Al Tomko (22 November 1931 – 5 August 2009) was a Canadian professional wrestler and wrestling promoter.
54-731: Tomko is a surname. Notable people with the surname include: Al Tomko (1931–2009), Canadian professional wrestler and wrestling promoter Brett Tomko (born 1973), Major League Baseball pitcher with the Kansas City Royals Dewey Tomko (born 1946), American professional poker player Jozef Tomko (1924–2022), Slovak cardinal in the Roman Catholic Church Sara Tomko , American actress Travis Tomko (born 1976), aka Tomko, American professional wrestler [REDACTED] Surname list This page lists people with
108-444: A MEN1 mutation eventually develop a PanNet. Other genes that are frequently mutated include DAXX , mTOR , and ATRX . The symptoms of pancreatic adenocarcinoma do not usually appear in the disease's early stages, and they are not individually distinctive to the disease. The symptoms at diagnosis vary according to the location of the cancer in the pancreas, which anatomists divide (from left to right on most diagrams) into
162-402: A tumor microenvironment that is short of blood vessels (hypovascular) and so of oxygen ( tumor hypoxia ). It is thought that this prevents many chemotherapy drugs from reaching the tumor, as one factor making the cancer especially hard to treat. Negative for: Pancreatic cancer is usually staged following a CT scan . The most widely used cancer staging system for pancreatic cancer
216-421: A better prognosis than the other exocrine types. Pancreatoblastoma is a rare form, mostly occurring in childhood, and with a relatively good prognosis. Other exocrine cancers include adenosquamous carcinomas , signet ring cell carcinomas , hepatoid carcinomas , colloid carcinomas, undifferentiated carcinomas, and undifferentiated carcinomas with osteoclast -like giant cells . Solid pseudopapillary tumor
270-410: A combination of medical imaging techniques such as ultrasound or computed tomography , blood tests, and examination of tissue samples ( biopsy ). The disease is divided into stages , from early (stage I) to late (stage IV). Screening the general population has not been found to be effective. The risk of developing pancreatic cancer is lower among non-smokers, and people who maintain
324-401: A combination of these. Treatment options are partly based on the cancer stage. Surgery is the only treatment that can cure pancreatic adenocarcinoma, and may also be done to improve quality of life without the potential for cure. Pain management and medications to improve digestion are sometimes needed. Early palliative care is recommended even for those receiving treatment that aims for
378-401: A considerably increased risk remains of pancreatic cancer developing subsequently. The third type, pancreatic mucinous cystic neoplasm (MCN), mainly occurs in women, and may remain benign or progress to cancer. If these lesions become large, cause symptoms, or have suspicious features, they can usually be successfully removed by surgery. A fourth type of cancer that arises in the pancreas
432-456: A cure or to alleviate symptoms. Risk factors for pancreatic adenocarcinoma include: Drinking alcohol excessively is a major cause of chronic pancreatitis , which in turn predisposes to pancreatic cancer, but considerable research has failed to firmly establish alcohol consumption as a direct risk factor for pancreatic cancer. Overall, the association is consistently weak and the majority of studies have found no association, with smoking
486-527: A cure. Pancreatic cancer is among the most deadly forms of cancer globally, with one of the lowest survival rates. In 2015, pancreatic cancers of all types resulted in 411,600 deaths globally. Pancreatic cancer is the fifth-most-common cause of death from cancer in the United Kingdom, and the third most-common in the United States. The disease occurs most often in the developed world, where about 70% of
540-509: A healthy weight and limit their consumption of red or processed meat ; the risk is greater for men, smokers, and those with diabetes. There is some evidence that links high levels of red meat consumption to increased risk of pancreatic cancer. Smokers' risk of developing the disease decreases immediately upon quitting, and almost returns to that of the rest of the population after 20 years. Pancreatic cancer can be treated with surgery, radiotherapy , chemotherapy , palliative care , or
594-545: A strong confounding factor. The evidence is stronger for a link with heavy drinking, of at least six drinks per day. Exocrine cancers are thought to arise from several types of precancerous lesions within the pancreas, but these lesions do not always progress to cancer, and the increased numbers detected as a byproduct of the increasing use of CT scans for other reasons are not all treated. Apart from pancreatic serous cystadenomas , which are almost always benign, four types of precancerous lesion are recognized. The first
