Flashcards in Pancreatic Cancer Deck (111)
What will pancreatic cancer typically refer to?
Ductal carcinoma of the pancreas
What % of primary pancreatic malignancies are ductal carcinoma of the pancreas?
Up to 90%
What are the remaining 10% of primary pancreatic malignancies?
Give an example of an exocrine tumour of the pancreas
Pancreatic cystic carcinoma
Give an example of an endocrine tumour of the pancreas?
Tumour derived from islet cells of pancreas
How common is pancreatic cancer compared to other cancers?
10th most common cancer in UK
How deadly is pancreatic cancer compared to other cancers?
4th most common cause of cancer death in UK
What age group does pancreatic cancer occur in?
Rare under 40 years of age, 80% cases occur between 60-80 years
Why does pancreatic cancer have a high mortality?
It is rarely diagnosed early enough for curative treatment
How does the mortality of rarer types of pancreatic tumours differ from that of ductal carcinoma?
They often have a much better prognosis
What does direct invasion of pancreatic ductal carcinoma typically involve?
What does the lymphatic metastasis of pancreatic ductal carcinomas typically involve?
Regional lymph nodes, liver, lungs, and peritoneum
Is metastasis common at the time of diagnosis of pancreatic ductal carcinoma?
What are the risk factors for the development of carcinoma of the pancreas?
Recent onset of diabetes mellitus
Late onset diabetes
What % of people with pancreatic cancer have a family history of the disease?
By how much does a diagnosis of diabetes after 50 increase the risk of developing pancreatic carcinoma in the next 3 years?
What % of cases of pancreatic carcinoma are unresectable at diagnosis?
Why is pancreatic cancer often diagnosed late?
Due to the late and often vague and non-specific nature of its presentation
What do the specific clinical features of pancreatic carcinoma depend on?
The site of the tumour
How do cancers affecting the head of the pancreas typically present?
Abdominal pain, radiating to the back
Why do cancers affecting the head of the pancreas cause obstructive jaundice?
Due to compression of the common bile duct
What % of cases of cancer affecting the head of the pancreas have obstructive jaundice at the time of diagnosis?
Why do cancers affecting the head of the pancreas cause abdominal pain radiating to the back?
Due to invasion of the coeliac plexus, or secondary to pancreatitis
Why do cancers affecting the head of the pancreas cause weight loss?
Due to the metabolic effects of the cancer, or secondary to exocrine dysfunction
What are the less common presentations of pancreatic cancer?
What is thrombophlebitis migrans?
A recurrent migratory superficial thrombophlebitis
What causes thrombophlebitis migrans in pancreatic cancer?
A paraneoplastic hypercoagulable state
What is the problem with the diagnosis of tumours of the tail of the pancreas?
They have an insidious course, and are generally not symptomatic until a late stage
What may be found on examination in pancreatic cancer?
Patient may appear cachetic, malnourished, and jaundiced
On palpation, and abdominal mass in the epigastric region may be felt, as well as enlarged gallbladder (as per Courvoisier's Law)