Pancreatic cancer Flashcards
What is the key part of pancreatic cancer?
Pancreatic Cancer = Painless jaundice, Palpable gallbladder (Courvoisier’s law)
Where are most pancreatic cancer located?
75% in head of pancreas, mostly arising from exocrine tissue
What condition can predispose you to pancreatic cancer?
MEN1 – pancreatic tumours arising from endocrine tissue (much less common)
What are RF for pancreatic cancer?
- Age >60
- Smoking
- Obesity
- T2DM
- Chronic pancreatitis,
What is the prognosis like for pancreatic cancer?
poor prognosis as they are often diagnosed late
What are signs and symptoms of pancreatic cancer?
- Signs are non-specific (hence diagnosed late)
- FLAWS
- Loss of exocrine function leads to steatorrhoea
- Loss of endocrine function leads to diabetes
- Painless jaundice is a late sign
- Trossaeu sign (migratory thrombophlebitis)
- Hepatomegaly if hepatic mets occur
What does the loss of exocrine function lead to?
steatorrhea
What does loss of endocrine function lead to?
diabeties
What is Trosseaeu sign?
- more common in pancreatic cancer than other malignancies
2. phenomenon of vessel inflammation which are recurrent and arise in different locations
What does courvoisier’s law state?
states that in the presence of painless obstructive jaundice, a palpable gallbladder is unlikely to be due to gallstones
What is the gold standard Ix for pancreatic cancer?
biopsy via ERCP or EUS
What other tests are done for pancreatic cancer?
- Bloods
- USS
- High resolution CT scan – Ix of choice if high index of suspicion (more sensitive)
What bloods are done for pancreatic cancer?
CA19-9
What can high res CT scan show?
imaging shows the “double duct” sign
How common is surgery in pancreatic cancer?
<20% suitable for surgery due to mets – ERCP with stenting - FOR LATE STAGE
