Successful treatment of pancreatic cancer can depend on a timely diagnosis. Various tests can help doctors rule out cancer or decide whether further testing is necessary.
According to the American Cancer Society (ACS),
If a person experiences symptoms that may be due to pancreatic cancer, doctors may recommend various diagnostic tests.
This article explains how doctors diagnose pancreatic cancer. It outlines the main diagnostic tests and what the results may mean.
Pancreatic cancer can be
No routine screening tests are available for pancreatic cancer because experts do not believe that screening reduces deaths.
If a person experiences symptoms of pancreatic cancer, they should consult a doctor. Doctors will likely recommend a series of tests to help determine the cause of a person’s symptoms. The following sections explain the main diagnostic tests.
Asking about a person’s medical history is essential to help a doctor understand the person’s risk of pancreatic cancer. Doctors also ask about the medical history of family members, as having a relative who has had pancreatic cancer may increase a person’s chances of developing it.
Doctors usually ask about a person’s lifestyle and current symptoms as well.
A doctor will perform a physical exam to check for signs of cancer. If the doctor notices the following, they may order further testing:
- swelling of the liver or gallbladder
- yellow-tinted whites of the eyes
- yellowing of the skin, or jaundice
Imaging tests provide visual images of a person’s internal organs and tissues. They can help doctors:
- identify suspicious areas that may be cancer
- see how far cancer may have spread
- determine how well treatment is working
A radiologist is responsible for interpreting the results of an imaging test. They discuss the results with a doctor, possibly an oncologist, who then contacts the person to inform them of the results.
Doctors may use the following tests to diagnose pancreatic cancer:
Computed tomography (CT) scans
CT scans take images of a person’s body in a cross section and show the pancreas clearly. These types of scans can also show whether tumors have spread to other regions of the body, such as the lymph nodes.
If a doctor suspects pancreatic cancer, they may order a type of CT scan called a
Magnetic resonance imaging (MRI)
Some doctors prefer CT scans for viewing the pancreas, but MRI scans can also be helpful. These scans use radio waves to create imagery of the internal organs.
There are two types of MRI scans:
- MR angiography (MRA): This scan looks specifically at the blood vessels, using an injectable dye. This can help highlight whether a tumor is blocking any part of the pancreas.
- MR cholangiopancreatography (MRCP): This scan allows doctors to look at the pancreatic and bile ducts in the liver.
Ultrasound scans are helpful for initial investigations into the abdomen, as they do not release any radiation. An endoscopic ultrasound is the most accurate type of ultrasound scan.
A doctor inserts an endoscope into the digestive tract to examine it and possibly to take a tissue sample, or biopsy. An endoscope is a thin, flexible tube with a light and lens at one end.
Positron emission tomography (PET) scan
A PET scan involves injecting a radioactive form of sugar into a vein. This substance, which is safe in small doses, collects in cancerous tumors and highlights any masses present within the body.
This type of scan is beneficial for investigating cases where cancer may have spread to other areas of the body.
Typically, the results of a PET scan are available in a
Doctors use multiple blood tests to help diagnose pancreatic cancer, such as:
- Tumor markers: These substances, including CA 19-9 and carcinoembryonic antigen, are present in the blood of people with cancer. However, their presence is not definitive enough to be the only reason for a diagnosis, so further tests are necessary.
- Liver function tests: Jaundice and yellowing of the eyes could be symptoms of pancreatic cancer. Blood tests to assess the levels of bilirubin — the substance that the liver produces — help doctors find out whether a person’s jaundice results from blockage by a tumor or from another disease.
A biopsy is the most accurate way to determine whether a mass is cancerous. Doctors remove a small sample of the mass and send it to a laboratory for analysis.
There are three main
- Percutaneous biopsy: A doctor inserts a thin, hollow needle into the skin over the abdomen to remove a tumor sample from the pancreas. They use ultrasound or CT images to guide the needle to the correct location.
- Surgical biopsy: This type of biopsy is less common. Most often, keyhole surgery, or laparoscopy, allows a doctor to look at other areas in the abdomen to check whether cancer has spread.
- Endoscopic biopsy: As described above, doctors use a thin, flexible endoscope to examine the digestive tract and remove a small tissue sample from the tumor.
The doctor sends the biopsy sample to a laboratory, where a pathologist views it under a microscope. The pathologist can:
- determine whether a mass is cancerous
- determine the likely cause of the cancer
- check for genetic causes, as this may help determine the best route for treatment
Specific genes can make a person more likely to develop pancreatic cancer.
The BRCA mutations are
If a person receives positive results for specific gene mutations, other family members may wish to consider genetic counseling and testing.
Imaging scans, blood tests, biopsies, and genetic testing are critical for understanding a person’s pancreatic cancer diagnosis.
These tests can either rule out a cancer diagnosis or help determine the best treatment path if a person has pancreatic cancer.