pancreatic cancer

Question 1

define pancreatic cancer?

Answer 1

Malignancy arising from the exocrine or endocrine tissues of the pancreas

Question 2

what are the risk factors of pancreatic cancer?

Answer 2

o	Age 
o	Smoking
o	Alcohol 
o	Diabetes mellitus 
o	Chronic pancreatitis 
o	Hereditary non-polyposis colorectal carcinoma 
o	Dietary
o	Multiple endocrine neoplasia 
o	BRCA2 gene 
o	KRAS gene mutation

Question 3

what is the prognosis for pancreatic cancer?

Answer 3

● Poor prognosis as it presents very late

Question 4

where is the cancer of the pancreas normally located?

Answer 4

● 75% occur within head or neck of pancreas

Question 5

what is the epidemiology of pancreatic cancer?

Answer 5

● 2 x more common in MALES

● Peak age: 60-80 yrs

Question 6

presenting symptoms of pancreatic cancer?

Answer 6

●	Anorexia
●	Malaise 
●	Nausea
●	Epigastric pain 
●	Weight loss 
●	Jaundice 
●	Loss of exocrine function (steatorrhea) 
●	Loss of endocrine function (diabetes mellitus)

Question 7

what are the signs of pancreatic cancer on physical examination?

Answer 7

● Jaundice and a palpable gallbladder - Courvoisier’s law
● Trousseau’s Sign of Malignancy - superficial thrombophlebitis
● Pale stools, dark urine and pruritis

Question 8

what is the first line investigation for pancreatic cancer?

Answer 8

● First line: LFTs and Abdo USS

Question 9

what is the gold standard investigation for pancreatic cancer?

Answer 9

high resolution CT

Question 10

what might the bloods show for pancreatic cancer?

Answer 10

o Raised lipase
o CA 19-9 and CEA are tumour markers
o Can cause obstructive jaundice

Question 11

what is a key feature that imaging might show of pancreatic cancer?

Answer 11

double duct sign