Pancreatic cancer Flashcards
What type of patients can we expect to see?
- Around 60-80 years
- African American
- Male
- previous smoking history
What are the aetiological factors of pancreatic cancer?
- smoking
- chronic pancreatitis
- high alcohol consumption
- obesity
- type 2 diabetes
- 10% inherited genetic syndromes such as BRCA1 and BRCA2
Where does the pancreatic tumour usually occur?
It usually occurs in the head of the pancreas usually-65%
The body-15%
The tail-10%
The other 10% is multifocal
What type of cancer is pancreatic cancer?
-adenocarcinoma (85%) arising from the ductal epithelium
Which cells between endocrine and exocrine cells usually develop into tumours?
-exocrine cells
What is the only potentially curative procedure for pancreatic cancer?
-surgical excision
What are the 2 types of cancer that can occur in the pancreas?
- Adenocarcinoma of the head of the pancreas
2. Peri ampullary carcinoma
Where does adenocarcinoma carcinoma originate from?
- Tubular or acinar epithelium of exocrine pancreas
Where does the peri-ampullary carcinoma originate from?
- 2nd part of the duodenum
- Distal bile duct
- Ampulla of vater
What are the special investigations you do in pancreatic ca?
- Tumour markers-CA19-9
- Abdominal ultrasound: first test with double duct sign
- ERCP
- Endoscopic ultrasound and do fine needle aspiration
How does adenocarcinoma of the pancreatic head present?
- Loss of weight, nausea, anorexia
- Deep set abdominal pain that radiates to the back
- Painless obstructive jaundice
- Palpable gallbladder
Adenocarcinoma of the body/tail of the pancreas clinical signs?
- Loss of weight, anorexia, nausea
- Deep set epigastric Pain with palpable pancreas and travels to the back
- Left sided portal hypertension because of obstruction of the splenic vein
How do cystic tumors present?
Cry few symptoms with vague upper abdominal symptoms and palpable epigastric mass
