-IBIS-1.5.0-
tx
digestive system
pancreatic cancer
diagnoses

definition and etiology

definition: malignancy of the pancreas

etiology: The incidence of pancreatic cancer has tripled over the last forty years. There is no known cause, although chronic pancreatitis, smoking, certain chemicals (coke and metal workers, gas plant workers), coffee, alcohol and diabetes mellitus (only in women) are risk factors. It is a rare cancer, accounting for only 2-3% of all cancers; however, it accounts for 10% of all fatal abdominal malignancies, and is now the fourth most common fatal cancer in the U.S. It is 3-4 times more common in men, and is seen between the years of 35-70, with the peak at about 60.

signs and symptoms

signs and symptoms:
onset is insidious

carcinoma:
• asthenia, anorexia
• weight loss: often rapid and severe
• alteration in bowel habits
• thrombophlebitis
• nausea, bloating
• depression
• diabetes mellitus
• pain: dull, deep; in the epigastrium or back
• persistent jaundice with itching (head of pancreas tumor)
• palpable gallbladder (head of the pancreas tumor)
• palpable abdominal tumor (tail of pancreas tumor)

islet cell tumor:
• functioning tumors (symptoms from over-secretion of insulin): hypoglycemia, fatigue, lethargy, restlessness, malaise, change in consciousness, staggering, coma, hypothermia; worse in the morning before breakfast
• nonfunctioning tumors (Zollinger-Ellison syndrome): severe peptic ulcer disease

lab findings:
• (+) CT scan
• (+) endoscopic retrograde cholangiopancreatogram
• (+) biopsy
• (+) ultrasound
• Increased CEA

course and prognosis

Conventional treatment is surgery, irradiation, and chemotherapy. Pancreatic cancer is a quickly metastasizing malignancy that is usually surgically untreatable by the time of diagnosis. The prognosis is extremely unfavorable; the 5-year survival rate is only 9%, and it is rare for a patient to live beyond 5 years, though some have done so.

differential diagnosis

• pancreatitis
• infectious GI disorders
• hepatitis


footnotes