Pancreatic Cancer
Pancreatic cancer is most often an exocrine ductal adenocarcinoma; it may present with obstructive jaundice, weight loss, upper-abdominal or back pain, new diabetes or malabsorption, and treatment depends on specialist staging and whether the tumour is resectable.
Definition
Pancreatic cancer is a malignant tumour arising in the pancreas, most commonly an exocrine ductal adenocarcinoma. It can obstruct the distal bile duct, invade vessels or metastasise, and treatment is determined by specialist staging, resectability, fitness and the person's goals.
First principles
Anatomy explains the presentation
A tumour in the pancreatic head can obstruct the distal common bile duct and cause cholestatic jaundice, dark urine, pale stools and pruritus. Body and tail tumours do not sit beside the distal bile duct, so they may grow with less specific symptoms such as pain, weight loss or metastatic disease. A palpable, non-tender gallbladder with jaundice can suggest malignant obstruction, but Courvoisier's sign is not diagnostic and imaging is required.
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