Web resources for pancreatic cancer

Dr Keith Barnard recommends websites relating to this week's Clinical Review.

Treatment guidelines

This page gives you the option to look up the guidelines for treatment of pancreatic cancer. We don't see that many cases, so reminding ourselves of what our patients may be offered in terms of treatment is useful.

There is NICE guidance on laparascopic distal pancreatectomy and on the use of gemcitabine, and a 17-page PDF from the British Society of Gastroenterology on the management of patients with periampullary and ampullary carcinomas.

It's fairly technical stuff, but it's worth knowing where to look if a patient is facing any of these options.

Why go there: keep abreast of treatments.

Downside: not a quick read.

Information from: CancerBackUp.

Address: http://www.cancerbackup.org.uk/Healthprofessionals/Treatmentguidelines/Specificcancers/Pancreas.

Patient Information

Pancreatic cancer is not an easy topic to discuss with patients, especially given its still poor prognosis compared to many other malignancies.

We should not be discouraged from going into detail with patients and family members, but referring them to these pages will surely help.

I particularly like the clear colour diagrams that demonstrate where the pancreas is and what it does, and the detailed information is clearly and sympathetically handled.

Why go there: well illustrated.

Downside: linked pages; complicate navigation.

Information from: Cancer Research UK.

Address: http://www.cancerhelp.org.uk/help/defaultasp?page=3095.

Alternative therapy

I make no apology for having another go at the claims of alternative medicine for cancers. I practically had steam coming out of my ears reading all the claims of strangely-qualified practitioners and case studies of people who had been 'cured' of their cancer by herbs, medication, bucketsful of enzymes or homoeopathy.

It is sad that it is so easy to convince people to part with their money on the offer of false promises. It is a long time since I have waded through such pseudoscientific claptrap as I have found while searching alternative medicine 'treatments' for pancreatic cancer.

Do the purveyors of this rubbish really believe that their products work, or are they just happy to take the money and run? And a lot of money it is, this 'remedy' for pancreatic cancer costs £200 for a three months' supply.

Why go there: to convince you this is bad news.

Downside: bad for your patients, bad for your BP.

Information from: HerbChina 2000.

Address: http://www.herbchina2000.com/therapies/CPC.shtml

Pancreatic cysts

I confess I had no idea there was such a variety of cystic neoplasms that can affect the pancreas - serous cystic, solid pseudopapillary, mucinous cystic and others.

These pages give you a brief summary of the different types and their key features. I learnt that one type of neoplastic cyst occurs in young women in their twenties. It's rare, but that's no reason not to know about it. It'll only take you a couple of minutes to find out more.

Why go there: maybe learn something new.

Downside: somewhat esoteric.

Information from: Johns Hopkins University.

Address: http://www.pathology2.jhu.edu/pancreascyst/index.cfm

- Dr Barnard is a former GP in Fareham, Hampshire.

Website of the week

These pages on the diagnosis and management of pancreatic cancer are detailed but have the great advantage that they are aimed at the family doctor. This means that although there is plenty of information, the small print stuff is limited and it is nearly all relevant.

The information is also presented in the form of an easily printed PDF, so you can keep it for reference or teaching.

It may sound a lot of reading, but it is not an indigestible mass of text as it contains frequent tables, diagrams and excellent coloured illustrations of surgical options.

I particularly liked the CT scans accompanied by a labelled drawing that explain to the uninitiated exactly what you are looking at.

There's also a useful table of key recommendations for practice, with evidence ratings for each, and a reminder of the TNM staging system for pancreatic cancer.

Why go there: good for revision and the coloured diagrams are good examples for teaching.

Downside: none.

Information from: American Academy of Family Physicians.

Address: http://www.aafp.org/afp/20060201/485.pdf

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