Pancreatic Cancer Diagnosis

If you are experiencing symptoms of pancreatic cancer, our team will ask about your health history, your family’s history of cancer and risk factors. We may perform diagnostic tests to help determine if you have pancreatic cancer. A diagnosis is often determined through a combination of imaging tests and tissue sampling (biopsy) by our experts in the Departments of Radiology and Pathology. Diagnostic tests may include the following, though most patients will not require all tests:

  • Computed tomography (CT or CAT) scan: This lets doctors see inside your body using a combination of X-rays and software to create images of your organs, bones and other soft tissues.
  • Magnetic resonance imaging (MRI) and/or Magnetic resonance cholangiopancreatography (MRCP): The MRI test uses magnets and radio waves to create detailed images of your pancreas and nearby organs. The MRCP test creates detailed pictures of the bile ducts and is a lot like an ERCP, but it uses an MRI instead of an endoscope or contrast dye. MRCP can show both the bile ducts and the pancreatic duct without the need to insert a scope. In this setting, MRIs are always obtained with MRCPs.
  • Positron emission tomography (PET scan): For this test, a radioactive sugar is put into your blood through a vein in your arm or hand. Over time, the radioactive sugar collects in very active cells, like cancer cells. A special camera is then used to make pictures that show where the radioactive sugar collects.
  • Endoscopic ultrasound (EUS): This is an endoscopic procedure that examines the lining and walls of the upper and lower gastrointestinal tract by combining endoscopy and high frequency ultrasound.
  • Pancreatic biopsy: This is a procedure in which a sample of pancreatic tissue is removed (with a needle or during surgery), and a doctor who specializes in looking at cells (a pathologist) looks at the samples under a microscope to see if they contain cancer. This is usually the only way to be sure that a person has pancreatic cancer. A biopsy is often done if an imaging test shows something in your pancreas that looks like it might be cancer. It is typically done with an EUS, described above.
  • Endoscopic retrograde cholangiopancreatography (ERCP): This is a procedure that combines the use of a flexible, lighted scope (endoscope) with X-ray pictures to examine the tubes that drain the liver, gallbladder and pancreas. It is one of the best ways to find bile duct cancer that is close to the pancreas. Medicines are used to put you into a light sleep during this test. An endoscope is inserted through the mouth and gently moved down the throat into the esophagus, stomach and duodenum (part of the small intestine) until it reaches the point where the ducts from the pancreas (pancreatic ducts) and gallbladder (bile ducts) drain into the duodenum. The scope puts dye in the common bile duct, and the dye shows up on X-rays and can help show blockages or narrowing of the ducts.
  • Percutaneous transhepatic cholangiography (PTC): This is a type of X-ray of the bile duct. The ducts are reached by passing a thin needle through the skin on the right side of your belly and into your liver. Dye is injected and highlights blockages in bile ducts, which can then be seen on an X-ray. If a blocked bile duct is seen, your care team may take a biopsy and check it for cancer.
  • Chest X-ray: This is an X-ray of the organs and bones inside the chest.
  • Special blood tests: These look for signs of pancreatic cancer, but they can’t diagnose pancreatic cancer on their own. Tests may include liver function tests (LFTs) and CA19-9 (tumor marker) tests.

Learn more about diagnostic tests and our center’s overall diagnosis process.

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