Pancreatic Cancer - Diagnosis & Treatment

How is pancreatic cancer diagnosed?

Surgeons will take a medical history followed by a physical examination. Pancreatic cancer is usually diagnosed using a combination of blood tests and radiological scans. These tests will help doctors determine the stage of the cancer and help them tailor a suitable treatment plan for the patient.

Diagnostic tests for pancreatic cancer may include one or more of the following:

Blood test

Sometimes known as blood chemistry studies, blood tests can check for substances in the blood such as higher bilirubin levels, which may indicate signs of disease.

Tumour marker test

Analysis of a sample of blood, urine or tissue can reveal substances produced by cancerous cells. High levels of these substances, known as tumour markers, can sometimes help to identify specific types of cancer.

Magnetic resonance imaging (MRI)

An MRI uses magnetic rays and is a good imaging modality for organs such as the liver or pancreas. It takes a series of detailed pictures to create a clear image of the pancreas and surrounding tissues.

Computerised tomography (CT) scan

In a CT scan, a computer linked to an X-ray machine captures images from different angles. Contrast is usually injected into the vein to better visualise the pancreas and surrounding organs.

Positron emission tomography (PET) scan

In a PET scan, a small amount of radioactive glucose is injected into the vein. The scan will indicate where the glucose is being consumed, indicating the location of the tumour.

Ultrasound

An ultrasound uses high-energy soundwaves that bounce off internal tissues and structures to create an image called a sonogram. Endoscopic ultrasound (EUS) is a special ultrasound imaging that is done from the inside of the abdomen via endoscopy. This technique is often used to do biopsy and assess invasion of the tumour.

Endoscopic retrograde cholangiopancreatography (ERCP)

This is performed with the help of a dye and an endoscope. A thin tube is passed through the mouth into the oesophagus, stomach and the first part of the small intestine. In addition to detecting blockages, an ERCP also allows the doctor to treat the blockage by inserting a stent.

Percutaneous transhepatic cholangiography (PTC)

A dye is inserted into the liver or bile ducts and then X-rayed to reveal any blockage. A stent may be used to allow drainage of bile. A PTC is usually performed if an ERCP is not possible.

Biopsy

Biopsy is the removal of cells or tissues for analysis. It can be performed in different ways, using a needle or during laparoscopy.

How is pancreatic cancer treated?

Treatment for pancreatic cancer depends on the stage and location of the cancer.

Your doctor may recommend a combination of surgery, radiotherapy or chemotherapy to remove the tumour. You should see a surgeon who specialises in pancreatic surgery before you start any form of treatment for pancreatic cancers.

• Surgery is performed to help remove the tumour. Complete surgical removal of the tumour is the only form of cure for pancreatic cancer. The position of the tumour will determine the part of the pancreas to be removed.
• Radiotherapy uses high-energy X-rays or other forms of radiation to destroy the cancer cells or to keep them from growing further. It may be used as an adjunct to surgery or as an option where surgery is not an option.
• Chemotherapy uses strong drugs to kill cancer cells or stop the cancer cells from dividing. Chemotherapy can be used after or before surgery. It can help prevent the cancer from returning after surgery or improve the chance of successful surgery.

Early diagnosis and treatment of pancreatic cancer offer the best chance for effective treatment. Speak to your doctor to find out more about your treatment options.