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#1732873067968648-519: A sufficient quantity to give rise to overt clinical symptoms, so nonfunctioning PanNETs are often diagnosed only after the cancer has spread to other parts of the body. As with other neuroendocrine tumors, the history of the terminology and classification of PanNETs is complex. PanNETs are sometimes called "islet cell cancers", though they are now known to not actually arise from islet cells as previously thought. Since pancreatic cancer usually does not cause recognizable symptoms in its early stages,
702-469: Is a rare low- grade neoplasm that mainly affects younger women, and generally has a very good prognosis. Pancreatic mucinous cystic neoplasms are a broad group of pancreas tumors that have varying malignant potential. They are being detected at a greatly increased rate as CT scans become more powerful and common, and discussion continues as how best to assess and treat them, given that many are benign. The small minority of tumors that arise elsewhere in
756-457: Is accompanied by typical symptoms such as unexplained weight loss, persistent abdominal or back pain, indigestion, vomiting, or fatty feces. Jaundice accompanied by a painlessly swollen gallbladder (known as Courvoisier's sign ) may also raise suspicion, and can help differentiate pancreatic cancer from gallstones . Medical imaging techniques, such as computed tomography (CT scan) and endoscopic ultrasound (EUS) are used both to confirm
810-453: Is by far the most common type, representing about 85% of all pancreatic cancers. Nearly all these start in the ducts of the pancreas, as pancreatic ductal adenocarcinoma (PDAC). This is despite the fact that the tissue from which it arises – the pancreatic ductal epithelium – represents less than 10% of the pancreas by cell volume, because it constitutes only the ducts (an extensive but capillary-like duct-system fanning out) within
864-648: Is different from Wikidata All set index articles Al Tomko Tomko started out as a wrestler in his hometown of Winnipeg on 9 July 1954, with the Madison Wrestling Club , losing his debut match to John DePaulo . During that same period, he ran his own promotion in Winnipeg, the Olympia Wrestling Club . After he shut down the Olympia Club to pursue non-wrestling ventures, but he rejoined
918-410: Is less sensitive and will miss small tumors, but can identify cancers that have spread to the liver and build-up of fluid in the peritoneal cavity ( ascites ). It may be used for a quick and cheap first examination before other techniques. A biopsy by fine needle aspiration , often guided by endoscopic ultrasound, may be used where there is uncertainty over the diagnosis, but a histologic diagnosis
972-456: Is not usually required for removal of the tumor by surgery to go ahead. Liver function tests can show a combination of results indicative of bile duct obstruction (raised conjugated bilirubin , γ-glutamyl transpeptidase and alkaline phosphatase levels). CA19-9 (carbohydrate antigen 19.9) is a tumor marker that is frequently elevated in pancreatic cancer. However, it lacks sensitivity and specificity , not least because 5% of people lack
1026-485: Is pancreatic intraepithelial neoplasia (PanIN). These lesions are microscopic abnormalities in the pancreas and are often found in autopsies of people with no diagnosed cancer. These lesions may progress from low to high grade and then to a tumor. More than 90% of cases at all grades carry a faulty KRAS gene, while in grades 2 and 3, damage to three further genes – CDKN2A ( p16 ), p53 , and SMAD4 – are increasingly often found. A second type
1080-428: Is technically feasible because the celiac axis and superior mesenteric artery are still free) and those that are "unresectable" (due to more locally advanced disease); in terms of the more detailed TNM classification, these two groups correspond to T3 and T4 respectively. Locally advanced adenocarcinomas have spread into neighboring organs, which may be any of the following (in roughly decreasing order of frequency):
1134-505: Is the intraductal papillary mucinous neoplasm (IPMN). These are macroscopic lesions, which are found in about 2% of all adults. This rate rises to about 10% by age 70. These lesions have about a 25% risk of developing into invasive cancer. They may have KRAS gene mutations (40–65% of cases) and in the GNAS Gs alpha subunit and RNF43, affecting the Wnt signaling pathway . Even if removed surgically,
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#17328730679681188-571: Is the intraductal tubulopapillary neoplasm. This type was recognised by the WHO in 2010 and constitutes about 1–3% of all pancreatic neoplasms. Mean age at diagnosis is 61 years (range 35–78 years). About 50% of these lesions become invasive. Diagnosis depends on histology, as these lesions are very difficult to differentiate from other lesions on either clinical or radiological grounds. The genetic events found in ductal adenocarcinoma have been well characterized, and complete exome sequencing has been done for
