Diagnosis of Pancreatic Cancer
If pancreatic cancer is suspected, the first step is to perform a series of tests. Imaging tests often are used to produce pictures of internal organs and tissues. If these tests detect pancreatic cancer that appears to be resectable (see the Staging section), surgery is often the next step. In some cases, a tumor marker CA 19-9 (cancer antigen) test also may be performed.
According to the American Association for Cancer Research (AACR) in a report published in May 2014 in the journal Cancer Research, the location of the pancreas deep within the abdomen may makes it difficult to use imaging procedures to diagnose pancreatic cancer early in the course of the disease.
The following diagnostic tests may be used to help diagnose pancreatic cancer:
- Magnetic resonance imaging (MRI scan)In this test, the patient passes through a tunnel surrounded by a powerful magnet and a computer tracks the magnetism and produces pictures of the tissues being studied.
- Upper GI (gastrointestinal) seriesIn this procedure, the patient swallows a contrast solution containing the mineral barium. While the solution is in the digestive system, x-rays are taken to detect abnormalities.
- Computerized axial tomography (CAT scan or CT scan)This is a specialized x-ray technique that produces detailed cross-sectional images of internal organs and tissues.
- UltrasoundThis test uses high frequency sound waves that bounce off structures in the patient's body. A computer translates these echoes into a sonogram image.
If imaging tests detect an abnormality that warrants further investigation, a biopsy may be performed. In a biopsy, a sample of tissue is removed and examined for cancer cells.
One method of obtaining a tissue sample is a needle biopsy. In this procedure, the surgeon inserts a needle into the abdomen, guided by an imaging technique, and removes a small sample of pancreatic tissue. Laparoscopy, which involves using a device called a laparoscope to remove a small piece of tissue from the pancreas, also may be performed.
In the laboratory, pathologists (doctors who specialize in diagnosing diseases) can evaluate the specimen for abnormal growth. If there is a tumor (an abnormal mass of cells), it may be benign (not cancer) or malignant (cancerous).
When a patient is diagnosed with pancreatic cancer, an oncology team determines the best course of action. This health care team may include medical oncologists (doctors who specialize in diagnosing and treating cancer), radiation oncologists (doctors who perform radiation therapy), and endocrinologists (doctors who specialize in hormones and the glands that produce them).