If you have symptoms that suggest cancer of the pancreas, your doctor will try to find out what’s causing the problems.
You may have blood or other lab tests. Also, you may have one or more of the following tests:
- Physical exam: Your doctor feels your abdomen to check for changes in areas near the pancreas, liver, gallbladder, and spleen. Your doctor also checks for an abnormal buildup of fluid in the abdomen. Also, your skin and eyes may be checked for signs of
- Computerized Tomography (CT scan): An x-ray machine linked to a computer takes a series of detailed pictures of your pancreas, nearby organs, and blood vessels in your abdomen. It may show the nature and location of the tumor, as well as its resectablity (chance it can be surgically removed). You may receive an injection of contrast material so your pancreas shows up clearly in the pictures. Also, you may be asked to drink water so your stomach and duodenum show up better. On the CT scan, your doctor may see a tumor in the pancreas or elsewhere in the abdomen.
- Ultrasound: Your doctor places the ultrasound device on your abdomen and slowly moves it around. The ultrasound device uses sound waves that can’t be heard by humans. The sound waves make a pattern of echoes as they bounce off internal organs. The echoes create a picture of your pancreas and other organs in the abdomen. The picture may show a tumor or blocked ducts.
- Endoscopic Ultrasound (EUS): Your doctor passes a thin, lighted tube (endoscope) down your throat, through your stomach, and into the first part of the small intestine. An ultrasound probe at the end of the tube sends out sound waves that you can’t hear. The waves bounce off tissues in your pancreas and other organs. As your doctor slowly withdraws the probe from the intestine toward the stomach, the computer creates a picture of the pancreas from the echoes. The picture can show a tumor in the pancreas. It can also show whether the cancer has invaded the blood vessels.
Some doctors also use the following tests:
- Endoscopic Retrograde Cholangiopancreatography (ERCP): The doctor passes an endoscope through your mouth and stomach, down into the first part of your small intestine. Your doctor slips a smaller tube through the endoscope into the bile ducts and pancreatic ducts. After injecting dye through the smaller tube into the ducts, the doctor takes x-ray pictures. The x-rays can show whether the ducts are narrowed or blocked by a tumor or other condition.
- Magnetic Resonance Imaging (MRI): A large machine with a strong magnet linked to a computer is used to make detailed pictures of areas inside your body.
- Positron Emission Tomography (PET scan): You’ll receive an injection of a small amount of radioactive sugar. The radioactive sugar gives off signals that the PET scanner picks up. The PET scanner makes a picture of the places in your body where the sugar is being taken up. Cancer cells show up brighter in the picture because they take up sugar faster than normal cells do. A PET scan may show a tumor in the pancreas. It can also show cancer that has spread to other parts of the body.
- Needle biopsy: The doctor uses a thin needle to remove a small sample of tissue from the pancreas. EUS or CT may be used to guide the needle. A pathologist uses a microscope to look for cancer cells in the tissue. Technically, this is called a fine needle aspiration.
- Laparoscopy: A diagnostic procedure in which the abdominal cavity is examined by inserting a laparoscope (a miniature camera) through one or more small incisions in the abdominal wall. Laparoscopy is unnecessary in most cases where tumors are likely to be resectable.