1242-686: Is the one formulated by the American Joint Committee on Cancer (AJCC) together with the Union for International Cancer Control (UICC). The AJCC-UICC staging system designates four main overall stages, ranging from early to advanced disease, based on TNM classification of T umor size, spread to lymph N odes, and M etastasis. To help decide treatment, the tumors are also divided into three broader categories based on whether surgical removal seems possible: in this way, tumors are judged to be "resectable", "borderline resectable", or "unresectable". When
1296-426: Is typically characterized by moderately to poorly differentiated glandular structures on microscopic examination. There is typically considerable desmoplasia or formation of a dense fibrous stroma or structural tissue consisting of a range of cell types (including myofibroblasts , macrophages , lymphocytes and mast cells ) and deposited material (such as type I collagen and hyaluronic acid ). This creates
1350-553: The Lewis (a) antigen and cannot produce CA19-9. It has a sensitivity of 80% and specificity of 73% in detecting pancreatic adenocarcinoma, and is used for following known cases rather than diagnosis. All those with pancreatic cancer require genetic testing as high risk oncogenic mutations may provide prognostic information and certain mutations with high risk features require first degree relatives to undergo genetic testing as well. The most common form of pancreatic cancer (adenocarcinoma)
1404-443: The duodenum , stomach , transverse colon , spleen , adrenal gland , or kidney . Very often they also spread to the important blood or lymphatic vessels and nerves that run close to the pancreas, making surgery far more difficult. Typical sites for metastatic spread (stage IV disease) are the liver, peritoneal cavity and lungs , all of which occur in 50% or more of fully advanced cases. The 2010 WHO classification of tumors of
1458-480: The hormone -producing ( endocrine ) tissue of the pancreas have different clinical characteristics and are called pancreatic neuroendocrine tumors , sometimes abbreviated as "PanNETs". Both groups occur mainly (but not exclusively) in people over 40, and are slightly more common in men, but some rare subtypes mainly occur in women or children. The exocrine group is dominated by pancreatic adenocarcinoma (variations of this name may add "invasive" and "ductal"), which
1512-407: The stomach , begin to multiply out of control and form a mass . These cancerous cells have the ability to invade other parts of the body. A number of types of pancreatic cancer are known. The most common, pancreatic adenocarcinoma , accounts for about 90% of cases, and the term "pancreatic cancer" is sometimes used to refer only to that type. These adenocarcinomas start within the part of
1566-439: The surname Tomko . If an internal link intending to refer to a specific person led you to this page, you may wish to change that link by adding the person's given name (s) to the link. Retrieved from " https://en.wikipedia.org/w/index.php?title=Tomko&oldid=1241533102 " Categories : Surnames Slovak-language surnames Hidden categories: Articles with short description Short description
1620-584: The Vancouver territory, he began pushing himself as All Star's top star under the ring name Master Sergeant Tomko in the early-1980s (despite his age, being physically past his prime, and lacking wrestling skills) and gave himself almost all of All Star's championships (including the Vancouver version of the NWA Canadian Heavyweight title) at various points. Under Tomko's leadership, All Star went into decline (with co-owner Gene Kiniski selling his share of
1674-408: The body and tail typically also cause pain. People sometimes have recent onset of atypical type 2 diabetes that is difficult to control, a history of recent but unexplained blood vessel inflammation caused by blood clots ( thrombophlebitis ) known as Trousseau sign , or a previous attack of pancreatitis . A doctor may suspect pancreatic cancer when the onset of diabetes in someone over 50 years old
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1728-403: The body. Pancreatic cancer rarely occurs before the age of 40, and more than half of cases of pancreatic adenocarcinoma occur in those over 70. Risk factors for pancreatic cancer include tobacco smoking , obesity , diabetes , and certain rare genetic conditions. About 25% of cases are linked to smoking, and 5–10% are linked to inherited genes . Pancreatic cancer is usually diagnosed by
1782-552: The common forms of pancreatic cancer have found that 75% of human genes are expressed in the tumors, with some 200 genes more specifically expressed in pancreatic cancer as compared to other tumor types. Pancreatic ductal adenocarcinoma cancer cells are known to secrete immunosuppressive cytokines, creating to a tumor microenvironment that inhibits immune detection and blocks anti-cancer immunity. Cancer associated fibroblasts secrete fibrous tissue ( desmoplasia ) consisting of matrix metalloproteinases and hyaluronan which blocks
