Carcinoma of the Pancreas Flashcards

1
Q

What is the most common type of pancreatic cancer?

A
  • Adenocarcinoma
  • Arises from glandular duct cells that line ducts of exocrine system
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2
Q

Who is pancreatic adenocarcinoma common in?

A
  • Elderly males
  • Very little is known about underlying cause
  • Smoking is only well recognised risk factor
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3
Q

Most pancreatic adenocarcinomas involve the head of the pancreas. What do they present with?

A
  • Obstructive, painless jaundice
    • tumour compresses common bile duct as it passes through the head of pancreas so that bile is unable to drain into duodenum
  • other features: weight loss, mid-epigastric pain (often radiating to back)
  • palpable gallbladder
  • loss of exocrine fxn (steatorrhoea)
  • loss of endocrine fxn (diabetes)
  • Trousseau’s sign (hand spasm w/ BP cuff inflation)
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4
Q

What investigations are performed for pancreatic cancer?

A
  • USS
  • high-res CT investigation of choice if diagnosis suspected
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5
Q

What is the treatment for majority of pancreatic carcinoma patients?

A
  • 80% of pts with pancreatic carcinoma have advanced disease (high stage) at time of dx
  • treatment is palliative
  • palliative treatment options:
    • chemotherapy
    • stenting the common bile duct to relieve jaundice
    • optimising symptom control
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6
Q

A minority of pancreatic carcinoma patients (20%) are suitable for curative surgery - Why are they suitable? What is the procedure called?

A
  • bc tumour appears to be confined to pancreas and lymph nodes are not involved
  • Whipple’s procedure
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7
Q

What happens in a Whipple’s procedure?

A

The distal stomach, gallbladder, common bile duct, head of pancreas, duodenum, proximal jejunum and regional lymph nodes are resected.

Reconstruction restores intestinal fxn by re-establishing flow of pancreatic juices, bile and food along GI tract.

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8
Q

What is the 5 year survival following a) curative surgery (Whipple’s) and b) overall survival for pancreatic cancer?

A

A) Whipple’s - 20-40%

B) 5% (incl majority of pts who have advanced disease)

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