-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