Pancreatic cancer Flashcards
function of pancreas
-excretes enzymes to break down fats , carbs , protein, and nucleic acid in food
-secretes insulin and glucagon to control blood sugar levels
Types of Pancreatic Cancer:
most common
ductal adenocarcinoma 80-90%
Prognosis
carries a high mortality rate
1 year survival=24%
5 year survival=9%
Aetiology
-smoking- 20% of cancer
-hereditary-10% (genetic predisposition or inherited cancer syndromes)
-chronic pancreatitis
-genetic disorders associated with the BRCA1, BRCA2, PALB2, and ATM genes
-obesity
signs and symptoms
-early stages is usually asymptomatic
-80% of patients are diagnosed at late stages
signs and symptoms: early onset symptoms
-abdominal pain
-bloating
-flatulence
-vomiting
-change in bowel habits (constip or dia)
signs and symptoms: late onset symptoms
-abdominal or mid back pain
-obstructive jaudince (caused by compression of distal common bile duct)
-weight loss
-dark urine or light colour stool
Diagnostic Workup: Imaging used to
-define anatomy- is there a mass and what is the extent
-determine pathology -fine needle aspiration by EUS or CT
-dictate management- is the cancer restectable
indications of imaging modalities used to investigate pancreatic tumours:
-US
-CT
-MRI
-ENDOSCOPIC ULTRASOUND
-primary investigation for jaundice and epigastric pain
-investigation of choice for when pancreatic cancer is suspected
-used when CT findings are inconclusive
-problem solver. Most useful when there is a biliary obstruction w no definite mass in CT or MRI
what is biomarkers
looks for genes , proteins and other substances that gives info about the cancer
Biomarkers for Differential Diagnosis:
CA-19 features
-NOT FOR screening
-poor predictive value for cancer
-CA-19 value will still be normal w patients in early stage
-when elevated indicates advanced stage cancer
-may be more useful in surveillance
stage IA & IB
purely based on size of tumour
T1= less than or 2cm
T2=inbetween 2 and 4cm
Stage IIA
T3 ( greater than 4cm) but N= -ve
Stage IIA
T1,T2 or T3
N1
stage IIB
T1, T2 or T3
N1 = Stage IIB disease