1. Running head: MEDICAL CASE STUDY 1
Medical Case Study
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2. MEDICAL CASE STUDY 2
Case Study #4 Pancreatic Cancer
Pancreatic cancer is a malignant tumor that grows in the pancreas. Pancreatic cancer
has been known as the “silent killer” as this disease shows no signs or symptoms during its
beginning stages. If a tumor caused by pancreatic cancer blocks the common bile ducts, and
prevents bile to travel toward the digestive system, the skin of the patient and eyes will
become yellow (jaundice), as a result their urine could become darker in color due to the
accumulated bile (bilirubin).
Pancreatic cancer has been known to begin in the tissue of the pancreas—an organ
inside the abdomen which lies in a horizontal position behind the lower stomach. The
Pancreas secretes enzymes into the stomach that aids in digestion; it also releases hormones
that help regulate sugar metabolism.
Pancreatic cancer has been known to have a poor prognosis, even so when diagnosed
in its early stages; the cancer also spreads rapidly and it is unusual to detect it in its early
stages, due to the lack of detection this cancer is considered one of the deadliest cancers and
has a high death rate. Signs and symptoms of pancreatic cancer are usually observed in its
late stages and due to this, it is quite impossible to remove it surgically.
Pancreatic Cancer: Diagnosis
In many cases, doctors will use many test in order to diagnose cancer and may find
out that it has spread to other parts of the body, this is called metastis. When running tests on
the patients may determine which is the proper course of treatment, which treatments will be
most effective against that particular type of cancer; although the only way to obtain a
definitive diagnosis is by taking a biopsy.
There are cases in which a biopsy is not possible for a number of reasons, in such
cases a doctor might suggest to run a variety of tests in order to determine a diagnosis. In
certain cases a doctor might ask to run imaging tests which help in diagnosing if the cancer

3. MEDICAL CASE STUDY 3
has spread to parts of the body, but there are factors that need to be considered when deciding
which tests to run, for example:
Age, medical history and medical condition
Type of cancer that is suspected
Symptoms or signs of the cancer
Previous results to tests
One of the first steps a doctor will take is to as for a patient’s medical history and
examine said patient in order to determine if they present any signs of the disease. These tests
are ideally given in a center specialized on disease control and the most important factor is
early and timely diagnosis. Some of the tests that may be performed are the following:
Examination and Signs of Pancreatic Cancer:
Physical Examination:
A doctor will examine the patient’s skin and eyes in order to determine if they have a
yellow “tint” or coloration, which can mean a sign of jaundice. Jaundice can be caused by a
tumor that has formed near the head of the pancreas and is obstructing the normal bile flow
which is produced in the liver; although jaundice is not observed in many pancreatic cancer
patients when it is originally diagnosed. Doctors will usually feel the patient’s abdomen for
any changes that could be caused by the cancer (the pancreas itself which is located in the
back upper abdomen is rarely felt by hand): Doctors are looking for an abnormal build of
fluid in the abdomen which is called ascites, which can be another sign of cancer.
Blood Tests:
A doctor may as to take sample of blood in order to the check any abnormal levels of
bilirubin build up and any other substances. Pancreatic cancer patient’s show signs of high
bilirubin levels due to a blockage which is caused by a bile duct being obstructed by the

4. MEDICAL CASE STUDY 4
tumor. Although there are other causes for high levels of bilirubin which include:
pancreatitis, cirrhosis, and non-cancerous blockage of the bile ducts.
Computed Tomography Scan:
Pancreatic cancer for the most part does not develop as a singular tumor, due to this it
can be hard to see with normal imaging tests, but new computed tomography scanners (CAT
or CT) are much better at interpreting imaging tests. Newer CAT use dyes or contrasts that
target the tumor area in order to determine the size or position of a tumor.
PET scan:
Positron emission tomography (PET scan) is an imaging machine that creates
multicolored images of body tissue and organs. It is used in tandem with a CT scan but has
not yet been standardized for pancreatic cancer diagnosis.
There are many other tests that may be used to find definitive proof of pancreatic
cancer, but the ones mentioned above are the most prominent. These tests are rarely done in
single tests, they usually involve repeated testing and a combination of various tests in order
for them to be effective.
Factors of Pathogenesis:
Many types of cancer are almost impossible to predict or even to determine what the
main cause of the disease is. In pancreatic cancer patients there are several factors that could
predispose them to develop the cancer, but this is not a proven science.
Pancreatic cancer is primarily a disease that is caused by damage done to DNA cells.
In the medical community they refer to this damage as “mutations”. Some of the following
factors may be the culprit that causes pancreatic cancer to develop:
Age

5. MEDICAL CASE STUDY 5
The risk for pancreatic cancer to develop increases with age. Patients that range from
60-80 years old are in higher risk as 80% of pancreatic cancer patients are within that age
range.
Race
Studies have shown that patients with African American dissent are in higher risk of
developing pancreatic cancer when compared to the Caucasian population (this may have to
do with socioeconomic elements and increased cigarette smoking within their community).
Cigarette smoking
Studies have shown that 25% of pancreatic cancer patients are cigarette smokers. In
simple terms, stopping to smoke cigarettes is a leading preventable factor of pancreatic
cancer.
Gender
Men are in higher risk of developing pancreatic cancer than their female counterparts.
Diet
International studies have shown that a diet high in cholesterol, nitrosamines, fried
food and red meat will increase the risk for pancreatic cancer.
Visible Symptoms:
Abdominal Pain
70% of pancreatic cancer patients experience some sort of abdominal pain. In most
cases it starts as a small pain in the tummy area and it will grow in severity and move toward
the back. In the first stages the pain will be a “fleeting” one that comes and goes, but can turn
into a chronic pain.
When there is buildup of bilirubin in the blood Jaundice will develop. Cancer tumors
that develop in the pancreas may obstruct the bile duct which in turn causes Jaundice.

6. MEDICAL CASE STUDY 6
Weight Loss
One of the most visible symptoms of pancreatic cancer is significant weight loss for
no reason. Due to the cancer the body does not produce sufficient digestive enzymes which
allow the body to digest food, especially food high in fat content; if the body doesn’t property
digest food it will not consume enough nutrients and weight loss will follow.
Other Affected Body Functions
Pancreatic cancer affects many parts of the body and some of the other symptoms it
can cause are the following: Digestive problems, bowel problems, nausea and vomiting,
heartburn, indigestion, diabetes, back pain, chronic fatigue, VTE, acute pancreatitis.
Sources: Lowy, A. (2008). Pancreatic cancer. New York: Springer.
Heiken, J. (2009). Pancreatic cancer. Cambridge, UK: Cambridge University Press.