Abdominal: Pancreatic Carcinoma (brief) Flashcards
what is the prognosis for pancreatic carcinoma?
Five year survival is below 5%
Who does pancreatic carcinoma affect more, men or women?
men
what are the risk factors of pancreatic carcinoma?
- Age (50 to 80).
- Overweight/obesity.
- Smoking.
- Excess alcohol.
- Excess caffeine.
Past medical history of certain health conditions – such as diabetes, long-term inflammation of the pancreas (chronic pancreatitis), a stomach ulcer and Helicobacter pylori infection (a stomach infection).
what are clinical features of a carcinoma in the head of the pancreas?
- jaundice
- pancreatitis
what are clinical features of a carcinoma in the body or tail of the pancreas?
- abdominal. pain
- anorexia/weight loss
- back pain
A characteristic feature is partial relief of pain by sitting forward.
which is more common, carcinoma in the head of the pancreas, or in the body/tail of the pancreas?
head of pancreas is the most frequent site for cancer to develop
which conditions present in a similar way a pancreatic carcinoma?
Causes of obstructive jaundice – Gallstone disease, cholangiocarcinoma, benign gallbladder stricture.
Causes of epigastric abdominal pain – Gallstones, peptic ulcer disease, pancreatitis, abdominal aortic aneurysm (AAA), gastric carcinoma, acute coronary syndrome.
what investigations would you do to diagnose a pancreatic cancer?
- Blood tests; FBC, LFTS (jaundice), CA19-9 (tumour marker for pancreatic cancer)
- Abdominal ultrasound
what tumour marker can we look for in the blood that has a high specificity and sensitivity for pancreatic cancer?
CA19-9
what is the treatment for a pancreatic carcinoma?
- Head of the pancreas – Whipple’s procedure (pancreaticoduodenectomy).
- Body or tail of the pancreas – Distal pancreatectomy.
- Adjuvant chemotherapy after surgery is recommended – improves survival rate.
- Palliative care – Obstructive jaundice can be relieved with a biliary stent, palliative chemotherapy, enzyme replacement for malabsorption.
