pancreatic cancer Flashcards
(42 cards)
median age of diagnosis
70
who gets it more male or female
male
what are the majority of cancers
adenocarcinoma
whee are majority origin
ductal origin
what increases incidence
- smoking
- alcohol
- coffee
- aspirin use
- diabetes
what mutation in chronic pancreatitis increases risk
PRSS-1
what type of gene is BRCA2
DNA repair gene
where does the cancer originate
in the ductal epithelium
what are the precursors of malignancy
pancreatic intraepithelial neoplasia (PainIN)
what mutation does majority of patients have
KRAS
if there is a mutation in tumour suppressors (p53, SMAD) what type of neoplasia does it cause
type 2
and
type 3 lesions
what is the genetic model for development of pancreatic malignancy
- normal
- PanIN-1A
- PanIN-1B
- PanIN-2
- PanIN-3
- invasion
where do a small percentage of pancreatic adenocarcinomas arise from
cystic lesions
where are most pancreatic cancers located
in head of pancreas
symptoms
- abdominal pain radiates through to back
- anorexia
- weight loss
- depressive
- jaundice (early)
- pale stools
- dark urine
- itching
- malabsorption
- steatorrhoea
- skin nodules
what does malabsorption mean
the pancreatic duct is obstructed by cancer
signs
- palpable gallbladder
- palpable epigastric mass
- hepatomegaly (if liver metastases)
investigations if patients has upper gut symptoms
upper GI endoscopy
what is the initial imaging investigation
ultrasound
what is seen on ultrasound of bile obstruction
dilated intrahepatic bile ducts
and
mass in the head of the pancreas
what investigation can confirm the presence of a mass lesion
CT
what is the most sensitive for detection of pancreatic cancer
endoscopic ultrasound
what tumour markers are good
CA19-9
what is the only treatment for long term survival
surgical intervention
