Pancreatic Cancer Flashcards
How many people does pancreatic cancer affect. (2)
10-15/100,000 in Western populations.
Rising to 100/100,000 in those over 70.
How many people does pancreatic cancer affect. (2)
10-15/100,000 in Western populations.
Rising to 100/100,000 in those over 70.
What percentage of malignancies are pancreatic cancer.
How many deaths per year does pancreatic cancer cause in the UK.
6500 per year.
What are the two main features of a typical patient presenting with pancreatic cancer. (2)
> 60.
Male.
What are the risk factors for pancreatic cancer. (7)
Smoking. Alcohol. Carcinogens. DM. Chronic pancreatitis. Increased waist circumference (ie adiposity). High pat and red or processed meat diet.
What are the pathological features of pancreatic cancer. (6)
Mostly ductal adenocarcinoma.
60% arise in the pancreas head, 25% in the body, 15% in the tail.
A few arise in the ampulla of Vater (ampullary tumour) or pancreatic islet cells - both of these have a better prognosis.
What are the features of ductal adenocarcinomas. (2)
Metastasise early.
Present late.
What mutation is associated with pancreatic tumours. (2)
95% have mutations in the KRAS2 gene.
5-10% of patients have a genetic predisposition (eg hereditary pancreatitis, MEN).
How do tumours in the head of the pancreas present (and also the ampulla of Vater). (2)
Painless obstructive jaundice.
Often with severe pruritis.
How do tumours in the head of the pancreas present.
Painless obstructive jaundice.
How do tumours in the body and tail of the pancreas present. (3)
75% present with epigastric pain.
The pain radiates to the back and is relieved by sitting forward.
What are some typical features of pancreatic cancer. (4)
Weight loss.
Anorexia.
Diabetes.
Acute pancreatitis.
What are some of the rarer features of pancreatic cancer. (5)
Thrombophlebitis migrans (an arm vein becomes swollen and red, then a leg vein).
Raised calcium.
Marantic endocarditis.
Portal hypertension (splenic vein thrombosis).
Nephrosis (renal vein metastases).
What are some of the signs of pancreatic cancer on physical exam. (7)
Jaundice and palpable gallbladder (Courvoisier's law). Epigastric mass. Hepatomegaly. Splenomegaly. Lymphadenopathy. Ascites.
What is the median survival rate for patients with pancreatic cancer. (2)
6-10 months for those with locally advanced disease.
3-5 months if metastases are present.
What is the median survival rate for patients with pancreatic cancer. (2)
6-10 months for those with locally advanced disease.
3-5 months if metastases are present.
What percentage of malignancies are pancreatic cancer.
How many deaths per year does pancreatic cancer cause in the UK.
6500 per year.
What are the two main features of a typical patient presenting with pancreatic cancer. (2)
> 60.
Male.
What are the risk factors for pancreatic cancer. (7)
Smoking. Alcohol. Carcinogens. DM. Chronic pancreatitis. Increased waist circumference (ie adiposity). High pat and red or processed meat diet.
What are the pathological features of pancreatic cancer. (6)
Mostly ductal adenocarcinoma.
60% arise in the pancreas head, 25% in the body, 15% in the tail.
A few arise in the ampulla of Vater (ampullary tumour) or pancreatic islet cells - both of these have a better prognosis.
What are the features of ductal adenocarcinomas. (2)
Metastasise early.
Present late.
What are some examples of pancreatic islet cell tumours. (3)
Insulinoma.
Gastrinoma.
Glucagonomas.
What mutation is associated with pancreatic tumours.
95% have mutations in the KRAS2 gene.
How do tumours in the head of the pancreas present.
Painless obstructive jaundice.
How do tumours in the body and tail of the pancreas present. (3)
75% present with epigastric pain.
The pain radiates to the back and is relieved by sitting forward.
What are some typical features of pancreatic cancer. (4)
Weight loss.
Anorexia.
Diabetes.
Acute pancreatitis.
What are some of the rarer features of pancreatic cancer. (5)
Thrombophlebitis migrans (an arm vein becomes swollen and red, then a leg vein).
Raised calcium.
Marantic endocarditis.
Portal hypertension (splenic vein thrombosis).
Nephrosis (renal vein metastases).
What are some of the signs of pancreatic cancer on physical exam. (7)
Jaundice and palpable gallbladder (Courvoisier's law). Epigastric mass. Hepatomegaly. Splenomegaly. Lymphadenopathy. Ascites.
What is the overall survival for pancreatic cancer.
3-5%.
What is the median survival rate for patients with pancreatic cancer. (2)
6-10 months for those with locally advanced disease.
3-5 months if metastases are present.
What percentage of pancreatic tumours are adenocarcinomas.
90%.
What is the pain caused by pancreatic cancer typically described as. (4)
Incessant and gnawing.
It often radiated to the back and may be eased a little by bending forward.
How is a diagnosis of pancreatic cancer often made. (2)
Ultrasound and contrast enhanced CT.
What is a rare presentation of pancreatic cancer.
Recurrent episodes of typical acute pancreatitis.
