Pancreatic Carcinoma

Question 1

What is the pneumonic for the risk factors of pancreatic carcinoma?

Answer 1

SINED

Smoking
Inflammation: chronic pancreatitis
Nutrition: high fat diet
EtOH
DM

Question 2

What are the vast majority of pancreatic cancers (90%)?

Answer 2

Ductal adenocarcinomas

Question 3

What percentage of cancer is located in the head, body and tail of the pancreas?

Answer 3

Head 60%
Body 25%
Tail 15%

Question 4

Where does pancreatic cancer extend to (metastasise)

Answer 4

Direct extension to local structures
Lymphatics
Blood -> liver + lungs

Question 5

what age and sex is pancreatic cancer most common in

Answer 5

men over 60

Question 6

What are the 5 presenting features of pancreatic cancer

Answer 6

Painless obstructive jaundice (dark urine, pale stools)
Epigastric pain: radiates to back, relieved when sitting forward
Anorexia, wt loss and malabsorption
Acute pancreatitis
Sudden onset DM in the elderly

Question 7

What is Courvoisier’s Law?

Answer 7

In the presence of painless obstructive jaundice, a palpable gallbladder is unlikely to be due to stones.

Question 8

Pancreatic cancer 5 year survival with surgery?

Answer 8

5-14%

Question 9

What is the main procedure for pancreatic cancer called?

Answer 9

Whipple’s pancreaticoduodenectomy

Question 10

Pancreatic cancer 5 year survival without surgery?

Answer 10

<2%