Pancreatic Cancer Flashcards
What is a key feature of pancreatic cancer?
Painless Obstructive jaundice
Average survival when diagnosed with advanced disease is?
6 months
presentation of pancreatic cancer?
jaundice, pale stools dark urine, generalised itching, weight loss, mass, epigastric pain, change in bowel habit, nausea vomiting, worsening of diabetes or new onset
when to refer for suspecting pancreatic cancer?
patient over 40 with jaundice. 2 week wait
or over 60 with weight loss plus additional symptoms direct access CT Abdo
when to refer for suspecting pancreatic cancer?
patient over 40 with jaundice. 2 week wait
or over 60 with weight loss plus additional symptoms direct access CT Abdo
Courvoisier’s law?
palpable gallbladder and jaundice- cholangiocarcinoma or pancreatic cancer
trousseau’s sign?
migratory thrombophelbitis
diagnosis of pancreatic cancer?
CT scan plus biopsy
tumour marker raised in cholangiocarcinoma and pancreatic cancer?
CA 19-9
management of pancreatic cancer?
surgery if tumour small isolated in head. total pancreatectomy, distal, pylorus preserving pancreaticoduodenectomy (modified whipple), or whipple
whipples procedure?
head of pancreas, pylorus, duodenum, gallbladder, bile duct and lymph nodes
associations with pancreatic cancer?
increasing age
smoking
diabetes
chronic pancreatitis (alcohol does not appear an independent risk factor though)
hereditary non-polyposis colorectal carcinoma
multiple endocrine neoplasia
BRCA2 gene
KRAS gene mutation
what else do you get in pancreatic cancer?
loss of exocrine function steatorrhoea and loss of endocrine function DM
first investigation of choice in pancreatic cancer?
CT- double duct sign- dilatation of pancreatic and common bile ducts
side effects of whipple procedure?
dumping syndrome and peptic ulcer disease
