Patient case: Pancreatic Cancer
A 58-year-old male presents to the clinic with complaints of persistent abdominal pain, unintended weight loss of 7 kg over the past three months, and a recent onset of jaundice. He describes the pain as dull and constant, radiating to his back, and worsening after meals. He has also experienced loss of appetite and generalized fatigue. Additionally, he notes his stools have become pale and greasy.
On physical examination, the patient appears jaundiced, and there is tenderness in the epigastric region. No palpable masses are detected. Laboratory tests reveal elevated bilirubin and liver enzymes, as well as mildly elevated CA 19-9, a tumor marker. An abdominal CT scan identifies a mass in the head of the pancreas, causing obstruction of the bile duct. A subsequent biopsy confirms the diagnosis of pancreatic adenocarcinoma.
After consultation with a multidisciplinary team, the tumor is determined to be locally advanced but potentially resectable. The patient is scheduled for a Whipple procedure (pancreaticoduodenectomy) and is counseled on the risks, benefits, and postoperative care. Preoperative chemotherapy is also considered to shrink the tumor before surgery.
a). Nausea and vomiting
b). Abdominal pain, weight loss, jaundice, and greasy stools
c). Chest pain and cough
d). Fever and chills
a). Alpha-fetoprotein (AFP)
b). CA 19-9
c). CEA (carcinoembryonic antigen)
d). PSA (prostate-specific antigen)
a). MRI of the abdomen
b). Abdominal ultrasound
c). Abdominal CT scan
d). Endoscopy
a). Chemotherapy only
b). Whipple procedure (pancreaticoduodenectomy)
c). Radiation therapy
d). Palliative care
