Pancreatic Cancer

Pancreatic cancer is the second most common gastrointestinal malignancy and the third most common cause of cancer-related deaths in the United States. The incidence of pancreatic cancer increases after age 45, making it a significant problem in the geriatric population. Risk factors include cigarette smoking, obesity, genetic factors, chronic pancreatitis, diabetes mellitus, and diet. Most patients are diagnosed after they become symptomatic with abdominal pain, jaundice, or weight loss. Surgery remains the mainstay of treatment, but fewer than 20% of cases are resectable at presentation. Chemoradiation is an adjunct to surgery mainly for palliation of metastases. Even in those who are resectable, the median survival is a dismal 18 months. Palliation of pancreatic cancer serves as a cornerstone of management in the older adults. Pain management is an important step and includes appropriate use of analgesics and celiac ganglion block. Endoscopic stent placement of biliary duct relieves obstructive jaundice. Screening for pancreatic cancer is not routinely recommended as per USPSTF. Currently significant efforts are being made to validate screening protocols in prospective trials.