Pancreatic cancer

Question 1

define Pancreatic cancer

Answer 1

Usually refers to PRIMARY pancreatic ductal adenocarcinomas (over 85% of pancreatic cancers)-head of the pancreas
BAD prognosis

Question 2

Aetiology and risk factors of pancreatic cancer

Answer 2

65% are in the head (bad) and the rest In body and tall
Thought to linearly progress from micro lesions to cancer. Found KRAS mutations

Risk factors
old-65-75
Smoking-1.7 times
FHx 
DM

Question 3

Epidiemology of pancreatic cancer

Answer 3

55440 new cases in US last year-
7.8 in 100000 in UK (age adjusted)-
3rd biggest cancer killer-very very bad prognosis (die in a few months)

Question 4

Signs and Sx of Pancreatic cancer

Answer 4

Most common: painless jaundice and weight loss
ALWAYS THINK pancreatic cancer in painless jaundice

other:
FLAWS, non specific upper abdomen pain (RUQ, Epigastric)
Stratthorea (as obstruct bile)
Thrist/polyuria/dipsia/weight loss–consider pancreatic cancer in older adults with new DM and no risk factors or FHx

Courvoisiers sign-palpable gallbladder -sign of advanced disease
(law is-painless and palpable-cancer. painful and non palpable-gallstones)

liver metastases can show as hepatomegaly and signs of liver failure

Question 5

Investigations of pancreatic cancer

Answer 5

Abdo USS-shows mass, obstructions, dilated duct and possible liver metastasis
Abdo CT-see mass as well
LFTs-high ALP, conjugated bilirubin and GGT
ALT-normal
CA19 cancer antigen-pancreatic cancer marker
ERCP for sample

PT -prolonged (do before invasive)