1836-516: The common types of tumor. Four genes have each been found to be mutated in the majority of adenocarcinomas: KRAS (in 95% of cases), CDKN2A (also in 95%), TP53 (75%), and SMAD4 (55%). The last of these is especially associated with a poor prognosis. SWI/SNF mutations/ deletions occur in about 10–15% of the adenocarcinomas. The genetic alterations in several other types of pancreatic cancer and precancerous lesions have also been researched. Transcriptomics analyses and mRNA sequencing for
1890-419: The company in 1985) and went out of business by 1989. His two sons were Todd (who wrestled under the ring name Rick Davis) and Terry (who competed as The Frog, first while wearing a mask, and later unmasked). On 5 August 2009, Tomko died, aged 77, after a two-month bout with pancreatic cancer . Pancreatic cancer Pancreatic cancer arises when cells in the pancreas , a glandular organ behind
1944-444: The degree to which they produce hormones. The functioning types secrete hormones such as insulin , gastrin , and glucagon into the bloodstream, often in large quantities, giving rise to serious symptoms such as low blood sugar , but also favoring relatively early detection. The most common functioning PanNETs are insulinomas and gastrinomas , named after the hormones they secrete. The nonfunctioning types do not secrete hormones in
1998-500: The diagnosis and to help decide whether the tumor can be surgically removed (its " resectability "). On contrast CT scan , pancreatic cancer typically shows a gradually increasing radiocontrast uptake, rather than a fast washout as seen in a normal pancreas or a delayed washout as seen in chronic pancreatitis. Magnetic resonance imaging and positron emission tomography may also be used, and magnetic resonance cholangiopancreatography may be useful in some cases. Abdominal ultrasound
2052-436: The digestive system grades all the pancreatic neuroendocrine tumors (PanNETs) into three categories, based on their degree of cellular differentiation (from "NET G1" through to the poorly differentiated "NET G3"). The U.S. National Comprehensive Cancer Network recommends use of the same AJCC-UICC staging system as pancreatic adenocarcinoma. Using this scheme, the stage-by-stage outcomes for PanNETs are dissimilar to those of
2106-424: The disease include weakness and tiring easily, dry mouth , sleep problems, and a palpable abdominal mass . The spread of pancreatic cancer to other organs ( metastasis ) may also cause symptoms. Typically, pancreatic adenocarcinoma first spreads to nearby lymph nodes , and later to the liver or to the peritoneal cavity , large intestine , or lungs. Uncommonly, it spreads to the bones or brain. Cancers in
2160-444: The disease is still in an early stage (AJCC-UICC stages I and II), without spread to large blood vessels or distant organs such as the liver or lungs, surgical resection of the tumor can normally be performed, if the patient is willing to undergo this major operation and is thought to be sufficiently fit. The AJCC-UICC staging system allows distinction between stage III tumors that are judged to be "borderline resectable" (where surgery
2214-422: The disease is typically not diagnosed until it has spread beyond the pancreas itself. This is one of the main reasons for the generally poor survival rates. Exceptions to this are the functioning PanNETs, where over-production of various active hormones can give rise to symptoms (which depend on the type of hormone). Common presenting symptoms of pancreatic adenocarcinoma include: Other common manifestations of
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2268-637: The exocrine cancers. A different TNM system for PanNETs has been proposed by the European Neuroendocrine Tumor Society. Apart from not smoking, the American Cancer Society recommends keeping a healthy weight, and increasing consumption of fruits, vegetables, and whole grains , while decreasing consumption of red and processed meat , although there is no consistent evidence this will prevent or reduce pancreatic cancer specifically. A 2014 review of research concluded that there
2322-569: The host's CD8+ T-cells from reaching the tumor. Tumor associated macrophages , neutrophils and regulatory T-cells secrete cytokines and work to create a tumor microenvironment that promotes cancer growth. The genes often found mutated in pancreatic neuroendocrine tumors (PanNETs) are different from those in exocrine pancreatic cancer. For example, KRAS mutation is normally absent. Instead, hereditary MEN1 gene mutations give risk to MEN1 syndrome , in which primary tumors occur in two or more endocrine glands . About 40–70% of people born with
2376-665: The larger Madison Club in the 1960s to become one of that promotion's top heels . He bought the Madison Club in 1967 and merged it with the American Wrestling Association in 1968. Tomko acted as the AWA's Winnipeg promoter from 1966 through to the mid-1970s, and he was credited with launching the career of Roddy Piper . He also competed sometimes in Stampede Wrestling under a mask as Cosmo #1, and later wrestled without
