Pancreatic Cancer Flashcards
Define Pancreatic Cancer?
Malignancy arising from the exocrine or endocrine tissues of the pancreas
What percentage of pancreatic cancers are hereditary?
5-10%
What causes these hereditary pancreatic cancers?
MEN
HNPCC
FAP
Von-Hippel Lindea Syndrome
What are the risk factors for Pancreatic Cancer?
Age Smoking Diabetes Mellitus Chronic Pancreatitis Dietary (low intake of fresh fruit and vegetables)
What is the epidemiology of pancreatic cancer?
Increasing incidence
2x more common in MALES
Peak age: 60-80 years
What are the presenting symptoms of pancreatic cancer?
Initial symptoms are often NON-SPECIFIC Anorexia Malaise Nausea Epigastric Pain Weight Loss DM Jaundice
What are the signs of Pancreatic Cancer on physical examination?
Weight Loss
Epigastric tenderness or mass
Jaundice and a palpapble gallbladder (Courvoisier’s Law)
If metastatic spread then you would see hepatomegaly
Trousseau’s Sign of Malignancy
What is Trousseu’s Sign of Malignancy?
Superficial Thrombophlebitis
What bloods would you do for pancreatic cancer and what would you see?
CA 19-9
CEA is also elevated
Obstructive jaundice features
What are Obstructive Jaundice features?
High Bilirubin
High ALP
Deranged clotting
What are the imaging investigations you would do for Pancreatic Cancer?
Ultrasound
CT with/without guided biopsy
MRI/MRCP
ERCP - may allow biopsy, bile cytology and stenting