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#Phase 2.1: Peri Op > Pancreatic Cancer > Flashcards

Pancreatic Cancer Flashcards

1
Q

What are the 3 types of Pancreatic cancer?

A
  1. Ductal carcinoma (most common)
  2. Exocrine tumours (pancreatic cystic carcinoma)
  3. Endocrine tumours (derived from islet cells)
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2
Q

What are the risk factors for pancreatic cancer? (6 things)

A
  1. Smoking
  2. Age
  3. Chronic Pancreatitis
  4. DM
  5. HNPCC
  6. BRCA2 gene
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3
Q

Why is pancreatic cancer diagnosed late?

A

Presents in an unspecific way

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4
Q

What are the clinical features of pancreatic cancer? (3 things)

A
  1. Obst jaundice
  2. Weight loss
  3. Abd pain
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5
Q

What causes the obst jaundice is pancreatic cancer?

A

Compression of common bile duct

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6
Q

What are the features of the obst jaundice in pancreatic cancer? (3 things)

A
  1. Painless
  2. Pruritis (itchy skin)
  3. Light coloured stools
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7
Q

What does weight loss indicate about pancreatic cancer?

A

Advanced disease

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8
Q

What causes the abd pain in pancreatic cancer?

A

Invasion of coeliac plexus

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9
Q

What are some differentials that present similarly to pancreatic cancer? (7 things)

A

Causes of obst jaundice

  1. Gallstone disease
  2. Cholangiocarcinoma
  3. Benign gall bladder stricture

Causes of epigastric abd pain

  1. Gallstones
  2. PUD
  3. Gastric carcinoma
  4. Acute coronary syndrom
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10
Q

What lab tests should be done for suspected pancreatic cancer?

A
  1. FBC
  2. LFT
  3. CA19-9 tumour marker
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11
Q

What would a FBC show in pancreatic cancer? (2 things)

A
  1. Anaemia

2. Thrombocytopenia

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12
Q

What would a LFT show in pancreatic cancer? (3 things)

A
  1. High bilirubin
  2. High alkaline phosphatase
  3. High gamma-GT

= obst jaundice

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13
Q

What imaging should be done for suspected pancreatic cancer? (5 thigns)

A
  1. Abd US (initially)
  2. CT (diagnostic)
  3. CT chest-abd-pelvis
  4. Endoscopic US
  5. ERCP
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14
Q

What would an Abd US show in pancreatic cancer? (2 things)

A
  1. Pancreatic mass

Dilated biliary tree

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15
Q

What is the most important scan for pancreatic cancer diagnosis?

A

CT

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16
Q

What is the most prognostically informative scan for pancreatic cancer and why?

A

CT chest-abd-pelvis

Bc tells you stage

17
Q

What is an Endoscopic US used for in pancreatic cancer?

A

To guide Fine Needle Aspiration (FNA) biopsy

18
Q

What is an ERCP used for in pancreatic cancer?

A

To access lesion for biopsy / cytology

19
Q

What is the only curative treatment for pancreatic cancer?

A

Radial resection

20
Q

If the tumour is @ head of pancreas, what surgery should be done?

A

Pancreaticoduodenoectomy

aka Whipple’s Procedure

21
Q

If the tumour is @ body / tail of pancreas, what surgery should be done?

A

Distal pancreatectomy

22
Q

What are the contraindications for pancreatic cancer surgery? (2 things)

A
  1. Peritoneal liver
  2. Distant metastases

Bc HIGH morbidity

23
Q

What are the complications of pancreatic cancer surgery? (3 things)

A
  1. Pancreatic fistula
  2. Delayed gastric emptying
  3. Pancreatic insuff.
24
Q

What chemo is done for pancreatic cancer?

When is it recommended?

A

Adjuvant chemo (5-Flourouracil)

Recommended after surgery

25
Q

What proportion of pancreatic cancer will only have palliative care?

A

Most

26
Q

What are the palliative care methods for pancreatic cancer? (3 things)

A
  1. Biliary stent insertion (via ERCP / percutaneously)
  2. Palliative chemo
  3. Enzyme replacement
27
Q

Why is biliary stenting done in palliative management of pancreatic cancer?

A

To relieve obst jaundice + associated prurits

28
Q

Why is enzyme replacement done in palliative management of pancreatic cancer?

A

For malabs. + steatorrhoea (caused by exocrine insuff bc excision of pancreas)

29
Q

Where does pancreatic cancer metastasise to? (3 things)

A
  1. Lymph nodes
  2. Liver
  3. Lungs

#Phase 2.1: Peri Op (24 decks)

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