Pancreatic cancer

Question 1

Epidemiology
- vast majority of cancers are[…] and 5 year survival rates are extremely poor (<[…]%).

Answer 1

adenocarcinomas, 5

Question 2

Features
- presents […] due to its non-specific early symptoms e.g. malaise, abdominal […], nausea or weight […]
- Advanced symptoms
1. Blockage of […] […] […] from a tumour in the pancreatic […] leads to […] […].[…] sign may be present
2. Diabetes mellitus

Answer 2

late, pain
common bile duct, head, obstructive jaundice, Courvoisier’s

Question 3

Courvoisier’s sign

Answer 3

refers to painless palpable gallbladder with jaundice.

Question 4

Pancreas inflitration can lead to:
- Unexplained […]
- Pancreatic […] dysfunction with […]

Answer 4

pancreatitis
exocrine, steatorrhoea

Question 5

Paraneoplastic syndromes
- […] syndrome – migratory thrombophlebitis affecting the extremities of the body
- Disseminated intravascular coagulation (DIC)

Answer 5

Trousseau’s

Question 6

1. Metastasis (LLB)
   - which may present with haemoptysis, jaundice or constipation.

Answer 6

lung, liver, bowel

Question 7

[…] […] jaundice is a red flag symptom of pancreatic carcinoma and should be assessed IMMEDIATELY

Answer 7

Painless obstructive

Question 8

Investigations
1. CT […]
2. USS abdomen
3. ENDOSCOPIC ULTRASOUND > ERCP

Answer 8

abdo pelvis

Question 9

Treatment
- Only curative is […] […] (only possible for few) - radical pancreaticoduodenectomy (Kausch-Whipple procedure) if in head of pancreas

Answer 9

surgical resection

Question 10

Criteria for surgical resection
- No […] or […] arteries involvement
- No evidence of […] […]

Answer 10

SMA, coeliac
distant metastases

Question 11

Palliative
- bile duct […]
- Palliative surgery
- Chemo/radio

Answer 11

stenting