Pancreatic cancer is usually diagnosed with imaging tests and procedures. The process used to find out if cancer cells have spread inside and around the pancreas is called staging. Tests and procedures for the detection, diagnosis, and staging of pancreatic cancer are usually performed at the same time. To plan treatment, it is important to know the stage of the disease and if pancreatic cancer can be removed or not by surgery.

The following tests and procedures may be used:

Physical Exam and Medical History

A physical exam is performed to diagnose the general health condition, including the analysis of disease signs. An account will be taken of the patient\’s personal history of illness and his / her general health.

Biochemical blood tests

This will measure certain substances, such as bilirubin, released into the blood by organs and tissues in the body. An unusual amount (higher or lower than normal) of a substance may be a sign of the disease.

Testing for tumor markers

A procedure by which a blood, urine or tissue sample is analyzed to measure the number of certain substances, such as CA 19-9 and carcinoembryonic antigen (CEA).

MRI (magnetic resonance imaging)

A procedure that uses a magnet, radio frequency wave, and a computer to obtain a series of detailed images of areas within the body. This procedure is also called magnetic resonance imaging. CT scan – a procedure that gets a series of detailed images of areas inside the body from different angles. This procedure is also called computed tomography.

Positron emission tomography

A procedure used to detect malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and helps to get an image of the region where glucose is used. Malignant tumor cells appear brighter in images because they are more active and consume more glucose than normal cells. A PET scan and CT scan can be performed at the same time. This is called PET-CT.

Abdominal ultrasound

Designed to produce images from within the abdomen. The ultrasonic transducer is pressed onto the abdomen and directs the high energy waves (ultrasounds) that hit the internal tissues and organs and produce echoes. The transducer picks up the echoes and sends them to a computer where the image is formed.

Retrograde endoscopic cholangiopancreatography (ERCP)

A procedure used to radiograph channels (tubes) that carry the bile from the liver into the bile and from the bile to the small intestine. Sometimes, pancreatic cancer leads to narrowing or blockage, or slows the flow of bile, causing jaundice. An endoscope is inserted through the oral cavity, esophagus, and stomach into the first part of the small intestine. A catheter is then inserted through the endoscope into the pancreatic ducts, and a contrast substance is injected through the catheter into the channels.

Transcutaneous Percutaneous Collagenography (PTC)

A thin needle is inserted through the skin under the ribs and the liver. The contrast substance is injected into the liver or bile ducts. If a blockage is found, a thin, flexible tube, called the stent, is placed to drain the ball into the small intestine or in a collection bag outside the body.

Laparoscopy

A surgical procedure used to analyze the organs inside the abdomen. Small incisions will be made in the abdomen wall and a laparoscope (a thin tube) is inserted into one of the incisions. The laparoscope may have an ultrasound probe or a device for tissue sampling in the pancreas or abdominal fluid samples to detect any cancer.

Biopsy

Taking cells or tissues so that they can be analyzed at the microscope by an anatomo-pathologist to detect signs of cancer.