Pancreatic cancer

What is the most common presentation of pancreatic cancer?

Progressive, painless obstructive jaundice.

List 5 symptoms of pancreatic cancer.

• Dark urine

• Pale stools

• Anorexia

• Weight loss

• Vague abdominal or back pain

What are less common presentations of pancreatic cancer?

• Acute pancreatitis

• new-onset diabetes

• malabsorption

• steatorrhoea

What might general exam show in pancreatic cancer?

• jaundice

• pallor

• skin excoriations

• weight loss or cachexia

What might be found on abdominal exam in pancreatic cancer?

• Epigastric tenderness

• Upper abdominal mass

• Palpable gallbladder (Courvoisier’s sign)

• Nodular hepatomegaly

• Ascites

What lymph node should be checked for in pancreatic cancer?

Virchow’s node (left supraclavicular lymph node).

What blood test findings suggest obstructive jaundice in pancreatic cancer?

• ↑ bilirubin

• ↑ ALP

• ↑ GGT

• ± ↑ ALT

What does a disproportionately raised ALT suggest in pancreatic cancer?

Possible liver metastases.

What is the most accurate imaging test for detecting pancreatic cancer?

Abdominal CT scan.

What is the surgical treatment for a tumor in the head of the pancreas?

Modified Whipple procedure (pylorus-preserving pancreaticoduodenectomy).

What surgery is done for a tumor in the body or tail of the pancreas?

Distal pancreatectomy (removal of body and tail of pancreas + spleen).