Pancreatic Cancer Program
Pancreatic Cancer Awareness
DetectionIf you have symptoms that suggest cancer of the pancreas, your doctor will try to find out what's causing the problems.
Patients with symptoms suspicious for pancreatic cancer will undergo tests to determine the cause of these symptoms. In addition to a physical exam, blood and other lab tests, below are some tests and procedures used for diagnosis:
Ultrasound of the abdomen
An ultrasound can identify a tumor or mass in the pancreas or bile duct system that may be causing blockage or jaundice.
Endoscopic Ultrasonography (EUS)
The EUS test is done with a lighted tube that is inserted through the mouth and placed into the stomach. Ultrasound images of the pancreas are obtained through the stomach wall. It is highly sensitive for diagnosing pancreatic cancer. EUS is particularly useful for detecting small (less than two centimeters) tumors which may not be well visualized by CT. It can also identify tumors that may involve important blood vessels. The procedure can provide details about the arteries and veins next to the pancreas. A biopsy with a small or 'fine' needle aspiration (FNA) of the tumor may also be performed during an EUS to diagnose pancreatic cancer. Intravenous sedation is used for this procedure.
ERCP (endoscopic retrograde cholangiopancreatography)
An ERCP is done with a lighted tube called an endoscope to look at the bile ducts. It can also be used to place a stent or tube to open a blocked bile duct for drainage. Intravenous sedation is most commonly used for this procedure. The patient is not awake during the test. This procedure helps to determine what is causing the blockage.
Some causes of these blockages include ampullary tumors, cholangiocarcinoma (bile duct cancer), inflammation or cancer of the pancreas. Bile duct juice and tissue samples may be obtained and sent to the pathologist to evaluate for cancer cells.
Computed Tomography (CT)
The CT scan can show small tumors as well as important blood vessels that the tumor might be growing into or around. A CT scan can also look at surrounding organs for spread (metastasis) of the cancer into the lymph nodes, liver and other areas. The doctor may suggest a pancreatic mass CT to be done at the U-M for the first clinic visit to better assess the tumor for size, location and involvement of surrounding vessels and organs. This is a special CT scan done at the Cancer Center that examines the pancreas very closely. A special dye is used for the CT, to give additional information to the radiologist; therefore a temporary IV (intravenous catheter) will be placed prior to the scan.
In some cases the radiology department can perform needle biopsies using the CT or ultrasound technique to locate the mass (tumor) and obtain a tissue sample through the abdomen for a diagnosis. At the U-M Interventional Radiology department, there are specialists who may be consulted to do one of these procedures.
Source: U-M Comprehensive Cancer Center - Diagnosing Pancreatic Cancer.