Actor Patrick Swayze died after a 20-month battle with pancreatic cancer. He was 57.
• Epidemiology:– < 2% of all malignancies– ~ 6500 deaths/year
• Typical patient: – male > 60yrs old
• Risk factors:– smoking– alcohol– carcinogens– chronic pancreatitis
• Symptoms & signs:– jaundice– pain in the upper or middle abdomen and back– unexplaind weight loss– loss of appetite– fatigue
• Investigations:– transabdominal ultrasound– contrast-enhanced spiral CT scan– laparoscopy– ERCP– percutaneous needle biopsy– MRI scanning and endoscopic ultrasound– several tumour markers (CA19-9)
• Pathology: – mostly ductal adenocarcinoma
(metastasizes early; presents late)
Location of
tumor:
- 60% head
- 25% body
- 15% tail
• Treatment:– surgery
• Whipple`s procedure• total pancreatectomy• distal pancreatectomy
– radiation therapy– chemotherapy
• Prognosis:– dismal
Mean survival: < 6 months5yr survival: < 2 %After Whipple`s procedure: 5-14%
Better if: tumour < 3 cm no nodes involved
negative resection margins at surgery
ampullary or islet cell tumors
References:
• http://www.meb.uni-bonn.de/cancer.gov/CDR0000062957.html• Longmore, Oxford Handbook of Clinical Medicine, Oxford
University Press, 2010
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