How Doctors Diagnose Pancreatic Cancer
Because it produces few or no early symptoms, pancreatic cancer diagnosis often doesn’t occur until the advanced stages of the disease. Doctors use a range of tests to diagnose pancreatic cancer, stage it and treat it. Understanding what to expect during pancreatic cancer diagnosis may help ease the anxiety involved with facing this difficult disease.
Pancreatic cancer rarely produces any early symptoms, and the symptoms it does produce can be attributed to other conditions. In general, the signs of pancreatic cancer at any stage might include:
Fatigue and exhaustion
Jaundice, or yellowing of the eyes and skin
Loss of appetite for no reason
Pain in the upper or middle abdomen or back
Urine that is persistently darker than normal
Gallbladder disease and liver conditions can produce these same general signs and symptoms, so your doctor will rely on various tests to determine the exact cause of symptoms like this.
Your personal and family health histories also contribute to determining early if you might have pancreatic cancer. Tell your doctor if you or a family member has or ever had:
Hereditary (genetic) health syndrome, such as breast and ovarian cancer syndrome or multiple endocrine neoplasia type 1 (MEN1) syndrome
Personal history of smoking
Weight conditions like obesity
All of these factors contribute to diagnosing pancreatic cancer, so be sure to convey a thorough health history to your doctor.
After evaluating your health history and symptoms, your doctor will perform several tests to detect pancreatic cancer. The most common tests include:
Abdominal ultrasound, a noninvasive imaging test to examine the pancreas and surrounding structures for abnormalities
Biopsy of the pancreas using a small needle
Blood tests to examine the levels of certain chemicals in your blood
Computed tomography (CT) scan, a noninvasive imaging test to evaluate the size and shape of the pancreas
Endoscopic retrograde cholangiopancreatography (ERCP), an imaging test that looks for narrowing or blockages of the bile ducts. Percutaneous transhepatic cholangiography (PTC) is an alternative to ERCP; an injected contrast dye and X-rays highlight the bile ducts.
Endoscopic ultrasound, which uses a thin scope to create images of the pancreas from inside the esophagus
Laparoscopy, an exploratory procedure in which instruments are inserted into the abdomen through small incisions
Positron emission tomography (PET) scan, a noninvasive imaging test that can highlight malignant (cancerous) cells anywhere in the body
Tumor marker test, performed using blood, urine or tissue samples
Your doctor likely will not use all of these tests to diagnose pancreatic cancer. Instead, doctors usually use a combination of tests based on your specific symptoms and medical history.
A pancreatic cancer diagnosis includes tumor staging at the same time. Cancer staging refers to determining the size and location(s) of the cancerous cells.
Pancreatic cancer stages include:
Stage 0: the cancer consists only of a small collection of abnormal cells within the pancreas.
Stage IA: tumor of less than 2 cm (approximately 1 inch) in size within the pancreas only.
Stage 1B: tumor between 2 cm and 4 cm (approximately 1.5 inches) within the pancreas.
Stage IIA: tumor larger than 4 cm that has not spread outside the pancreas.
Stage IIB: tumor larger than 4 cm that has spread to fewer than three adjacent lymph nodes.
Stage III: tumor of any size with cancer cells that have spread to more than four lymph nodes or any of the major blood vessels next to the pancreas.
Stage IV: tumor of any size with cancer cells that have spread to other parts of the body, such as the lungs or liver. This is metastatic pancreatic cancer.
The treatment plan for pancreatic cancer depends heavily on the cancer’s staging.
Treatment options for pancreatic cancer can include surgery, chemotherapy, radiation therapy, and a combination of treatments. Unfortunately, pancreatic cancer is difficult to treat. The disease may temporarily enter remission, meaning there are no signs of cancer in the body, but treatment cannot cure it.
Advances in pancreatic cancer treatment, including immunotherapy, continue to help patients live longer, even years after diagnosis. Thoroughly discuss your treatment options—including risks, benefits, and side effects—with your doctor and your family so you can make an informed decision about the best choice for your personal situation and stage of cancer.
Receiving a pancreatic cancer diagnosis can be frightening. However, improved treatment options can mean longer survival rates for many people diagnosed with this difficult type of cancer, and better supportive care options can improve quality of life during and after pancreatic cancer treatment.