Curriculum · Gastroenterology
Pancreatic cancer
What it is
Pancreatic cancer is divided into an exocrine form, the adenocarcinoma, and an endocrine form. The head is the most common site. In one set of national cancer death data for men, it came after lung, prostate and colorectal cancer among the leading causes of cancer death, at 12.6 deaths per 100,000 per year.
How it presents
The picture is obstructive jaundice in the absence of pain, with weight loss. Over 2 months there may be yellowish eyes with increased itching, then pale stool and darker urine, together with lethargy, loss of appetite and weight loss, while the rest of the systemic review stays unremarkable. Courvoisier law is the rule that goes with it: in a patient with a palpable mass in the right upper quadrant, jaundiced in the absence of pain, a gallstone is less likely to be the cause.