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Types of Cancer > Pancreatic Cancer > Symptoms, Diagnosis, and Staging
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| How is Pancreatic Cancer Diagnosed? |
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The diagnosis of pancreatic cancer will usually involve a combination of physical exams, imaging tests, blood tests and biopsy. The first step of diagnosis is the physical exam. During this appointment, the physician will ask the patient questions regarding the patient's medical history and family history in order to assess the individual's risk of having developed pancreatic cancer. The physician will also ask questions about the symptoms the patient is experiencing, when the symptoms started and whether or not there have been any changes since the onset of the symptoms. The doctor will then perform a physical examination and will check the abdomen for any masses and will check the patient¡¯s skins and eyes for yellowing, also known as jaundice. The physician will also check the lymph nodes for any signs of cancer.
If a patient is displaying signs of jaundice, blood tests will usually be ordered to rule out other diseases, such as hepatitis or liver problems. Blood tests can also indicate whether or not levels of CA19-9 are elevated. If the physical exam and/or blood tests indicate that pancreatic cancer may be present, the physician will likely order imaging tests.
There are a number of imaging tests that are used in diagnosing pancreatic cancer, including CT scans, positron emission tomography, ultrasound, MRI, angiography and ERCP. A CT scan is an x-ray procedure that is helpful in diagnosing and staging pancreatic cancer. Positron emission tomograpy, also referred to as PET, is another imaging test used to diagnose pancreatic cancer. When using this procedure, a doctor will administer a glucose substance that contains a radioactive atom. Because cancer cells have such high metabolism rates, the cells will absorb large amounts of this substance quickly. A special camera is then used to detect the radiation and can locate where the cancer has spread to. This procedure is very useful when a doctor suspects that the cancer has spread, but he or she isn't sure where it has spread or how far.
An MRI, or magnetic resonance imaging, uses a combination of radio waves and magnets rather than x-rays to produce images of the body. While most doctors will order a CT scan to diagnose pancreatic cancer, an MRI will offer more information in certain circumstances.
With ERCP, the patient must have a long tube placed down their throat. The tube will go through the esophagus, through the stomach and into the small intestine. The doctor performing the procedure will then guide the tube to the bile duct, where a small amount of dye is injected. The dye then outlines the bile duct and the pancreatic duct in the x-ray images that are taken.
Angiography is a procedure that is often used to determine whether or not it is likely that cancer can be completely removed from the pancreas. The test is also useful in showing blockages caused by a tumor or any abnormal blood vessels. Doctors usually use angiography as a means of planning the operational procedures.
Even if the blood tests, the physical exam and the imaging studies all indicate that pancreatic cancer is present, the only way to know for sure is by performing a biopsy. Fine needle aspiration is the normally the biopsy method chosen for purposes of detecting pancreatic cancer. This procedure involves sticking a very thin needle through the skin into the pancreas and then uses a syringe to remove tissue samples from the pancreas. The samples are then studied under a microscope so a diagnosis can be made.
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| Author: | Robert Dale, Certified Medical Writer |
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| Reviewer: | Jiade Jay Lu, M.D.
Diplomate, American Board of Radiology (Radiation Oncology) |
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| Publish Date: December 16, 2004 |
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