Pancreatic cancer

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Unit 608

February 2024

Pancreatic cancer

The purpose of this activity is to provide you with an understanding of the subtle signs and symptoms associated with pancreatic cancer in order to facilitate timely referrals for further evaluation and appropriate diagnostic tests.

Pancreatic cancer is a challenging disease with significant diagnostic and treatment hurdles. In 2022, an estimated 4534 new cases were diagnosed in Australia. The absence of cardinal symptoms specific to pancreatic cancer contributes to delayed diagnosis and limits early intervention opportunities. This, in turn, reduces the chances of successful treatment outcomes. Unlike breast, cervical or colorectal cancer, pancreatic cancer lacks a routine screening method, further complicating early detection efforts.

In this unit of check, the investigation and management of pancreatic cancer is a key focus. An understanding of the subtle signs and symptoms associated with pancreatic cancer is required to facilitate timely referrals for further evaluation and appropriate diagnostic tests.

Learning outcomes

At the end of this activity participants will be able to:
  • discuss the management of patients with pancreatic cystic lesions
  • summarise the early signs and symptoms of pancreatic cancer
  • outline the criteria for individuals who are at high risk of developing pancreatic cancer
  • describe the investigations recommended for diagnosing pancreatic cancer 
  • list the red flags for pancreatic cancer that warrant early specialist referral.

Case studies

Below is a list of the case studies found in this month's edition of check. To see how these case studies unfold and gain valuable insights into this months topic, log into gplearning to complete the course.

Richard, aged 66 years, presents with epigastric pain that has been worsening over the past three weeks and which has been disrupting his sleep. He mentions that the pain started one month ago and at that time he was diagnosed with reflux and prescribed esomeprazole. Initially Richard experienced relief from his symptoms; however, he now reports that the medication is no longer providing the same level of relief.

John, aged 52 years, was diagnosed with new-onset diabetes mellitus six months ago. Despite being prescribed metformin 1 g twice daily and empagliflozin 25 mg once daily, he remains concerned about his uncontrolled glucose levels. He occasionally experiences epigastric pain, which he is not overly worried about. However, over the past month, he has been feeling extremely lethargic and struggles to complete a full day of work. Prior to this, he had no significant health issues and was generally fit and well.

Emma, aged 41 years, presents to your clinic seeking a review of her abdominal ultrasound results. She recently underwent a comprehensive health check, including an ultrasound examination, in her country of origin before migrating to Australia. The blood tests revealed abnormal liver function, specifically, elevated alkaline phosphatase levels at 173 µmol/L (normal range: 30–129 µmol/L) and slightly elevated alanine aminotransferase levels at 46 U/L (normal range: <41 U/L). The rest of her liver function test results were within normal limits. Results from the cancer antigen 19-9 test, which was also performed, came back normal. 

Anita, aged 78 years, visits your clinic with a chief complaint of ‘yellowish eyes’. Upon examination, you observe that Anita appears lethargic, but otherwise appears to be in generally good health. She has a longstanding history of diabetes, which is well controlled with metformin 1 g twice daily.

Sarah, aged 40 years, has come to your clinic with concerns about her risk of developing cancer due to her family history. At the consultation, Sarah is accompanied by her sister Jessica, aged 42 years. Jessica was diagnosed with breast cancer aged 40 years, which has raised concerns about hereditary factors contributing to their family’s cancer history.

CPD

This unit of check is approved for 10 hours of CPD activity (two hours per case). The 10 hours, when completed, including the online questions, comprise five hours’ Educational Activities and five hours’ Reviewing Performance.
 
Educational
Activities
5
hours
Measuring
Outcomes
0
hours
Reviewing
Performance
5
hours

Complete check online

To enroll in this check unit online: 

  1. Log into myCPD home page
  2. Select 'Browse' and search for 620992
  3. Select the course and register

Please note: If you're not a member of the RACGP or don't have a check subscription, click here.

TOPICS

Education in general practicePain managementPalliative care

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