Gastro

Pancreatic Cancer

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Pathology

Can be an exocrine tumour (adenocarcinoma) or endocrine (e.g. Insulinoma, VIPoma, gastrinoma)

Aetiology

Exocrine tumours more common in patients with chronic pancreatitis and smokers .

Signs

Painless jaundice, steatorrhoea, palpable gallbladder, ascites

Symptoms

Abdominal Pain, weight loss and anorexia

Investigations

Bloods: LFTs show a raised Bilirubin and ALP
Tumour Markers: Raised CA 19-9 
Imaging: Ultrasound Abdomen shows a dilated biliary tree and pancreatic mass. 
CT Abdomen shows a  pancreatic mass, 

Treatment

Medical: If unresectable, treatment is chemotherapy
Surgical: If resectable, usually treated with Whipple’s pancreatoduodenectomy 

Prognosis

Often diagnosed late so prognosis is poor. 
Median survival with advanced disease is 8 to 12 months and metastatic disease is 3 
to 6 months
Pancreatic leaks, fistula, chronic pain

Key Facts

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Key Images

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Key References

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