Master Pancreatic Cancer with a Mnemonic

Abdominal pain is one of the most common presenting signs of pancreatic cancer, however it is very non-specific.

One sign of pancreatic carcinoma is epigastric pain with weight loss, which is a non-specific sign common to many malignancies.

Migratory superficial thrombophlebitis, also known as Trousseau's syndrome, is characterized by recurrent thromboses of the superficial venous system. This is likely a reflection of the hypercoagulable state, and tends to present later in the disease course.

New onset diabetes in a patient over 50 may be associated with pancreatic cancer. In fact, 50% of patients diagnosed with pancreatic adenocarcinoma have diabetes at the time of diagnosis, and patients with newly diagnosed diabetes after age 50 have 8 times the risk of developing pancreatic adenocarcinoma.

Pancreatic cancers arising near the head of the pancreas may result in obstructive jaundice due to the inability to effectively excrete bilirubin.

Steatorrhea, or fatty/oily stool, is a presenting sign that is commonly associated with pancreatic adenocarcinomas localized to the head of the pancreas. This is because tumors in the head of the pancreas may obstruct the secretion of bile, which contains bile salts that aid in the emulsion and digestion of fats.

Cancers that arise in the head of the pancreas may cause white stool due to obstruction of the common bile duct, leading to decreased entry into the intestine by bile, which gives stool its pigment.

Pancreatic carcinomas that arise near the head of the pancreas may present with palpable gall bladder (due to biliary obstruction).

Pancreatic carcinoma is most common in the elderly (>70).

Chronic pancreatitis, which itself has many risk factors such as alcoholism, is a common risk factor associated with pancreatic adenocarcinoma.

Smoking is a well-known risk factor for development of pancreatic adenocarcinoma.

Chronic alcohol abuse has been shown to be linked to increase risk of pancreatic adenocarcinoma. This may be related to its association with chronic pancreatitis.

Diabetes is a well-studied risk factor that can increase one's predisposition to developing pancreatic adenocarcinoma. The exact mechanism is unclear, though it has been hypothesized that increased risk of pancreatic cancer in patients with diabetes may be related to reduced plasma adiponectin, which is a fat-derived hormone that induces insulin sensitivity and has anti-inflammatory action.