Pancreatic cancer is the fifth leading cause of cancer death in the US with an annual incidence of 12.3/100,000. Many cases are asymptomatic, but symptoms can include abdominal or back pain, weight loss, nausea, vomiting, painless jaundice, fatigue and depression. Physical findings include abdominal mass, jaundice and ascites. Paraneoplastic syndromes can occur. Diagnostic techniques include ERCP, laparoscopy, needle biopsy, or ascetic fluid cytology. A CA 19-9 level is obtained as a baseline and followed for response or recurrence. Staging involves CT and PET.
Treatment options include surgery, adjuvant chemotherapy, chemoradiation, or chemotherapy alone for metastatic disease. Chemotherapy agents include 5-FU, oxaliplatin, iriniotecan, gemzar, abraxane, and tarceva.