There are currently no screening tests recommended to detect pancreatic cancer with the exception of minimizing your cancer risk factors, which include, but are not limited to: 

  • Smoking
  • Being very overweight
  • Having a personal history of diabetes or chronic pancreatitis
  • Having a family history of pancreatic cancer or pancreatitis

Having certain hereditary conditions, such as:

  • Multiple endocrine neoplasia type 1 (MEN1) syndrome
  • Hereditary nonpolyposis colon cancer (HNPCC; Lynch syndrome)
  • von Hippel-Lindau syndrome
  • Peutz-Jeghers syndrome
  • Hereditary breast and ovarian cancer syndrome
  • Familial atypical multiple mole melanoma (FAMMM) syndrome

(Source: National Cancer Institute)

Diagnosing Pancreatic Cancer

Pancreatic cancer can be difficult to diagnose early because symptoms vary and may be similar to those of other diseases. For those reasons, it is important to pay careful attention to symptoms and understand risk factors for this disease.

Doctors use several types of tests to diagnose and stage pancreatic cancer.

Blood and Laboratory Tests

Blood Chemistry Analysis

A blood sample is analyzed to measure substances in your blood. A large amount of glucose could indicate a pancreatic neuroendocrine tumor. Presence of bilirubin indicates jaundice. Bilirubin is a chemical made in the liver and can mean that a pancreatic cancer is affecting the liver’s function.

Tumor Marker Tests

Some people with pancreatic cancer have abnormally high levels of certain markers, called antigens, called CA 19-9 and CEA (carcinoembryonic antigen), which may signal pancreatic cancer.

High levels of chromogranin A, a protein marker found in blood plasma, can indicate a patient has a functioning neuroendocrine tumor, even when the patient’s hormones are normal.

Diagnostic Imaging

Computed Tomography

Computed tomography (CT) uses X-rays to produce detailed images of the body.

Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) uses a high-powered magnet and radio waves to produce detailed images of the body.

Positron Emission Tomography

Called a PET scan, positron emission tomography uses a small amount of a radioactive agent and a special imaging camera to identify areas of cancerous activity in the body. Cancerous cells appear brighter on PET images.

Ultrasound

An abdominal ultrasound can be used to evaluate the organs and spaces inside the abdomen.

Exploratory Procedures

Percutaneous Transhepatic Cholangiography

This procedure uses X-rays to evaluate blood vessels and to image the liver and bile ducts. If a blockage is detected, a tiny thin tube called a stent may be left in place to drain bile into the small intestine or a collection bag outside the body.

Endoscopic Ultrasound

This procedure uses ultrasound waves to produce images of organs and tissues inside the abdomen. A doctor can also biopsy a tumor found this way while using the endoscope.

Endoscopic Retrograde Cholangiopancreatography

This procedure uses an endoscope to create X-ray images of the pancreatic ducts. The images show areas of the ducts that are blocked or narrowed because of pancreatic cancer. While the endoscope is in place, the physician can place a tiny tube called a stent in the ducts to open them and also take samples of the tissue for biopsy.

Laparoscopy

A surgeon inserts a thin, lighted tube through a small incision in the patient’s abdomen to inspect the inside of the abdomen on a monitor to guide the surgeon to the pancreas or other organs to evaluate them and to take samples for biopsy.

Biopsy

Tissue from pancreatic tumors can be analyzed under a microscope for diagnosis and staging of pancreatic cancer. Tissue for a biopsy also can be collected from the pancreas or duct using a special. Needle biopsies do not require patients to have surgery or general anesthesia.

Pancreatic Cancer Staging

Physicians determine the stage of pancreatic cancer at the time they diagnose the disease. Staging for pancreatic cancer is based on the size of the tumor, how the tumor’s cells appear under a microscope and whether the cancer cells have spread within the patient’s body.

Stage 0

In stage 0, abnormal cells are found in the lining of the pancreas. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage I

Cancer has formed, but is found only in the pancreas. Stage I is divided into stage IA and stage IB, depending on the tumor’s size.

Stage IA

The tumor is 2 centimeters or smaller.

Stage IB

The tumor is larger than 2 centimeters.

Stage II

In stage II, cancer may have spread to nearby tissue and organs, and may have spread to lymph nodes near the pancreas. Stage II is divided into stage IIA and stage IIB, based on where the cancer has spread.

Stage IIA

Cancer cells have spread to nearby tissue and organs, but not to nearby lymph nodes.

Stage IIB

Cancer cells have spread to lymph nodes near the pancreas, and the tumor may have spread to nearby tissue and organs.

Stage III

In stage III, cancer has spread to the major blood vessels near the pancreas and may have spread to nearby lymph nodes.

Stage IV

In stage IV, the tumor may be any size and has spread to distant organs, such as the liver, lung and peritoneal cavity (space within the abdomen). It may have also spread to organs and tissues near the pancreas or to lymph nodes.

(Source: National Cancer Institute)

Pancreatic Neuroendocrine Cancer

Doctors also stage pancreatic neuroendocrine cancer, but do not use the staging to plan a patient’s treatment. Instead, treatment is based on whether the cancer:

  • Is found in one place in the pancreas
  • Is found in several places in the pancreas
  • Has spread to lymph nodes near the pancreas or to other parts of the body, such as the liver, lung, peritoneum or bone

Treatment Categories

In certain cases, doctors do not categorize the patient’s pancreatic cancer until they evaluate the tumor during surgery. These categories are:

Resectable

When a pancreatic cancer is found to be in the pancreas only or slightly beyond the pancreas, the surgeon can remove all of the tumor and a margin around it.

Locally Advanced

Some tumors invade nearby tissues and organs, which makes them too difficult to remove with surgery alone. This category also is called unresectable.

Metastatic

Metastatic cancer has spread beyond the pancreas and nearby abdominal organs to distant organs. The surgeon might still remove the tumor to relieve a patient’s symptoms.

(Source: National Cancer Institute)

 

If you have received a pancreatic cancer diagnosis, or if you want a second opinion or just want to speak to a pancreatic cancer specialist, we are here to help you. Call 800-293-5066 or 614-293-5066 to make an appointment.

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