Pancreatic cancer

Question 1

what is the most common type?

Answer 1

adenocarcinoma

Question 2

How does a tumor at the head of the pancreas present?

Answer 2

1. Couvosier’s law
   - jaundice
   - palpable gallbladder

Question 3

Clinical presentation of pancreatic cancer

Answer 3

1. non specific upper abdominal pain
2. weight loss
3. Mass in epigastric
4. Jaundice and steatorrhea

Question 4

What is the 2 week referral criteria?

Answer 4

1. > 40 years

2. weight loss

Question 5

What is the criteria for 2 week CT scan?

Answer 5

Over 60 and weight loss

1. diarrhoea
2. back pain
3. abdominal pain
4. nausea and vomiting
5. new onset diabetes

Question 6

What is the first line Ix?

Answer 6

Ct of the abdomen or ultrasound

Question 7

What is the tumor marker for pancreatic ca?

Answer 7

1. CA 19-9

Question 8

TNM and staging of Pancreatic Ca?

Answer 8

TNM
1. T
1 - less than 2 cm
2 - 2-4 cm
3 - > 4 cm
4 - invades into other structure

1. N
   1- 1-3 nodes
   2 - > 4 and over
2. M
   1- present

Question 9

Tx for stage 1 and 2

Answer 9

1. Surgical resection

Whipple’s procedure - removing head of pancreas, gallbladder, duodenum and pylorus

Question 10

Tx for > stage 2

Answer 10

1. edoscopic stenting/ERCP - billiary stent helps to relieve jaundice
2. Palliation