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6. Cancer > pancreatic cancer > Flashcards

pancreatic cancer Flashcards

1
Q

What is the five-year survival rate for pancreatic cancer?

A

Less than 5%

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2
Q

What is the most common type of pancreatic cancer?

A

Adenocarcinoma ( Infiltrating ductal adenocarcinomas)

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3
Q

Are most pancreatic cancers exocrine or endocrine?

A

Exocrine

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4
Q

Where are most pancreatic cancers located?

A

The majority arise in the head, neck or uncinate process

Head (66%)

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5
Q

Where do pancreatic cancers commonly spread to?

A

Liver, peritoneum, lungs

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6
Q

Which pancreatic cancers have the best prognosis?

A

Those arising from the distal common bile duct, the ampulla of Vater and the duodenum

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7
Q

At what age are pancreatic cancers commonly diagnosed?

A

70-80

Noo gender bias

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8
Q

What are the risk factors for pancreatic cancer?

A 
Smoking
Diet (high red meat)
High BMI
Diabetes
Alcohol intake
Family history
Familial cancer syndromes
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9
Q

What are the familial cancer syndromes?

A

BRCA1, BRCA2, familial adenomatous polyposis, Peutz-Jeghers syndrome, familial melanoma syndromes, Lynch syndrome, von Hippel-Lindau syndrome, multiple endocrine neoplasia type 1, Gardner’s syndrome.

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10
Q

How do patients with pancreatic cancer often present?

A

Early symptoms are often vague and nonspecific (frequently epigastric discomfort or dull backache)

Cancers in the head: painless, progressive, obstructive jaundice

Tumour in body and tail: nonspecific pain and weight loss and are much less likely to cause obstructive signs and symptoms

  1. Epigastric abdominal pain
  2. Jaundice
  3. Acute pancreatitis
  4. Unexplained weight loss
  5. Steatorrhoea
  6. Palpable gallbladder
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11
Q

What is Courvoisier’s sign?

A

A palpable gallbladder in the presence of painless jaundice

Can be a sign of pancreatic cancer

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12
Q

How do patients with advanced pancreatic cancer present?

A 
Rapid weight loss
Persistent back pain
Ascites
Epigastric mass
Enlarged supraclavicular node
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13
Q

What can Virchow’s node be a sign of?

A

Gastric cancer
Ovarian cancer
Pancreatic cancer

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14
Q

What investigations would you do for suspected pancreatic cancer?

A
  1. FBC - normochromic anaemia
  2. LFTs - jaundice
  3. Serum glucose - hyperglycaemia
  4. Tumour marker - Carbohydrate 19-9
  5. Ultrasound of the liver, bile duct and pancreas
  6. CT
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15
Q

How is pancreatic cancer managed?

A
  1. Resectable disease (curative, but only 10-20% of tumours is suitable) + adjuvant chemotherapy
  2. Unresectable disease: stenting, but mainly palliative
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16
Q

How would you stage pancreatic cancer?

A

Fluorodeoxyglucose positron-emission tomography/CT

6. Cancer (15 decks)

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