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Pancreatic cancer

Pancreatic cancer has a poor prognosis - 5 year survival is <5% 

Commonest pathology is ductal adenocarcinoma (>90%) and commonest location is head of pancreas.  

Presentation
  • Weight loss 
  • Pain
    • Persistent back pain suggests retroperitoneal infiltration 
  • Jaundice 
  • Adult-onset diabetes in past 2 years (5% of cases) 
  • Abdominal mass 
  • Ascites 
  • Courvoisier’s sign 
  • Migratory thrombophlebitis

Risk factors for pancreatic cancer
  • Smoking 
  • Alcohol
  • Family history
  • Peutz-Jeghers syndrome
  • HNPCC
  • Chronic pancreatitis
  • Hereditary pancreatitis
  • Diabetes mellitus

Investigation 
  • Most useful initial investigation: abdominal US
  • CT/MR/MRCP 

Management 
  • Surgical resection if appropriate
  • Stenting if required to relieve jaundice 
  • ?Chemo

References
 
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Abdelghafour

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Secret collector of interesting anonymised ECGs. Fan of the Bath Photomarathon. Lover of cream teas. [Sarah Hudson] (Your Picture)