Pancreatic cancer + Hepatocellular carcinoma Flashcards
What is pancreatic cancer?
Adenocarcinoma of exocrine pancreas (99% cases) of ductal origin typically affecting head
Who does pancreatic cancer affect?
Males 60+
RF for pancreatic cancer?
smoking, alcohol, DM, fHx, Chronic pancreatitis, genetic predisposition
% of pancreatic cancer where in pancreas?
60% head
25% body
15% tail of pancreas
Head of pancreas tumour causes what?
compress bile duct = obstructive jaundice
Metastasises early to?
liver, lungs and bones
Sx of pancreatic cancer?
Head?
Tail and body?
Head = Courvoisier sign (painless jaundice + palpable GB) with pale stools+ dark urine + painless jaundice
Body and tail = epigastric pain radiating to back, relieved by sitting forwards - much like acute pancreatitis
What is trousseau’s sign of malignancy?
Migratory thrombophlebitis
Non specific episodes od vessel inflammation + clots in diff parts of body
Dx of pancreatic cancer?
Suspected pancreatic cancer =
1st line = Abdo USS (less sensitive)
GS = Pancreatic CT protocol then bile duct drainage - diagnostic 97%
Ca19-9 tumour marker +ve
Non diagnostic = monitor disease progression
Tx of pancreatic cancer?
very poor prognosis (5y survival = 3%)
surgery + post op chemo if no mets
Palliative care otherwise
Liver cancers
LC = 1^
MC = 2^
1^ = Hepatocellular carcinoma, cholangiocarcinoma (benign)
2^ = GIT, Breast, bronchial
Hepatocellular carcinoma
Arise from?
what % of all 1^ cancer?
Affects who?
liver parenchyma
90% of all 1^ liver cancer
Males
HCC
RF?
Chronic hepatitis Virus C+B
Cirrhosis from ALD/NAFLD/Haemochromatosis
HCC
Metastasis to where? via?
metastasis to lymph nodes, bones, lungs via haematogenous spread (hepatic/portal veins)
HCC
Patient Sx?
Signs of decompensated liver failure (jaundice, ascites, HE…) + Cancer signs (TATT, Weight loss)
may ahem irregular hepatomegaly
