Pancreatic cancer Flashcards
What is pancreatic cancer
malignant tumour arising from cells of pancreas
what is the epidemiology of pancreatic cancer
4th leading cause of cancer deaths worldwide
often diagnosed late so poor prognosis
What is courvoisers law
painless jaundice and palpable gallbladder
Where in the pancreas does pancreatic cancer usually occur
75% in head , most arise from exocrine ductal epithelium
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What would a patient with pancreatic cancer present
painless jaundice
epigastric pain
weight loss
nausea
steatorrhoea
diabetes
What may be seen on physical examination
Trousseau sign
palpable gallbladder- mass in right upper quadrant
hepatomegaly if metastatic
What are risk factors for pancreatic cancer
increasing age
obesity
smoking
T2DM– more likely a consequence of carcinoma of the pancreas
chronic pancreatitis
What investigations are required
High resolution CT scan of chest,abdomen and pelvis - first investigation
ERCP with biopsy is gold standard diagnosis
Blood tests such as CA19-9 can be elevated in pancreatic cancer but not specific
What is the management for pancreatic cancer
depends on stage, presence of co-morbidities
Surgical resection for early stage
Chemo and radio for more advanced disease
What is whipples resection and what are some complications
pancreaticoduodenectomy and adjuvant chemotherapy
dumping syndrome/rapid gastric emptying and peptic ulcer disease
ERCP with stenting for late stage
Poor prognosis
