Pancreatic cancer Flashcards

1
Q

What type of patients can we expect to see?

A
  1. Around 60-80 years
  2. African American
  3. Male
  4. previous smoking history
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2
Q

What are the aetiological factors of pancreatic cancer?

A
  • smoking
  • chronic pancreatitis
  • high alcohol consumption
  • obesity
  • type 2 diabetes
  • 10% inherited genetic syndromes such as BRCA1 and BRCA2
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3
Q

Where does the pancreatic tumour usually occur?

A

It usually occurs in the head of the pancreas usually-65%
The body-15%
The tail-10%
The other 10% is multifocal

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4
Q

What type of cancer is pancreatic cancer?

A

-adenocarcinoma (85%) arising from the ductal epithelium

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5
Q

Which cells between endocrine and exocrine cells usually develop into tumours?

A

-exocrine cells

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6
Q

What is the only potentially curative procedure for pancreatic cancer?

A

-surgical excision

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7
Q

What are the 2 types of cancer that can occur in the pancreas?

A
  1. Adenocarcinoma of the head of the pancreas

2. Peri ampullary carcinoma

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8
Q

Where does adenocarcinoma carcinoma originate from?

A
  1. Tubular or acinar epithelium of exocrine pancreas
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9
Q

Where does the peri-ampullary carcinoma originate from?

A
  1. 2nd part of the duodenum
  2. Distal bile duct
  3. Ampulla of vater
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10
Q

What are the special investigations you do in pancreatic ca?

A
  1. Tumour markers-CA19-9
  2. Abdominal ultrasound: first test with double duct sign
  3. ERCP
  4. Endoscopic ultrasound and do fine needle aspiration
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11
Q

How does adenocarcinoma of the pancreatic head present?

A
  1. Loss of weight, nausea, anorexia
  2. Deep set abdominal pain that radiates to the back
  3. Painless obstructive jaundice
  4. Palpable gallbladder
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12
Q

Adenocarcinoma of the body/tail of the pancreas clinical signs?

A
  1. Loss of weight, anorexia, nausea
  2. Deep set epigastric Pain with palpable pancreas and travels to the back
  3. Left sided portal hypertension because of obstruction of the splenic vein
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13
Q

How do cystic tumors present?

A

Cry few symptoms with vague upper abdominal symptoms and palpable epigastric mass

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