Pancreatic Cancer

Overview

Pancreatic cancer is one of the most aggressive malignancies with a 5-year survival of about 10%. However, for the 15-20% of patients diagnosed with resectable disease, surgery offers the only chance of cure. Early detection and referral to an HPB surgeon is critical.

Causes

• Genetic mutations (KRAS, TP53, CDKN2A, SMAD4)
• Chronic pancreatitis
• Hereditary syndromes (BRCA2, Lynch, Peutz-Jeghers)
• IPMN (intraductal papillary mucinous neoplasm)
• Unknown in majority of cases

Risk Factors

• Age over 60
• Smoking (2-3x increased risk)
• Obesity
• Type 2 diabetes (new-onset)
• Chronic pancreatitis
• Family history of pancreatic cancer
• Heavy alcohol use
• High red meat diet

Symptoms

Diagnosis

• CT pancreas protocol (triple phase)
• MRI/MRCP
• Endoscopic ultrasound (EUS) with FNA biopsy
• CA 19-9 tumor marker
• PET-CT for staging
• Diagnostic laparoscopy (to rule out peritoneal disease)

Treatment Options

Surgical Treatment

Recovery

Whipple procedure: 7-10 days hospital stay, soft diet progressing over 2-3 weeks, pancreatic enzyme supplements, adjuvant chemotherapy starting 6-8 weeks post-operatively. Full recovery in 2-3 months.

Prevention

• Don't smoke
• Maintain healthy weight
• Limit alcohol
• Control diabetes
• Genetic counseling if family history
• Surveillance for high-risk individuals (IPMN, hereditary syndromes)

Frequently Asked Questions