pancreatic%20cancer
PANCREATIC CANCER
Treatment Guideline Chart
Pancreatic cancer is malignancy arising from the pancreas.
It is the 13th most common cancer in the world, 10th most common in the United States, and 4th leading cause of cancer-related deaths in the United Stated and Europe.
Exocrine tumors account for 95% of malignant pancreatic disease.
It is more common in women.
The median age of occurrence is at 71 years old.

Pancreatic%20cancer Signs and Symptoms

  • 13th most common cancer in the world
  • 10th most common cancer in the US
  • 4th leading cause of cancer-related deaths in the US and 7th in Europe
  • Exocrine tumors account for 95% of malignant pancreatic disease and these are adenocarcinomas
  • 30% more common in men than in women
  • Median age of diagnosis: 70 years
  • Most highly fatal cancer: Overall 5-year survival rate is approximately 10%
  • Presentation % of Patients at Initial Diagnosis Median Survival Rate
    Resectable/borderline resectable 15-20% 20-24 months
    Locally advanced/unresectable 25-30% 8-14 months
    Metastatic disease 50-60% 4-6 months
  • Most common anatomic location: 80% head, 15% body, 5% tail of the pancreas

Signs and Symptoms

  • Jaundice
    • Common in patients with malignancy in the head of the pancreas
  • Abdominal pain
    • Common in patients with tumors located in the body and tail of the pancreas
  • Weight loss
  • Back pain
  • Symptoms secondary to compression caused by the tumor:
    • Nausea/vomiting
    • Anorexia
    • Dyspepsia
    • Gastrointestinal bleeding
  • Symptoms caused by biliary obstruction:
    • Dark urine
    • Lightly colored-grayish stool
    • Pruritus
    • Infections (cholangitis, pancreatitis)
    • Scleral icterus
  • Symptoms caused by pancreatic enzyme insufficiency:
    • Malabsorption
    • Fatty stools
    • Increased flatulence
    • Ascites

Risk Factors

High Risk
  • Familial atypical multiple mole melanoma (FAMMM)
  • Hereditary pancreatitis
  • Peutz-Jeghers syndrome
  • >3 1st-degree relatives diagnosed with pancreatic cancer
Moderate Risk
  • 2 1st-degree relatives diagnosed with pancreatic cancer
  • Cystic fibrosis
  • Chronic pancreatitis
  • BRCA2 mutation carrier
  • PALB2 mutation carrier
Low Risk
  • Cigarette smoking
  • Diabetes mellitus (DM)
  • Obesity/increased body mass index (BMI)
  • Occupational exposure to chemicals (eg beta-naphthylamine, benzidine)
  • Heavy alcohol consumption
  • One 1st-degree relative diagnosed with pancreatic cancer
  • Increased consumption of red/processed meat and dairy products
  • Low intake of fruits and vegetables
  • Low plasma 25-hydroxyvitamin D levels
  • History of gallstones and H pylori infection
  • BRCA1 mutation carrier
  • Familial adenomatous polyposis
  • Li-Fraumeni syndrome
  • Lynch syndrome
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