Pancreatic cancer Flashcards
What is pancreatic cancer often diagnosed late?
Pancreatic cancer tends to present in a non-specific way.
What type of tumors are most pancreatic tumors?
Over 80% of pancreatic tumors are adenocarcinomas, typically occurring at the head of the pancreas.
What are some associations with pancreatic cancer?
Increasing age, smoking, diabetes, chronic pancreatitis, hereditary non-polyposis colorectal carcinoma, multiple endocrine neoplasia, BRCA2 gene, KRAS gene mutation.
What is a classic symptom of pancreatic cancer?
Classically painless jaundice.
What are some features of pancreatic cancer?
Pale stools, dark urine, pruritus, cholestatic liver function tests, abdominal masses (hepatomegaly, gallbladder, epigastric mass), anorexia, weight loss, epigastric pain, loss of exocrine function, loss of endocrine function, atypical back pain, migratory thrombophlebitis.
What is Courvoisier’s law?
In the presence of painless obstructive jaundice, a palpable gallbladder is unlikely to be due to gallstones.
What is the sensitivity of ultrasound in investigating pancreatic cancer?
Ultrasound has a sensitivity of around 60-90%.
What is the investigation of choice if pancreatic cancer is suspected?
High-resolution CT scanning.
What sign may imaging demonstrate in pancreatic cancer?
‘Double duct’ sign - the presence of simultaneous dilatation of the common bile and pancreatic ducts.
What percentage of pancreatic cancer patients are suitable for surgery at diagnosis?
Less than 20%.
What is a common surgical procedure for resectable lesions in the head of the pancreas?
Whipple’s resection (pancreaticoduodenectomy).
What are some side effects of a Whipple’s resection?
Dumping syndrome and peptic ulcer disease.
What is often given following surgery for pancreatic cancer?
Adjuvant chemotherapy.
What procedure is often used for palliation in pancreatic cancer?
ERCP with stenting.
