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
