Pancreatic cancer

Question 1

Define

Answer 1

Carcinoma of the pancreas

Question 2

what is the most common type of pancreatic cancer?

Answer 2

adenocarcinoma

Question 3

name 4 risk factors for development of pancreatic cancer

SINED

Answer 3

Smoking
Inflammation>> chronic pancreatitis
Nutrition>> too much fat taken in 
Ethanol consumption
Diabetes

Question 4

which rank is pancreatic cancer in terms of cause of death in the UK?

a) 1st
b) 5th
c) 50th
d) 20th

Answer 4

b) 5th
25% survival rate after a year
5% after 5 years

Question 5

Presentation? (5) (includes some signs

Answer 5

FLAWS
Epigastric pain
Epigastric tenderness
Epigastric mass
Jaundice (because pancreatic cancer can compress and narrow the biliary duct which stops the bile from entering duodenum>> bilirubin builds up
Diabetes M symptoms

Question 6

Signs?

Answer 6

Epigastric mass

Palpable gall bladder (because the bile duct is narrowed so a lack of flow of bile through the duct means accumulation of bile in the gall bladder» enlarged gall bladder

jaundice

Question 7

What is courvoisier’s law?

Answer 7

When there is painless jaundice and a palpable gallbladder, it’s not due to gallstones»> it’s more serious

Question 8

Complication signs of pancreatic cancer? (2)

Answer 8

hepatomegaly due to mets

Diabetes symptoms due to messed up endocrine function of pancreas

Question 9

App Ix? (2) bloods and imaging

Answer 9

Bloods» FBC, ALP, Bilirubin both elevated
CA-19-9 and CEA both elevated as they are markers for pancreatic cancer
Imaging= US, CT, MRI, ERCP

Question 10

Mx? palliation and surgery? (2)

Answer 10

Palliation= if there is mets and there is no cure at all. Endoscopic stenting of bileduct to allow ease of sympotoms

Surgery= if no mets»whipple’s pancreaticoduodenalectomy