Diagnosing pancreatic cancer

A thorough and accurate cancer diagnosis is the first step in developing your pancreatic cancer treatment plan. Our cancer doctors will perform a comprehensive array of tests designed for diagnosing pancreatic cancer and determining the type and stage of the disease. During your diagnostic evaluation, you may undergo a number of tests, such as a laparoscopy, chest X-ray or bone scan, to determine if the cancer has grown beyond the pancreas. The test results help us formulate treatment recommendations tailored to you and your needs.

Common evaluations designed for diagnosing pancreatic cancer include:

Biopsy

A biopsy is an important part of formulating a pancreatic cancer diagnosis. During a biopsy, doctors remove a small amount of tissue from the pancreas. An endoscopic ultrasound-guided fine needle aspiration biopsy is a common procedure when pancreatic cancer is suspected.

Endoscopic retrograde cholangiopancreatography (ERCP)

We use ERCP for pancreatic cancer to remove samples of cells or fluid to be viewed under a microscope, to relieve an obstruction of the bile duct, or to place a stent into a narrowed duct to help keep it open. We may use a SpyGlass™ endoscope, which has a fiber-optic probe attached to a camera that allows us to identify obstructions in the bile duct.

Imaging tests

CT scan: A CT scan for pancreatic cancer uses X-ray images to present detailed images of the pancreas. With the GE Discovery™ PET/CT 600 Scanner, a four-dimensional CT scanner that produces detailed cross-sectional X-ray images of structures within the body, our radiologists are better able to plan treatment in accordance with patients’ breathing patterns.

MRI: When diagnosing pancreatic cancer, our team may use MRI, which uses radiofrequency waves to create detailed cross-sectional images of the pancreas.

Ultrasound: An ultrasound for pancreatic cancer uses sound wave technology to provide echoes of the pancreas. The echoes that pancreatic tumors produce are different from those of healthy tissues. In some cases, endoscopic ultrasound may be used. This technology allows us to view high-quality images of the pancreas and deliver treatment directly to a pancreatic mass.

X-ray: An X-ray for pancreatic cancer constructs images of inside the body to detect and stage the disease.

Percutaneous transhepatic cholangiography: During this test for pancreatic cancer, our doctors inject dye into the liver to closely examine bile ducts that have possibly been altered by the disease.

Angiogram: With this test, our doctors inject dye into an artery to outline the blood vessels and then take images to reveal how, or whether, blood flow in a particular area is blocked by a tumor.

Other imaging tests include:

Lab tests

We may use laboratory tests to check for tumor-associated antigens, such as an elevated CA 19-9 (carbohydrate antigen 19-9) level. We may also check billirubin levels because high levels may indicate blocked bile ducts.

Other lab tests may include:

Advanced genomic testing: Genomic testing examines a tumor on a genetic level to look for the DNA alterations that are driving the growth of cancer. By identifying the mutations that occur in a cancer cell’s genome, we can better understand what caused the tumor and tailor treatment based on these findings.

Nutrition panel: With this test, we evaluate patients for deficiency of nutrients, such as vitamin D and iron. The test helps us identify the nutrients patients need replaced or boosted to support their quality of life.

Laparoscopy

During a laparoscopy for pancreatic cancer, our doctors make a small incision in the abdomen to closely explore the normality of the area. This may be a useful tool for staging pancreatic cancer, and to determine whether the cancer has metastasized to the liver.

Next topic: How is pancreatic cancer treated?