Pancreatic cancer symptom

(Great Britain--The Practitioner, April 2000, p. 336.) Adenocarcinoma of the pancreas is one of the most common causes of cancer mortality. Most cases occur in the head of the gland. While the disease is increasing in incidence, the mean five-year survival rates are 5 percent or less; most patients survive about 17 months following pancreatic resection. Risk factors for pancreatic cancer include cigarette smoking, diets high in fat and protein, and certain occupational exposures to chemicals. It is unclear if diabetes is a predisposing condition or an early symptom of pancreatic pathology. Patients with pancreatic cancer typically present with weight loss, pain of the upper abdomen or back, and obstructive jaundice. Pruritus, nausea and vomiting are the symptoms of pancreatic cancer that may be the most distressing to patients. Several abnormalities on physical examination and laboratory testing may contribute to the diagnostic evidence of pancreatic cancer, but the most useful initial investigation is abdominal ultrasonography. Computed tomography or laparoscopy is often chosen as the next stage of investigation, depending on the clinical situation. Specialized investigations such as endoscopic retrograde cholangiopancreatography may be indicated in selected patients. Surgical resection of the pancreas using Whipple's procedure remains the mainstay of therapy, but many cases of pancreatic cancer are inoperable. Chemotherapy and/or radiotherapy may be used as adjuncts to surgery or as part of a palliative approach to treatment.