Management challenges of pancreatic cancer in a resource scarce setting|
Alatise, Olusegun Isaac; Lawal, Oladejo O. & Tope, Ojo Olumuyiwa
Background: Of all forms of gastrointestinal malignancy, adenocarcinoma of the pancreas is
associated with the worst survival. Management of pancreatic cancer is associated with some
challenges. This study is aimed at determining the hospital incidence, sociodemographic
characteristics, managements and management’s outcome of carcinoma of pancreas at our
hospital. We also discuss the management challenges encountered with these patients.
Patients and Methods: We review 96 pancreatic cancer patients seen at Awolowo University
Teaching Hospital Complex, Ile –Ife, Nigeria, from July 1989 to July 2007.
Results: There were ninety six patients diagnosed with cancer of the pancreas but only 80
patients had histological proof of pancreatic cancer. This account for 2.1% of all malignancies
seen and 238/100000 total admissions during the study period. The median age is 55.0. There
were 62 (64.6%) male and 34 (35.4%) female with male to female ratio been 2:1. Duration of
symptoms in the patients ranges from 4 weeks to 109 weeks. Only three (3.1%) patients have
tumor located in a particular anatomical sub site: two head of pancreas and one tail of the
pancreas. Other patients had extensive tumor involving the head and body of the pancreas. Two
patients had pancreaticoduodenectomy, one had resection of the tumor at the tail of pancreas
and 45 patients had triple bypass. Patients with low serum albumin and serum sodium and
elevated transaminases at presentation, had poorer prognosis than other patients.
Conclusion: We found that pancreatic cancer is not uncommon in our center with male
preponderance. Most patients present with advanced condition only amenable to palliative
measures. There are signiﬁcant challenges in the area of diagnosis, screening, treatment and
Pancreatic cancer; Managements; Challenges; Outcome