Diagnosis
Based on your symptoms, your doctor may suggest a number of tests to properly diagnose whether or not you have pancreatic cancer. These tests may include:
Physical exam
Your doctor can check for signs of jaundice, an enlarged gallbladder, and/or abnormal buildup of fluid in the abdomen with a physical exam. Your doctor may also check for swelling in the lymph nodes, which could indicate that the cancer has spread.
Lab tests
Blood, urine, and stool samples can be tested for bilirubin that can be elevated when pancreatic cancer tumors block the common bile duct. These tests are only used for preliminary screening, and cannot make a diagnosis of pancreatic cancer.
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Ultrasound
Ultrasounds can also produce images of your pancreas by using sound waves that bounce off the internal organs creating echoes that form a picture. Healthy tissue and tissue with tumors will create different echoes.
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CT scan
A computerized tomography (CT) scan uses X-rays to create detailed images of your internal organs. CT scans are considered the primary test used to diagnose pancreatic cancer and to determine the stage of the cancer.
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MRI (magnetic resonance imaging)
An MRI uses magnetic fields, which are not harmful, to create clear and detailed images of organs and structures in the body. The tissues absorb the energy from these fields in patterns depending on the type of tissue and disease. These patterns are then translated by a computer to provide images of multiple “slices” of the body.
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PET (positron emission tomography)
PET scans may be useful for discovering a spread of cancer from the pancreas to other areas of the body. In this procedure, a very low level of radioactive glucose is injected into the body. A special scanner then takes a picture. Because cancer cells will absorb more of the radioactive glucose than other cells, they will appear brighter in the pictures, thus indicating the location of the cancer.
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Endoscopic Ultrasound (EUS)
An endoscope is a thin tube with a camera and a light on the end. In this procedure, the doctor inserts an endoscope with an ultrasound transducer attached at the end. The transducer bounces sound waves off of internal organs in order to create a picture of the pancreas, as well as nearby organs and lymph nodes.
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ERCP (endoscopic retrograde cholangiopancreatography)
ERCP provides an X-ray image of the duct that carries bile through the abdomen. During ERCP, your doctor will inject a dye into the bile duct through a catheter inserted in an endoscope. This dye highlights the duct in the X-ray pictures your doctor will take as part of the procedure. The X-ray images can indicate the presence of a tumor. Additionally, if the duct is blocked by a tumor, a stent can be put in place to open the duct.
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PTC (percutaneous transhepatic cholangiogram)
During PTC, a dye is injected through the skin into the liver. A special X-ray machine will determine if this dye is flowing freely through the ducts. If not, the X-ray pictures can show whether the blockage is caused by a tumor or another condition. At this time, your doctor can insert a small draining tube called a catheter to help with drainage of the bile if necessary.
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Biopsy
Your doctor may decide to remove a small sample of tissue from the pancreas or another site such as the liver in order to physically look for cancer cells under a microscope. This procedure is known as a biopsy. The sample can be obtained with a needle guided by CT scan or ultrasound, or during other procedures such as ERCP.
