Pancreatic carcinoma Flashcards
1
Q
How common is pancreatic cancer?
A
9618 new cases of pancreatic cancer in 2014. Ductal denocarcinoma most common. 4th leading cause of cancer deaths
2
Q
What is the pathology of pancreatic carcinoma?
A
- Adenocarcinoma: Acinar, ductal and islet cells in pancreas undergo dysplasia, mainly in the head of the pancreas
- Neuroendocrine: originate from islet cells. May be functional (secrete hormones)
3
Q
What are the risk factors/aetiology of pancreatic cancer?
A
- Smoking
- Alcohol
- Age – more common in older people
- Diet – red meat, high fat
- Obesity
- Diabetes
- Family history (HNPCC, FAMMM)
- Chronic pancreatitis
- MEN1 – neuroendocrine
- Von Hipple Lindau – neuroendocrine
4
Q
What are the signs/symptoms of pancreatic cancer?
A
- Epigastric pain – radiates to the back
- Painless jaundice
- Weight loss
- Pruritis – itching of the skin
- Dark urine – if bile duct blocked
- Pale stools – if bile duct blocked
- Trousseau’s syndrome – sign of malignancy involving inflammation of vessels due to blood clots in different locations
- Courvoisier’s sign – enlarged palpable gallbladder without pain
- Diabetes
5
Q
What diseases can present similarly to pancreatic cancer?
A
- Pancreatitis
- AAA
- Gastric/ampullary/hepatocellular/bile duct tumours
- Intestinal ischemia
- Cholangitis
- Cholecystitis
- Peptic ulcer disease
6
Q
What investigations are carried out for suspected pancreatic cancer?
A
- Abdomen/endoscopic US
- CT
- MRI – occasionally
7
Q
What are the surgical treatments for pancreatic cancer?
A
- Whipple procedure – remove head of the pancreas
- Distil pancreatectomy – remove tail and body of pancreas and spleen
- Total pancreatectomy – remove whole pancreas, bile duct, gall bladder, spleen, part of small intestine, surrounding lymph nodes
- ERCP – stent helps to keep bile duct open
8
Q
What are the pharmacological treatments for pancreatic cancer?
A
- Chemotherapy
* Radiotherapy
