There are several medical imaging procedures and diagnostic tests that can help diagnose pancreatic cancer. These procedures include ultrasound scans, MRIs and CT scans of the abdomen, as well as pancreatic biopsies and other tests called PTC and ERCP.
Blood work is usually taken during the diagnostic process. A person who has pancreatic cancer may have abnormal results on some tests, such as the complete blood count, liver function tests and bilirubin levels in the serum. Bilirubin is a pigment that comes from the breakdown of red blood cells. Normally, this pigment is removed from the body, but liver or pancreatic disease can cause this pigment to build up in the skin, leading to a yellowing of the skin and mucous membranes. This yellow discoloration is called jaundice, and it is a common symptom of liver or pancreatic problems. Bilirubin also builds up in the blood, causing elevated levels when blood is drawn and analyzed in the lab. A protein called CA19-9 is commonly elevated in cases of pancreatic cancer, so this is another blood test that can indirectly indicate pancreatic cancer.
A basic ultrasound scan can find a tumor on the pancreas that may or may not be cancerous. Ultrasound uses sound waves of a higher frequency than the sounds we hear to create images of the inside of the abdomen. The most basic form of ultrasound is conducted from the outside of the abdomen. However, it is also possible to do an endoscopic ultrasound. In an endoscopic ultrasound, a device called an endoscope is threaded through the esophagus to the stomach of a patient who has been sedated for the procedure. An ultrasound scan is then conducted from the inside of the abdomen, rather than the outside. An endoscopic ultrasound is not usually the first diagnostic test that is conducted for pancreatic cancer, but it can provide valuable information about a tumor, such as whether or not the tumor is likely to be operable. It can also find smaller tumors that may not show up on other types of medical imaging scans, such as CT scans.
An abdominal MRI scan may be used to make images of the pancreas and find tumors. A CT scan is another option for a first diagnostic test for potential cases of pancreatic cancer. Both techniques can find tumors and give some information as to whether a tumor is likely to be surgically removable. However, these scans alone may be inconclusive as to whether the tumor is malignant or benign.
ERCP stands for endoscopic retrograde cholangiopancreatography. In this procedure, a type of dye is used to show the pancreatic bile ducts. The dye used in this procedure is injected through a catheter that is threaded through an endoscope that is placed through the esophagus into the stomach. The endoscope also serves to pump a small amount of air into the upper digestive tract to improve visibility for the procedure. This procedure is performed on a patient who has received anesthetic medication. This diagnostic procedure may be helpful in some cases, but it is not the first choice for a procedure used for diagnosing pancreatic cancer. The procedure is helpful to place stents in the pancreatic bile ducts as a treatment for jaundiced patients, however.
PTC stands for percutaneous transhepatic cholangiography. This procedure is very similar in theory to ERCP, in that a dye is used to help visualize bile ducts. However, in PTC the liver bile ducts are examined instead of the pancreatic bile ducts. The dye is injected via a needle that goes into the liver from the outside instead of a catheter and an endoscope that goes into the pancreas from the inside of the body. This procedure can help rule out problems with the bile ducts.
A biopsy is an important diagnostic procedure for pancreatic cancer. A pancreatic biopsy may be performed during an endoscopic procedure, such as an endoscopic ultrasound or ERCP, or by itself. If the biopsy is not performed during an endoscopic procedure, pancreatic tissue for examination may be obtained through a needle that is inserted through the skin from the outside of the body. Only a small amount of pancreatic tissue is necessary for the microscopic examination, but a biopsy can confirm a diagnosis of pancreatic cancer, or rule out malignancy.
As pancreatic cancer is not usually symptomatic during the early stages of the disease, the cancer is often discovered after it has already had time to grow and spread. For this reason, staging the pancreatic cancer is also important once a diagnosis has been made. Stage I pancreatic cancer is confined to the pancreas itself. Stage II pancreatic cancer has spread to nearby tissues. Stage III pancreatic cancer has spread beyond nearby blood vessels, and Stage IV pancreatic cancer has spread to other parts of the body. The sooner that pancreatic cancer is diagnosed, the better the prognosis for the patient.
Source: http://pain.com/library/2011/11/23-diagnosing-pancreatic-cancer/
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Useful cancer article!
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