Pancreatic cancer Flashcards
What is pancreatic cancer
usually primary pancreatic ductal adenocarcinoma
also endocrine tumours e.g. gastrinoma, VIPoma, insulinoma
What are risk factors for pancreatic cancer?
Age male smoking carcinogens chronic pancreatitis diabetes IBD fatty diet
What inherited cancer syndromes are associated with pancreatic cancer?
Peutz-Jeghers BRCA1/2 HNPCC MEN1 Von Hippel Lindau
What are Sx of pancreatic cancer
Mostly none.
Obstructive painless jaundice due to compression of CBD.
Weight loss, cachexia, N+V due to GOO.
Pain radiating to back relieved by sitting forward
Palpable gallbladder
What derm condition can be seen in pancreatic cancer
Thrombophlebitis migrans: caused by paraneoplastic hypercoagulable state
What are DDx for pancreatic cancer?
Gallstones
Cholangiocarcinoma
Gallstones
PUD
gastric carcinoma
What Ix in pancreatic cancer
BLOODS
LFTS show cholestatic pattern and FBC might show anaemia
Ca19-9: tumour marker
Abdo CT with contrast: diagnostic.
Abdo US: biliary dilation, double duct signs. Rules out gallstones.,
Endoscopic US or ERCP can be used to get a FNA + biopsy
staging e.g. CTCAP, PET-CT
What is Rx of pancreatic cance?
90% not for resection
Surgery = Whipples or distal pancreatectomy (not done if any mets)
Chemo used for most
Palliative biliary stent to relieve symptoms (ERCP, PC)
Creon
Opiates
What are complications of pancreas cancer surgrey
Pancreatic fistula
Delayed gastric emptying
Pancreatic insufficiency
What are complications of pancreas cancer
Duodenal obstruction
DVT/PE
