Episode 166: Pancreatic Cancer Series, Pt. 1 – Biology, Diagnosis, and Staging

Episode 166: Pancreatic Cancer Series, Pt. 1 – Biology, Diagnosis, and Staging

This week we kick off a brand-new series on pancreatic cancer, starting with the fundamentals. Using the case of a 68-year-old man with painless jaundice, weight loss, and new-onset diabetes, we cover the epidemiology and sobering survival statistics of pancreatic ductal adenocarcinoma, the major risk factors (and why late-onset diabetes is often a consequence rather than a cause), universal germline testing and the hereditary syndromes worth knowing for the boards, and how tumor location in the head, body, or tail shapes presentation. We then walk through the diagnostic workup (pancreatic-protocol CT, MRI/MRCP, EUS-guided biopsy, and the therapeutic role of ERCP), the pitfalls of CA 19-9, precursor lesions and the four-gene molecular story led by KRAS, somatic profiling for actionable targets, and the resectability framework that will drive treatment decisions for the rest of the series.