Pancreatic Cancer Diagnosis
To plan treatment for pancreatic cancer, it is important to know the stage of the disease and whether the tumor can be removed by surgery.
Our skilled pathologists, diagnostic radiologists, interventional radiologists, and technicians at UT Southwestern Medical Center bring specialized expertise to the challenge of diagnosing pancreatic cancer as early and accurately as possible.
We offer an unmatched pancreatic cancer prevention program that focuses on identifying risks and providing early detection and diagnosis.
Diagnostic Tests for Pancreatic Cancer
Because people with pancreatic cancer rarely experience distinct symptoms, the disease is often discovered in the course of evaluation for other conditions.
In addition to a physical exam and health history, tools and techniques to diagnose pancreatic cancer include:
- Blood chemistry studies: A blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. These samples can also be checked for tumor markers that are associated with certain types of cancer.
- Biopsy: A definitive diagnosis of pancreatic cancer requires a biopsy, in which cells or tissues are removed to be evaluated under a microscope by a pathologist for signs of cancer. Image-guided biopsies provide safe, accurate diagnosis of malignant lesions of the pancreas.
- Imaging studies: These varied technologies create detailed pictures of organs and areas in the body. They include:
- Magnetic resonance imaging (MRI)
- Computed tomography (CT) scan
- Positron emission tomography (PET) scan
- Abdominal or endoscopic ultrasound
- Endoscopic retrograde cholangiopancreatography (ERCP), which images bile ducts that might be narrowed by pancreatic cancer, causing jaundice
- Percutaneous transhepatic cholangiography (PTC), another technique for imaging the liver and bile ducts
- Laparoscopy, a surgical procedure in which a laparoscope is inserted in the body through small incisions to look at the organs inside the abdomen
Pancreatic cancers in the endocrine cells can often be difficult to diagnose with traditional diagnostic methods such as CT or MRI. Venous sampling, performed with a small tube guided by fluoroscopy, can sample the blood from tumors or nearby veins to locate the source of the elevated hormone in endocrine cancers.
Stages of Pancreatic Cancer
Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body. Knowing the stage helps us decide what kind of treatment is best.
Pancreatic cancers are commonly staged into one of four categories, based on whether they are resectable (removable with surgery) and if or where they have spread.
- Resectable: This type of pancreatic cancer can be surgically removed (resected). The tumor might be located only in the pancreas or slightly beyond it, but it has not grown into important arteries or veins in the area or spread to other body systems or organs. Approximately 10 to 15 percent of patients are diagnosed with this stage.
- Borderline resectable: This stage describes a tumor that can be difficult or impossible to resect when it is first diagnosed but that might be resectable after being shrunk with chemotherapy or radiation therapy.
- Locally advanced: The tumor is located only in the area around the pancreas, but it cannot be surgically removed because it has grown into nearby arteries, veins, or organs. However, it has not spread to any distant parts of the body. Approximately 35 to 40 percent of patients are diagnosed at this stage.
- Metastatic: The tumor has spread beyond the area of the pancreas and to other organs, such as the liver or distant areas of the abdomen. Approximately 45 to 55 percent of patients are diagnosed at this stage.