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Pancreas cancer

How do doctors diagnose pancreas cancer?

Pancreas cancer isn't always easy to diagnose. Your doctor may use several different ways to find out whether you have it.

Your doctor will find out whether you have pancreas cancer based on:

Your symptoms
A physical examination
Special tests that include taking a small sample of cells from your

pancreas
Your pancreas is an organ that's behind your stomach. It makes several different chemicals. Some of the chemicals help your body digest food. Your pancreas also makes a chemical called insulin, which helps your body use the sugar in your blood.

pancreas (a

biopsy
Biopsy is when doctors remove some tissue from a part of your body, so that it can be examined under a microscope.

biopsy).

Questions your doctor may ask

Your doctor will want to find out about your symptoms and your general health. These are some of the questions your doctor may ask you:

How do you feel?
Are you eating well?
Have you lost weight recently?
Has there been any change in your bowel movements?
What color are your stools and urine?
Are you in any pain?

Physical exam and tests

Examining you will help your doctor get a better idea of what is causing your symptoms. The exam will probably include:

Listening to your chest to check your heart and lungs
Looking at your skin and eyes for signs of jaundice (see What are the symptoms of pancreas cancer?)
Feeling your stomach and abdomen for signs of swelling or any buildup of fluid
Checking your

lymph nodes
Lymph nodes (also called glands) are small, bean-shaped lumps that you cannot usually see or easily feel. They are located in various parts of the body, such as the neck, armpit and groin. Lymph nodes filter the lymph fluid and remove unusual things, such as bacteria and cancer cells.

lymph nodes for swelling
Checking how well you are in general.

You may need to have some tests. These will help your doctor find out if you have pancreas cancer or some other illness.

They will also help your doctor decide which treatment might be best for you.

Samples

Your doctor may take samples of your blood, urine or stools. Here are some of the substances they will look for.

Bilirubin: Bilirubin is a waste product from worn-out blood cells. Usually, it's removed from your body through your common bile duct. But if your bile duct is blocked by pancreas cancer, you may have high levels of bilirubin in your blood, urine or stools. See More about your pancreas and bile duct.
Liver enzymes: These show whether your liver is working normally.
Cancer markers: High levels of a certain substance in your blood may mean you have cancer. Chemicals like this are called cancer markers. The one for pancreas cancer is called CA 19-9. But it's only released from some types of pancreas cancer.

Scans

Scans are special pictures of your internal organs. There are different ways of getting them. Doctors can use sound waves, radio waves or special X-rays that can pass through body tissues. But because of the position of the pancreas, it isn't easy to get good pictures of your pancreas to see if you have a tumor.

Here are the most common scans used to find out if you have pancreas cancer.

Source:
National Cancer Institute.
What you need to know about prostate cancer.
November 2008. Available at http://www.cancer.gov/cancerinfo/wyntk/prostate (accessed on 17 April 2009).

Ultrasound
CT scan (or CAT scan)
Endoscopic retrograde cholangiopancreatography (ERCP)
Magnetic resonance cholangiopancreatography (MRCP)

Biopsy

Your doctor may want to take out a small piece of your pancreas to look at under a microscope. This is called a biopsy.

A biopsy is the best way of diagnosing pancreas cancer. Unless you're going to have surgery, your doctor should offer you this procedure.

There are different ways of doing a biopsy.

The doctor may put a very fine needle through your skin into your pancreas to take out some cells. He or she uses an X-ray to guide the needle. This is called fine needle aspiration. You'll have a

local anesthetic
Local anesthetic is a painkiller for one area of your body. You usually get it as a shot. It makes that area numb. An example is the novocaine you get when your dentist fills a cavity.

local anesthetic to numb the area. The needle is usually put through your abdomen. It takes about 10 to 15 minutes, and you will be able to go home afterward. It can be uncomfortable.
Or your doctor may get a sample when you have a type of scan called an Endoscopic retrograde cholangiopancreatography (ERCP).

Staging your cancer

Doctors classify pancreas cancer according to the stage it has reached. Knowing what stage your cancer is helps your doctor decide which treatment is best for you. It also gives you some idea of what may happen to you.

The stage of cancer depends on:

The size of your tumor (lump)
Whether it has spread to your

lymph nodes
Lymph nodes (also called glands) are small, bean-shaped lumps that you cannot usually see or easily feel. They are located in various parts of the body, such as the neck, armpit and groin. Lymph nodes filter the lymph fluid and remove unusual things, such as bacteria and cancer cells.

lymph nodes
Whether it has spread to other parts of your body.

To learn more, see Stages of pancreas cancer.

Sources for the information on this page:

National Cancer Institute.What you need to know about prostate cancer.November 2008. Available at http://www.cancer.gov/cancerinfo/wyntk/prostate (accessed on 17 April 2009).

This information was last updated on Apr 22, 2009

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.

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