Pancreatic cancer Flashcards
Risk factors for pancreatic cancer
Age
Smoking
Diabetes
Chronic pancreatitis
HNPCC
Multiple endocrine neoplasia - MEN
BRCA2 gene
Types of pancreatic cncare
80% adenocarcinoma from ductal epithelium at head of pancreas
Features of pancreatic cancer
PAINESS JAUNDICE (esp if at head)
Anorexia
Weight loss
Epigastric pain
Loss of exocrine funciton - steatorrhoea
Endocrine - diabetes
Atypical back pain
Migratory thrombophlebitis
What sign is more common in pancreatic cancer than other cnacer s
Trousseas syndrome - migratory thrombophlebitis
Urgent referral for pancreatic cancer when do
> 40 with painless jaundice
60 and weight loss and:
-diarrhoea
-back pain
-abdo pain
-nausea
-vomitting
-constipation
-new onset diabetes
Investigation for pancreatic cnacer
US - 60-90% sensitive
High res CT investigaiton of choics
Management of pancreatic cncare
If possible surgery - whipples resection/pancreaticoduodenenectomy - lesions at head of pancreas
Adjucant chemo
ERCP with stenting in palleation +/- chemo
Whipple sprocedure side effects
Dumping syndrome
Peptic ulcer disease
Why is pancreatic cnacer often fatal
Asymntpomatic - present ectremely advanced
20% suitbale for surgery at presentatiin
Prognostic factors pancreatice cancer
Age
Overall health
Tumour size and location
Surgical resection
The two types of trousseaus sign
Inducing carpopedal spasm (invol muscle contractions) w blood pressure ciff - caused by hypocalcemia
Trousseas sign of malignancy = migratory thrombophlebitis
What is trousseas syndore of malignancy
Acquired blood clotting disorder -> migratory thrombophlebitis (inflammation of vein due to blood clot) ass with malignancy
Hypercoagulability
Most often seen in pancreatic cncare and mucin-producing adenocarcinomas
Can cause PE/cerbral infarct
What see on CT in pancreatitisD
Double duct sing
What is duming syndrome
Food moves too fast to duodenum -> N, V, diarrhoea, sweating, hypoglycaemia when eat high sugar or alot of food
Eat small meals + high fibre
Acrabose + ocreotide
