Pancreatic cancer

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The vast majority of pancreatic cancers are adenocarcinomas. Most pancreatic adenocarcinomas are asymptomatic until too late for curative treatment. Prognosis is poor and palliative treatment challenging. Surgical treatment with curative intent carries significant morbidity and an appreciable mortality. For a review see:[1]

Contents

Diagnosis

  • USS
  • CT scan ideally with biopsy
  • Staging laparoscopy
  • CA19-9

Treatment

Surgical

It is now known that if resection of a tumour of the pancreatic head causing jaundice is planned within 1 week of presentation, endoscopic preoperative biliary drainage should not be routine as it increases the complication rate[2]
Please supply a link for this paper.

Endoscopic

Medical

  • Palliative chemotherapy

Regimes include gemcitabine alone (approved by NICE in the UK [3]), and in combination with other drugs including erlotinib (Tarceva) and cisplatin.

References

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