Testing and diagnosis usually happen at the same time.
Don't hesitate to ask your doctor about his or her experience with diagnosing pancreatic cancer. If you have any doubts, get a second opinion.
Imaging Tests
EUS
Using an ultrasonic scope (EUS) An Endoscopic Ultrasound is an outpatient procedure. This imaging method uses an ultrasound device to make an image of your pancreas from the inside of your abdomen.
Ultrasound
Ultrasound uses sound waves to produce detailed pictures of the inside of the body.
Ultrasound is especially helpful for small soft tissues but can’t distinguish whether the lump or mass are cancerous or benign.
Ultrasound images are not as detailed as those from CT or MRI scans.
MRI & PET Scan
Magnetic Resonance Imaging (MRI), and Positron Emission Tomography (PET) scans. All of these tests carry a price tag in the thousands of dollars.
PET/CT Combo
PET/CT scan combo is a new test that possibly can better pinpoint tumors. This test may be especially useful for spotting cancer that has spread beyond the pancreas into other areas of the body. It may be useful for staging and may be able to help spot early cancer. Because the test is so new, it is still being studied.
CT Scan
Computerized tomography (CT) scans have been offered as a way to detect early signs of cancer.
Other Diagnostic Tests
ERCP
ERCP (endoscopic retrograde cholangiopancreatography) test uses a flexible tube is passed down the throat, into the small intestine. An ERCP is used to find where the common bile duct opens into the small intestine. A small amount of harmless dye is injected through the tube into the ducts. This dye helps outline the ducts on x-rays. The pictures can show narrowed or blocked ducts that might be caused by a cancer of the pancreas. During this test, a cell sample can be collected to determine if they appear to be cancer.
Biopsy
Biopsy- A biopsy is a procedure to remove a small sample of tissue. Ultrasound may also be used to place the needle through the wall of the intestine into the tumor. This test can be done with the patient awake. It rarely causes side effects. This sample is then tested for the presence of cancer. Sometimes, a sample can be collected from the pancreas by inserting a needle through your skin and into your pancreas called fine-needle aspiration. This is the only way to know for sure that cells are cancerous.
Angiography
Angiography is a type of test that looks at blood vessels to gauge wether the cancer is resectable or if chemotherapy and radiation are more appropriate.
If done by x-ray a small amount of dye is injected into an artery to help define the outline of the blood vessels for an x-ray. This test can help determine if the cancer tumor has grown into near by blood vessels. X-ray angiography requires a small catheter to be inserted into the artery leading to the pancreas.
Angiography can be done with a CT or an MRI which are being used more often because they are effective without the need for a catheter.
Blood Tests
Blood test- Your doctor may test your blood for specific proteins (genetic markers) shed by pancreatic cancer cells. This method is not especially reliable.
Laproscopy
Laparoscopy is where the patient is sedated, and the surgeon inserts a small, thin instrument into the abdomen. It may be connected to a video display. The surgeon can look at the abdomen and see how big the tumor is and whether it has spread.
Stages of Pancreatic Cancer
The stage of cancer helps doctors to determine what treatments are most likely to benefit you.
The stages of pancreatic cancer are indicated by Roman numerals ranging from 0 to IV. The lowest stages indicate that the cancer is confined to the pancreas. By stage IV, cancer has spread to other parts of the body.
Staging Criteria
Your doctor assigns your pancreatic cancer a stage depending on the size and location of cancer cells and tumors.
The following stages are used for pancreatic cancer:
Stage 0 (Carcinoma in Situ)Abnormal cells are found in the lining of the pancreas. These abnormal cells may become cancer and spread into nearby normal tissue.
Stage I, cancer has formed and is found in the pancreas only. Stage I is divided into stages IA and IB, depending on the size of the tumor.
Stage IA: The tumor is 2 centimeters or smaller.
Stage IB: The tumor is larger than 2 centimeters but not larger than 4 centimeters.
Stage II is divided into stages IIA and IIB, depending on the size of the tumor and where cancer has spread.
Stage IIA: The tumor is larger than 4 centimeters.
Stage IIB: The tumor is any size and cancer has spread to 1 to 3 nearby lymph nodes.
Stage III, the tumor is any size and cancer has spread to four or more nearby lymph nodes; or the major blood vessels near the pancreas.
Stage IV In stage IV, the tumor is any size and cancer has spread to other parts of the body, such as the liver, lung, or peritoneal cavity (the body cavity that contains most of the organs in the abdomen).
How does cancer spread?
There are three ways that cancer spreads in the body.
Cancer can spread through tissue, the lymph system, and the blood:
Tissue- Cancer spreads from the cells where it began by growing into cells it touches physically.
Lymph system- Cancer cells spread from where they began by getting into the lymph system and traveling through nodes and vessels called into other areas of the body.
Blood- Cancer cells spread from the site of origin by getting into the blood. It then travels through the blood vessels to other parts of the body.
Cancer that spreads to other parts of the body is called metastasis. The metastatic tumor is the same type of cancer as the organ of origin. For example, if pancreatic cancer spreads to the liver, the cancer cells in the liver are actually pancreatic cancer cells.
As you can imagine detecting cancer in the early stages before it spreads gives the patient more options beyond surgical removal of cancer and surrounding tissues and organs.