Pancreatic Tumor
www.pancreaspain.org
Pathology:
Pancreatic carcinoma is fourth leading cause of cancer death in the United States (Goodman & Fuller, 2009). Pancreatic tumors may grow initially without symptoms thus they are typically first found in more advanced stages (PubMed Health, 2009). The cause of pancreatic tumors is unknown.
Demographics:
Incidence: One in 10,000 people in the US (Yurkiw, D., 1995).
Prevalence: There is a higher prevalence of pancreatic carcinoma in patients with the following conditions (Ferri, F., 2011):
Clinical Presentation:
Early symptoms of pancreatic cancer include (PubMed Health, 2009):
The most common symptoms of pancreatic cancer include pain (80-85%), weight loss (60%), and Jaundice (47%) (Goodman & Fuller, 2009). Pancreatic cancer may cause abdominal pain which radiates into the thoracic or lumbar regions, especially T10-T12 (Yurkiw, D., 1995).
Other possible symptoms are (PubMed Health, 2009):
Differential Diagnosis:
Pain from pancreatic cancer may be deep-seated and progressive with relief upon initial standing and bending forward (Yurkiw, D., 1995). This temporary pain relief of flexion can also occur with musculoskeletal conditions and needs to be differentiated.
Screening questions associated with increased risk of cancer include (Deyo, R., 1988):
Need to rule in/out (Ferri, 2011):
Bottom Line: Refer Out
If cancer is suspected, the patient needs an immediate referral to their physician. A physical therapist cannot treat pancreatic cancer. A physical therapist may however treat a patient for musculoskeletal impairments even if they have cancer. Cancer is a contraindication for many modalities and treatment. Contraindicated treatments should not be used throughout treatment of a patient with cancer.
To refer to the references used in compiling this page, please refer to the "Cancer" section in the references list.
Pancreatic carcinoma is fourth leading cause of cancer death in the United States (Goodman & Fuller, 2009). Pancreatic tumors may grow initially without symptoms thus they are typically first found in more advanced stages (PubMed Health, 2009). The cause of pancreatic tumors is unknown.
Demographics:
Incidence: One in 10,000 people in the US (Yurkiw, D., 1995).
Prevalence: There is a higher prevalence of pancreatic carcinoma in patients with the following conditions (Ferri, F., 2011):
- Smoking
- Alcoholism
- Gallstones
- Diabetes Mellitus
- Chronic Pancreatitis
- Diet rich in animal fat
- Occupational exposures: oil refining, paper manufacturing, chemical industry
- Overweight or obesity during early adulthood
Clinical Presentation:
Early symptoms of pancreatic cancer include (PubMed Health, 2009):
- Pain or discomfort in the upper part of the belly or abdomen*
- Loss of appetite and weight loss*
- Jaundice* (a yellow color in the skin, mucus membranes, or the eyes)
- Dark urine and clay-colored stools
- Fatigue and weakness
- Nausea and vomiting
The most common symptoms of pancreatic cancer include pain (80-85%), weight loss (60%), and Jaundice (47%) (Goodman & Fuller, 2009). Pancreatic cancer may cause abdominal pain which radiates into the thoracic or lumbar regions, especially T10-T12 (Yurkiw, D., 1995).
Other possible symptoms are (PubMed Health, 2009):
- Back pain
- Blood clots
- Depression
- Diarrhea
- Difficulty sleeping
- Indigestion
Differential Diagnosis:
Pain from pancreatic cancer may be deep-seated and progressive with relief upon initial standing and bending forward (Yurkiw, D., 1995). This temporary pain relief of flexion can also occur with musculoskeletal conditions and needs to be differentiated.
Screening questions associated with increased risk of cancer include (Deyo, R., 1988):
- Past history of cancer*
- Age > 50* or <20 years
- Recent, unexplained weight loss*
- Failure of conservative management*
- No relief with complete bed rest *
- Severe pain unaffected by posture or position
- Night pain disturbing sleep
Need to rule in/out (Ferri, 2011):
- Common duct cholelithiasis
- Cholangiocarcinoma
- Sclerosing cholangitis
- Primary biliary cirrhosis
- Autoimmune pancreatitis
- Drug-induced cholestasis
- Chronic hepatitis
- Sarcoidosis
- Other pancreatic tumors
Bottom Line: Refer Out
If cancer is suspected, the patient needs an immediate referral to their physician. A physical therapist cannot treat pancreatic cancer. A physical therapist may however treat a patient for musculoskeletal impairments even if they have cancer. Cancer is a contraindication for many modalities and treatment. Contraindicated treatments should not be used throughout treatment of a patient with cancer.
To refer to the references used in compiling this page, please refer to the "Cancer" section in the references list.