Martina RastovacMentor: A. Žmegač Horvat

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

• Pancreas:– head– body– tail

• 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

• Stages of pancreatic cancer:

I II III IV

• Treatment:– surgery

• Whipple`s procedure• total pancreatectomy• distal pancreatectomy

– radiation therapy– chemotherapy

• Whipple`s procedure:

• WHO Pain relief ladder

Freedom from cancer pain

• 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