7 Things to Know About Pancreatic Cancer (2017)

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This infographic serves as a flash card with current key takeaways about pancreatic cancer. As usual, consult your doctor for any medical advice.

Health & Medicine

The fourth most common cause of cancer-related death in the USA has a poor prognosis.
While a few patients (5-10) can undergo potentially curative surgery (5-year survival of up to
22%), many patients with advanced pancreatic cancer (PC) live for only 3 to 6 months. Most
diagnosed tumors are primary pancreatic ductal adenocarcinomas (PDACs; >85%).
1. Definition
PDAC forms in the exocrine compartment of the pancreas and may have include the following
histological features: tubular, adenosquamous, colloid, hepatoid, and medullary. PDAC is thought to
progress from preinvasive pancreatic intraepithelial neoplastic (PanIN) lesions to invasive ductal
adenocarcinoma as a result of a complex interplay between environmental and genetic factors.
2. Diagnosis
Symptoms of PC include: unexplained upper abdominal pain, painless obstructive jaundice,
weight loss, and, in later stages, back pain. General health, imaging, blood, and tissue tests are
conducted to differentially diagnose PC. The NCCN suggests referral of select patients (young
patients,or those with a family history of PC, or those who cite Ashkenazi Jewish ancestry) to
a genetic counselor.
3. Familial PC
Subsets of individuals have been identified as having germline cationic trypsinogen
or PRSS1 mutations (hereditary pancreatitis), BRCA2 mutations (usually in association with hereditary
breast–ovarian cancer syndrome), CDKN2 mutations (familial atypical mole and multiple melanoma),
or DNA repair gene mutations (e.g., ATM and PALB2, apart from those in BRCA2). Diagnostic and
prognostic impacts of biomarkers are undergoing evaluation.
4. Treatment
Currently, treatments are tailored to appropriately staged patients with resectable,
borderline resectable, locally advanced resectable, or metastatic disease. Apart from
excising the tumor, chemotherapy and radiation may be offered in adjuvant or palliative
settings. Clinical trials may be appropriate for patients at any stage of the disease.
5. Emerging Therapies
Development of targeted therapies and various combination regimens,
combined with better patient selection, continues to be a high priority.
6. Complications
Clinical monitoring should include management of surgical complications, cholangitis,
duodenal obstruction, bleeding, deep vein thrombosis, pulmonary emboli, and any other
adverse events associated with active treatments.
7. Screening
Authors of one systematic review reported PC screening of familial high-risk individuals resulted in a high
curative resection rate (60% vs 25%, P = 0.011), longer median survival time (14.5 mo vs 4 mo, P < 0.001), and
higher 3-year survival rate (20% vs 15.0%, P = 0.624).
Sources
Lu C, Xu CF, Wan XY, et al. World J Gastroenterol. 2015;21(28):8678-8686; Rustgi AK. Genes & Dev. 2014;28(1):1-7; National Comprehensive Cancer
Network (NCCN). Pancreatic Adenocarcinoma (evidence blocks). Version 1. 2017.
https://www.nccn.org/store/login/login.aspx?ReturnURL=https://www.nccn.org/professionals/physician_gls/pdf/pancreatic_blocks.pdf; Epocrates (An Athenahealth

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