Pancreatic Cancer Flashcards
What are the vast majority of pancreatic cancers
Adenocarcinomas
What is the prognosis of pancreatic cancer
Diagnosed late with poor prognosis
Where do most of pancreatic cancers arise
Head as opposed to the body and tail
Where do pancreatic cancers tend to metastasise to
Liver, peritoneum, lungs and bones
Presentation of pancreatic cancer
Painless obstructive jaundice
Presentation when cancer is at the head
Yellow skin and sclera, pale stools, dark urine, generalised itching
Other vague presenting features of pancreatic cancer
Non specific upper abdominal or back pain, unintentional weight loss, palpable mass in epigastric region, change in bowels, nausea or vomiting
What is the relation between diabetes and pancreatic cancer
New onset of diabetes or worsening diabetes despite good type 2 control can be a sign
2 week wait referral for pancreatic cancer
Over 40 with jaundice
Direct access CT abdomen referral
Over 60 with weight los plus additional symptoms of: diarrhoea, back pain, abdo pain, nausea, vomiting, constipation, new onset diabetes
What is Courvoisier’s law
Palpable gallbladder along with jaundice is unlikely to be gallstones -> cholangiocarcinoma or pancreatic cancer
What is Trousseau’s sign of malignancy
Migratory thromboplebitis as a sign of malignancy, particularly pancreatic adenocarcinoma
Diagnosis of pancreatic cancer
Imaging (CT) and histology from biopsy
Investigations to conduct in suspected pancreatic cancer
Staging CT, CA19-9, MRCP, ERCP, biopsy through US, CT or endoscopy
Surgical options depending on location of tumour
Total pancreatectomy, distal pancreatectomy, pylorus preserving pancreaticoduodenectomy, radical pancreaticoduodenectomy
