Pancreatic Cancer
Diagnosing Pancreatic Cancer
Diagnosing a tumor in the pancreas can be difficult. Symptoms are not always obvious, and usually develop gradually. Supplementary medical tests are often required to establish the diagnosis of and to determine whether it has spread beyond the pancreas. M. D.Anderson uses state-of-the-art diagnostic imaging in the diagnosis and staging of pancreatic cancer.
Diagnostic tests for pancreatic cancer include:
Computerized tomography (CT): The CT scan is the primary test used to establish the stage of pancreatic cancer, which determines whether a tumor can be surgically removed. Using a special X-ray machine, this test gives detailed pictures of the body and can help to determine if the tumor has spread.
MRI can be used when there is a contraindication (patient allergy) to contrast-enhanced CT, and may provide similar information to CT scans.
Ultrasound helps determine the size of the pancreas and possibly the presence of a tumor. Ultrasound is commonly performed by placing a probe on the surface of the abdomen.
Endoscopic ultrasound (EUS) involves a special endoscope equipped with an ultrasound probe and a small needle at the end. The scope is placed through the mouth into the esophagus and the first portion of the small intestine. EUS provides an excellent opportunity to take a small biopsy of the pancreas.
Endoscopic retrograde cholangiopancreatography (ERCP): an endoscope is guided down the throat and into the small intestine. By injecting dye through the endoscope into the bile and pancreatic ducts (as X-rays are taken), this test can demonstrate narrowing of these ducts due to pressure from a tumor.
Blood tests: currently, no single blood test can make the diagnosis of pancreatic cancer. Blood tests can evaluate the function of the liver and other organs. M. D. Anderson and other institutions are doing research that may result in a blood test for the early diagnosis of pancreatic cancer in the future.
When a tumor has been identified, a biopsy can be obtained one of two ways:
CT-guided Fine Needle Aspiration (FNA): the CT scan helps the doctor locate the tumor and guide a small needle through the skin and abdomen and into the pancreas to obtain a tissue sample is obtained. CT-guided FNA is currently the most commonly performed method of pancreatic tissue diagnosis.
Endoscopic Ultrasound FNA: a special endoscope equipped with an ultrasound probe and a small needle at the end is placed through the mouth into the esophagus and the first portion of the small intestine. The physician then performs an ultrasound and uses the needle to obtain a sample of any tissue that appears abnormal.
Laparoscopy: this procedure is done in the operating room under general anesthesia. A tiny camera is guided through a very small (half inch) incision in the abdomen that enables the surgeon to directly visualize the pancreas and determine if the tumor has spread. |