2430-676: The mask in Stampede and in Vancouver's NWA All Star Wrestling as "Crazy Legs" Leroy Hirsch. In 1972, he started up another independent promotion called Central Canadian Championship Wrestling, which he ran in Manitoba cities and towns outside Winnipeg. He made use of mostly local talent, although he occasionally also brought in big-name stars for special appearances. Tomko later left Winnipeg and headed to Vancouver , where he bought Sandor Kovacs ' ownership stake in NWA All Star in 1977. While promoting
2484-471: The most-common form of pancreatic cancer may include yellow skin , abdominal or back pain , unexplained weight loss , light-colored stools , dark urine, and loss of appetite . Usually, no symptoms are seen in the disease's early stages, and symptoms that are specific enough to suggest pancreatic cancer typically do not develop until the disease has reached an advanced stage. By the time of diagnosis, pancreatic cancer has often spread to other parts of
2538-420: The new cases in 2012 originated. Pancreatic adenocarcinoma typically has a very poor prognosis; after diagnosis, 25% of people survive one year and 12% live for five years. For cancers diagnosed early, the five-year survival rate rises to about 20%. Neuroendocrine cancers have better outcomes; at five years from diagnosis, 65% of those diagnosed are living, though survival considerably varies depending on
2592-494: The pancreas are mainly pancreatic neuroendocrine tumors (PanNETs). Neuroendocrine tumors (NETs) are a diverse group of benign or malignant tumors that arise from the body's neuroendocrine cells , which are responsible for integrating the nervous and endocrine systems. NETs can start in most organs of the body, including the pancreas, where the various malignant types are all considered to be rare . PanNETs are grouped into 'functioning' and 'nonfunctioning' types, depending on
2646-403: The pancreas may also be secondary cancers that have spread from other parts of the body. This is uncommon, found in only about 2% of cases of pancreatic cancer. Kidney cancer is by far the most common cancer to spread to the pancreas, followed by colorectal cancer , and then cancers of the skin , breast , and lung . Surgery may be performed on the pancreas in such cases, whether in hope of
2700-410: The pancreas that makes digestive enzymes . Several other types of cancer, which collectively represent the majority of the non-adenocarcinomas, can also arise from these cells. About 1–2% of cases of pancreatic cancer are neuroendocrine tumors , which arise from the hormone-producing cells of the pancreas. These are generally less aggressive than pancreatic adenocarcinoma. Signs and symptoms of
2754-684: The pancreas. This cancer originates in the ducts that carry secretions (such as enzymes and bicarbonate ) away from the pancreas. About 60–70% of adenocarcinomas occur in the head of the pancreas . The next-most common type, acinar cell carcinoma of the pancreas , arises in the clusters of cells that produce these enzymes, and represents 5% of exocrine pancreas cancers. Like the 'functioning' endocrine cancers described below, acinar cell carcinomas may cause over-production of certain molecules, in this case digestive enzymes, which may cause symptoms such as skin rashes and joint pain. Cystadenocarcinomas account for 1% of pancreatic cancers, and they have
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#17328730679682808-458: The thick head, the neck, and the tapering body, ending in the tail. Regardless of a tumor's location, the most common symptom is unexplained weight loss, which may be considerable. A large minority (between 35% and 47%) of people diagnosed with the disease will have had nausea, vomiting, or a feeling of weakness. Tumors in the head of the pancreas typically also cause jaundice, pain, loss of appetite , dark urine, and light-colored stools. Tumors in
2862-404: The type of tumor. The many types of pancreatic cancer can be divided into two general groups. The vast majority of cases (about 95%) occur in the part of the pancreas that produces digestive enzymes , known as the exocrine component . Several subtypes of exocrine pancreatic cancers are described, but their diagnosis and treatment have much in common. The small minority of cancers that arise in
2916-494: Was evidence that consumption of citrus fruits and curcumin reduced risk of pancreatic cancer, while there was possibly a beneficial effect from whole grains, folate , selenium , and non-fried fish. In the general population, screening of large groups is not considered effective and may be harmful as of 2019, although newer techniques, and the screening of tightly targeted groups, are being evaluated. Nevertheless, regular screening with endoscopic ultrasound and MRI/CT imaging
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