Definition and Epidemiology of the Disease

Pancreatic cancer is an aggressive tumour with high mortality. Ductal adenocarcinomas, which make up 95% of cases, are mostly found in the head of the pancreas. The disease generally occurs between the ages of 65-85 and the annual incidence is 12.5 per 100,000.

Clinical Findings and Diagnosis

Patients usually present with jaundice, radiating abdominal pain, significant weight loss and new-onset diabetes. Contrast-enhanced abdominal CT, endoscopic ultrasound-guided biopsy and PET-CT are used for diagnosis. CA-19-9 level is an important marker for diagnosis and follow-up.

Risk Factors and Genetics

The main risk factors are heavy smoking, chronic pancreatitis and uncontrolled type 2 diabetes. Genetic factors include BRCA1/2, PALB2 mutations and Lynch syndrome. PRSS1 gene mutation increases the cancer risk in hereditary pancreatitis syndrome. Obesity is a risk factor, while regular physical activity is protective.

Treatment and Prognosis

The primary treatment in the early stage is the 6-8 hour Whipple procedure. 10-14 days of hospital follow-up is required after the operation. FOLFIRINOX chemotherapy is used in neoadjuvant and adjuvant therapy. Successful results are obtained in the early stage with modern treatment protocols.