Pancreatic cancer is difficult to detect early because of the location of the pancreas and its size. It also does not cause symptoms early on. When they do pop up, it's most likely that the cancer has already spread. If you are at high risk for pancreatic cancer, i.e., have genetic syndromes, a family history of the disease, or suffer from chronic pancreatitis, then your doctor may use the following tests for diagnosis:
Your doctor will administer a standard physical test to see if you have any of the symptoms of pancreatic cancer. Your medical history is crucial to determining whether you need further testing or not. Be honest with your doctor, especially about your alcohol and smoking habits, as these factors are shown to greatly increase the risk of pancreatic cancer development.
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Some people may have an increased risk of pancreatic cancer due to a family history of the disease or certain other cancers, which can be attributed to specific genetic syndromes. Genetic testing can identify gene changes that cause these inherited conditions and increase pancreatic cancer risk. But it does not diagnose the cancer itself. Knowing if one is at increased risk can help decide on early screening tests when the cancer might be more treatable. However, determining increased risk is complex. The American Cancer Society strongly recommends consulting with a genetic counselor or qualified healthcare professional before undergoing genetic testing. This is to understand the implications and limitations of the test results.
Imaging tests utilize x-rays, magnetic fields, sound waves, or radioactive substances to create a picture of the inside of the body to spot potential tumors. It also allows to see the extent of the cancer spread, determine if treatment is working, or spot potential recurrence of cancer. These tests can also be used to guide surgery and other treatments.
The CT scan produces detailed cross-sectional images of the body and is often used to diagnose pancreatic cancer. It can visualize the pancreas and show if the cancer has spread to nearby organs, lymph nodes, or distant organs. This helps determine if surgery is a viable treatment option. For suspected pancreatic cancer, a multiphase CT scan or pancreatic protocol CT scan may be performed. This iswhere multiple sets of CT scans are taken over several minutes after receiving an intravenous contrast injection. Additionally, CT scans can guide a biopsy needle into a suspected pancreatic tumor. Although most doctors prefer using endoscopic ultrasound for this purpose.
MRIs use magnets and radio waves instead of X-rays to generate a picture of the body’s insides. While CT scans are preferred for pancreatic cancer, MRIs can also be used. MR cholangiopancreatography (MRCP) is used to look at the pancreatic ducts and bile ducts, while MR angiography (MRA) looks at blood vessels.
Ultrasounds use sound waves to generate images of the insides of the body. If symptoms are not clear, abdominal ultrasounds will be used to ascertain the condition without exposing the person to radiation.
The endoscopic ultrasound is a more accurate version of the ultrasound which can look inside the digestive tract using a small probe on the tip of an endoscope. This can also be done during the collection of biopsy samples.
This looks at the pancreatic ducts and bile ducts to see if they are blocked, narrowed, or dilated.
This is a procedure where an endoscope (a thin, flexible tube with a camera) is passed down the throat, through the esophagus and stomach, and into the small intestine. It allows the doctor to visualize the ampulla of Vater (where the common bile duct empties into the small intestine) and take X-rays to detect any narrowing or blockage in these ducts that might be caused by pancreatic cancer.
During ERCP, the doctor can also use a small brush through the endoscope to obtain cells for a biopsy. Or, they canr place a stent (small tube) into a bile or pancreatic duct to keep it open if a nearby tumor is pressing on it.
Magnetic resonance cholangiopancreatography (MRCP) and percutaneous transhepatic cholangiography (PTC) are alternative non-invasive and invasive methods, respectively, to examine the pancreatic and bile ducts. MRCP uses MRI technology without contrast dye. Whereas PTC involves inserting a needle through the belly and injecting contrast dye directly into a bile duct in the liver. PTC can also be used for biopsies or stent placement but is more invasive and typically reserved for cases where ERCP is not feasible.
A slightly radioactive sugar is injected into the patient. This sugar mainly collects in the cancer cells. A special camera then takes a picture of the areas with radioactivity. This allows the doctor to map out the areas where the cancer may have spread.
This is an X-ray test that examines blood vessels by injecting a small amount of contrast dye into an artery to outline the vessels and then taking X-ray images. It can show if blood flow in a particular area is blocked by a tumor, revealing abnormal blood vessels feeding the cancer. This ultimately determines if pancreatic cancer has grown through the walls of certain blood vessels. This test helps surgeons decide if the cancer can be removed completely without damaging vital blood vessels, aiding in surgical planning.
Traditional X-ray angiography involves inserting a small catheter into an artery, typically in the inner thigh, and threading it up to the pancreas under local anesthesia. The contrast dye is then injected through the catheter to outline the vessels while X-rays are taken. This procedure can be uncomfortable. Alternatively, CT angiography or MR angiography can provide the same information without the need for an arterial catheter. Although an intravenous line may still be required to inject the contrast dye into the bloodstream during imaging.
Since jaundice is one of the primary symptoms of pancreatic cancer, a liver function test is administered when testing for pancreatic cancer. This is a blood test that checks bilirubin levels. Alternatively, blood tests to look for tumor markers such as CA 19-9 and Carcinoembryonic antigen (CEA) can also be done, along with the standard CBC.
A biopsy involves taking small pieces of tissue samples for analysis. Biopsy samples are looked at under a microscope. Since cancer cells have a distinct appearance from healthy cells, doctors will be able to determine the presence of pancreatic cancer. A biopsy may either be of the following:
Biopsies may not be necessary if the tumor is large and can be seen on the imaging tests. However, if chemotherapy or radiation is planned before surgery, a biopsy will be done. Along with examination through a microscope, biopsy samples will also undergo tests for gene changes like BCRA-2, BCRA1, or NTRK genes to see if the case can be a potential subject for targeted drug therapy.
If you or a loved one have suffered from a misdiagnosis or delayed diagnosis for your pancreatic cancer or from negligence during your treatment that caused you more harm, contact us at 833-PORTER9, or e-mail us at info@porterlawteam.com to discuss the details of our experience representing other clients and the results we were able to obtain in the past for clients who are suffering as you are. In many ways, our results speak for themselves, and we will stand ready to help you and your family in your time of greatest need.
