August 27, 2015 - Pancreas and Bile Duct Cancer

Question 1

5-Year Relative Survival of Pancreatic Cancer

Answer 1

Extremely poor. Between 5-7%. This is one of the worst cancers you can get.

Question 2

Risk Factors for Pancreatic Cancer

Answer 2

Obesity

Diabetes

Cigarette smoking

Question 3

Cholangiocarcinoma Location

Answer 3

May be intrahepatic, perihilar (most often), or distal.

Question 4

Intrahepatic CCA Presentation

Answer 4

Usually asymptomatic.

Usually not jaundiced.

Usually just with constitutional symptoms such as fatigue, malaise, anorexia, weight loss.

Increased ALP and GGT.

Question 5

Hilar/Extrahepatic CCA Presentation

Answer 5

Jaundice

Pruritis

Anorexia, malaise, weight loss

ALP, GGT >> ALT, AST

Question 6

Endoscopic Ultrasound (EUS)

Answer 6

A great diagnostic imaging test, however may not be as readily available. Can image the entire pancreas, apulla, gall bladder.

Question 7

Surgical Approach to Pancreatic Cancer

Answer 7

An R0 resection must be achieved to confer any survival benefit. This means aiming for at least a 1cm clear margin from the growth. It is hard to resect at this area without causing critical and lethal damage to nearby structures.

Question 8

Recurrence Rate After Resection

Answer 8

Unfortunately, still very high even with an R0 resection.

Question 9

Presentation for Pancreatic or Gall Bladder Cancer

Answer 9

Painless jaundice with weight loss are the ominous signs.