Exams and Tests
To look for or diagnose pancreatic cancer, your doctor will use one or more imaging tests—tests that produce pictures of the pancreas and the area around it. Such tests include:
- CT scan or MRI. You lie on a table while a large scanner takes images. Dye may be injected in your arm or swallowed to make the images clearer.
- PET scan. A radioactive liquid called a tracer is injected in your arm. When the tracer has had time to reach your pancreas, you lie on a table while a large scanner takes pictures.
- Endoscopic ultrasound. A small tube is inserted through your mouth and down into your digestive system. A camera at the end of the tube takes ultrasound pictures of the pancreas. The doctor can also insert a needle through the tube to collect tissue samples.
- Endoscopic retrograde cholangiopancreatogram. A small tube is inserted through your mouth and down into your digestive system. Dye is injected through the tube, and X-rays are taken.
- Percutaneous transhepatic cholangiogram. Dye is injected through the skin into the bile ducts, and X-rays are taken.
Imaging tests can show evidence of pancreatic cancer. But your doctor may also order a biopsy. This means getting a sample of tissue from the pancreas to see if it contains cancer cells. There are two main kinds:
- Laparoscopy. The doctor makes a small cut in your skin and inserts a small tube with a camera on the end. When the camera reaches the pancreas, the doctor can use the same tube to collect tissue samples.
- Needle biopsy. Tissue samples are collected through a needle. This may be done with a needle inserted through the skin and into the pancreas or as part of an endoscopy.
Staging and grading
An important part of treating most types of cancer is staging and grading. This means looking at tissue samples under a microscope to see whether the cancer cells have spread beyond the pancreas and what kind of cells they are.
For pancreatic cancer, the tissue samples may be collected during a separate biopsy or during an endoscopic ultrasound. Sometimes the biopsy is done at the time of surgery to remove the cancer.
Knowing the stage and grade helps doctors know whether surgery will work to remove the cancer or what kind of treatment will help you feel better.
E. Gregory Thompson, MD - Internal Medicine
Joseph O'Donnell, MD - Hematology, Oncology
March 5, 2012
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