers insights on Type 3C diabetes, which she does not have type 1 or type 2.
HIGHLIGHTS
00:00:00 The impact of the Whipple procedure on the gastric system
00:05:00 Overview of the digestive process with a focus on the upper GI tract, particularly the stomach and duodenum.
00:10:00 The stomach’s operations & functions and its relation to a tumor environment.
00:15:00 Digestive functions of the stomach, bowel, and how they operate in relation to digestion.
00:20:00 The roles of the pancreas and bile duct in the upper gastrointestinal (GI) tract.
00:25:00 The discussion revolves around the complexities of the digestive system and how it adapts to disease processes.
00:30:00 Long-term complications of the Whipple procedure, which affected nearly half of the patients in a study with a follow-up of at least four years.
00:35:00Challenges in treating gastroparesis, a condition in which the stomach’s nervous system function is disrupted, often after surgery or a cancer diagnosis.
00:40:00 Dietary management and pancreatic insufficiency, common issues post Whipple Procedure.
00:45:00 Two common issues that can arise after bowel surgery, specifically a Whipple procedure.
00:50:00 The importance of dietitians in managing nutritional complications after a Whipple procedure, specifically in regards to gastroparesis and pancreatic insufficiency.
00:55:00 The insufficient care given to patients after undergoing a Whipple procedure, which is used to treat pancreatic cancer.
OVERVIEW
HIGHLIGHTS
00:00:00 Dr. Crawford and Dr. Steele discuss the normal functioning of the digestive system and the potential effects of pancreatic cancer and its treatment on nutrition.
00:05:00 The importance of salivary glands and stomach in the digestive process.
00:10:00Relation between the roles of the stomach in digestion and nutrition.
00:15:00 The complex role of the nervous system, specifically the enteric nervous system, in digestion.
00:20:00 Functions of different regions of the stomach in aiding digestion.
00:25:00 Potential for cellular plasticity in the digestive system, specifically in the case of a total pancreatectomy or after a Whipple procedure.
00:30:00 Roles of various organs in the digestive system, including the pancreas – which is described as having both endocrine and exocrine functions.
00:35:00 The role of the pancreas in regulating glucose levels through the production of insulin and glucagon.
00:40:00 Consequences of losing parts of the digestive tract during surgeries like the Whipple and pancreatectomy.
00:45:00 Personal experiences with digestion and nutrition are shared, specifically regarding the absorption of certain vitamins and fats.
00:50:00 Absorption of nutrients and the role of the microbiome in various parts of the digestive system.
00:55:00 How chemotherapy can affect the endothelial cells in veins and arteries, potentially altering their functionality.
01:00:00 Ongoing clinical trials aimed at preventing pancreatic cancer recurrence.
HIGHLIGHTS
00:00:00 Dr. Kelly Martin from Henry Ford Health discusses the impact of fear and anxiety on individuals diagnosed with pancreatic cancer and their strategies for coping.
00:05:00 Emotional responses of individuals, including themselves, who have undergone surgery for cancer, with a focus on those diagnosed with pancreatic cancer.
00:10:00 A cancer survivor shares her experience of going through surgery and feeling a sense of relief and renewal afterward.
00:15:00 Greg dives into details of his experience surviving cancer and the subsequent challenges of adapting to a new normal.
00:20:00 Connection between fear and anxiety, particularly in relation to a cancer diagnosis, and depression.
00:25:00 The connection between physical & mental symptoms, specifically in the context of fear of recurrence or progression of cancer.
00:30:00 Different types of distorted thoughts that contribute to fear and anxiety, specifically in relation to health concerns. The ultimate goal here is not to eliminate anxiety entirely but to reduce it by shifting one’s perspective.
00:35:00 The importance of acceptance and understanding the power of these thoughts rather than trying to change them.
00:40:00 Using detachment to change the way of thinking and eliminate anxious thinking.
00:45:00 A guest shares her experience with managing anxiety through various methods.
00:50:00 Strategies for coping with stressors, and the importance of advocacy.
00:55:00 The importance of identifying and seeking different types of support, as well as applying self-advocacy to manage fear and anxiety.
01:00:00 Various aspects of living with anxiety and fear, particularly in the context of a serious illness such as pancreatic cancer.
01:05:00 Patty, Greg’s advocate and wife, shares feedback on the importance of self-value and reprioritization during a survivor’s journey.
01:10:00 The normal response of fear and anxiety after a cancer diagnosis, specifically for pancreatic cancer.
Dr. Howard Crawford discusses the significant role stress plays in the development and progression of pancreatic cancer. Stress can lead to perineural invasion, a common form of pancreatic cancer metastasis, and the presence of sensory neurons in the pancreas can lead to pain and gut issues experienced by patients. A study by Tim Wong at Columbia University found that isolating mice with precursors to pancreatic cancer and subjecting them to stress accelerated the formation and progression of the cancer. Research also suggests that patients on beta blockers, which reduce stress responses, have a longer survival rate. The discussion also explores personal experiences, early detection strategies, challenges in diagnosis, strategies for reducing stress, and the potential impact of beta-blockers on survival rates.
HIGHLIGHTS
00:00:00 The role stress plays in the development and progression of pancreatic cancer.
00:05:00 A significant finding in the field of cancer research regarding the role of stress in cancer progression.
00:10:00 The interconnected relationship between the nervous system and the pancreas, particularly relevant to pancreatic cancer patients.
00:15:00 Greg shares his personal experience of having ancestors with pancreatic cancer and the possible role of stress as a contributing factor.
00:20:00 The importance of having a support system and keeping an active lifestyle through treatment.
00:25:00 The topic shifts to the potential for early detection of pancreatic cancer through tests on the nervous system.
00:30:00 Generalized discomfort of symptoms related to pancreatic cancer and risk factos to avoid.
00:35:00 The importance of doctors listening to patients’ experiences and considering lesser-known causes of their symptoms to improve early detection and differential diagnosis.
00:40:00 Unique relationship between the pancreas and the nervous system.
00:45:00 Discussion shifts towards strategies for reducing stress in individuals who have had pancreatic cancer.
00:50:00 The potential impact of beta-blockers on the survival rates of pancreatic cancer patients.
00:55:00 The placebo effect and its potential impact on reducing stress.
