Pancreatic cancer is often diagnosed late as it tends to present in a non-specific way. Over 80% of pancreatic tumours are adenocarcinomas which typically occur at the head of the pancreas - most lesions arise from the exocrine ductal epithelium

Pancreatic cancers tend to spread and metastasise early, particularly to the liver, then to the peritoneum, lungs and bones. The average survival, when diagnosed with advanced disease, is around 6 months.

When caught early, the cancer is isolated to the pancreas and surgery is possible, the 5-year survival is still around 25% or less.

Epidemiology:

• 6th most common cause of cancer related death in europe
• Most common age group - 65-75

Risk factors:

• smoking
• Family Hx of pancreatic cancer - BRCA2 can be found in 20% of familial causes of pancreatic cancer
• Other hereditary syndromes
• chronic pancreatitis
• Diabetes

PC

*Presence of risk factors

• Key feature - Painless obstructive jaundice (DD is cholangiocarcinoma)
  • Yellow skin and sclera, pale stools, dark urine, pruritis
  • Obstructive jaundice does NOT typically occur in tumours in the body or tail

Other Presenting features:

• Non-specific upper abdominal or back pain
• Unintentional weight loss and anorexia