Pancreatic Cancer Flashcards
What percentage of all malignancies is pancreatic cancer?
less than 2%
What age and sex is the typical patient?
60yrs and male
What are the risk factors of pancreatic caner?
- smoking
- alcohol
- carcinogens
- Diabetes melitus
- chronic pancreatitis
- increased waist circumference
- high fat/red meat diet
Where do most pancreatic cancers arise?
60% in pancreatic head.
25% in body
15% in tail
What type of pancreatic cancers metastesize early and present late?
- ductal adenocarcinoma
what gene do 92% of pancreatic cancers have a mutation in>
KRAS2 gene
what do tumours in the head of the pancreas present with
painlesss obstructive jaundice
What do pancreatic tumours in the tail and body present with?
epigastric pain (radiates to back and relieved by sitting forward)
What are the general symptoms of pancreatic cancer?
- anorexia
- diabetes
- weight loss
- acute pancreatitis
(obstructive painless jaundice (head), epigastric pain (tail/body)
What are the rare features of pancreatic cancer
- thrombophelbitis
- raised calcium
- marantic endocarditis
- portal hypertension
- nephrosis
What are the examination signs of pancreatic cancer?
- jaundice
- palpable gallbladder
- epigastric mass
- hepatomegaly
- splenomegaly
- lymphadenopathy
- ascites
What blood tests are done for pancreatic cancer
- LFTs (bilirubin for cholestatic jaundice)
- calcium
- FBC (raised WCC - pancreatitis)
- CRP / ESR
What imaging is done for pancreatic cancer?
- USS or CT (shows pancreatic mass / dilated biliary tree / prognosis)
- guides biopsy
What is the treatment of pancreatic cancer
1) less than 20% are suitable for radical surgery
2) post op chemo delays disease progression
3) palliation of jaundice - stent to relieve obstruction
4) opiates for pain
What is the mean survival of pancreatic cancer
less than 6months
