[Pancreatic carcinoma]

Ductal adenocarcinomas represent over 90% of all pancreatic cancers. The high mortality has not changed over the last decades. Most patients are elderly and typically present with dull upper abdominal pain radiating to the back and often report reduced appetite, weight loss, and jaundice. A solid pancreatic tumor should be resected because this is the only chance for a cure. Cystic tumors are usually less malignant and need further diagnostic work-up. There is a benefit from adjuvant chemotherapy after resection. Locally advanced or metastatic tumors are treated symptomatically including pain medication and biliary drainage in the case of jaundice. There is a benefit from systemic chemotherapy mainly in patients with good performance status.