Pancreatic Cancer Flashcards
What is the most common type and site of pancreatic cancer?
> 90% are adenocarcinomas
65% at head of pancreas.
Describe the most common presentation of pancreatic cancer
65-75y with painless obstructive jaundice + weight loss.
Generally presents late with advanced disease.
May have atypical back pain
List 7 risk factors for pancreatic cancer
SMOKING (strongest RF)
Hereditary cancer syndromes
Chronic pancreatitis
High alcohol consumption
T2DM
Obesity
FH
List 4 hereditary cancer syndromes that increase risk of pancreatic cancer
Hereditary non-polyposis colorectal carcinoma
Multiple endocrine neoplasia
Peutz-Jeghers syndrome
BRCA2 gene
Give 3 symptoms of obstructive jaundice in pancreatic cancer
Pale stools
Dark urine
Pruritus
What abdominal masses may be found in pancreatic cancer? List these in order of decreasing frequency
Hepatomegaly: due to mets
Gallbladder: Courvoisier’s law (painless obstructive jaundice; palpable gallbladder is unlikely to be due to gallstones)
Epigastric mass: from primary tumour
Give 2 ways in which loss of pancreatic function in pancreatic cancer can manifest
Loss of exocrine function: Steatorrhoea
Loss of endocrine function: Diabetes mellitus
What sign is seen in pancreatic cancer more frequently than in other cancers?
Migratory thrombophlebitis (Trousseau sign)
Ix for pancreatic cancer
US (sensitivity ~60-90%)
High-resolution CT
LFTs: obstructive picture
What is the investigation of choice for suspected pancreatic cancer?
High-resolution CT
What sign may be seen on imaging in pancreatic cancer?
‘Double duct’ sign
Presence of simultaneous dilatation of the common bile + pancreatic ducts
What LFTs are seen in obstructive jaundice?
High BR
High ALP
High Gamma glutamyl transpeptidase
What % of pancreatic cancer is suitable for surgery at diagnosis?
<20%
What surgery is performed for resectable lesions in the head of pancreas?
Whipple’s resection (pancreaticoduodenectomy)
Name 2 side effects of a Whipple’s resection
Dumping syndrome
Peptic ulcer disease
