Pancreatic Cancer

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Questions to Ask Your Doctor About Your Cancer
(Free Handout)

Diagnosis

If pancreatic cancer is suspected, the first step is to perform a series of tests. Imaging tests often are used to produce pictures of internal organs and tissues. If these tests detect pancreatic cancer that appears to be resectable (see the Staging section), surgery is often the next step. In some cases, a tumor marker CA 19-9 (cancer antigen) test also may be performed.

The following diagnostic tests may be used to help diagnose pancreatic cancer:

• Magnetic resonance imaging (MRI scan)–In this test, the patient passes through a tunnel surrounded by a powerful magnet and a computer tracks the magnetism and produces pictures of the tissues being studied.
• Upper GI (gastrointestinal) series–In this procedure, the patient swallows a contrast solution containing the mineral barium. While the solution is in the digestive system, x-rays are taken to detect abnormalities.
• Computerized axial tomography (CAT scan or CT scan)–This is a specialized x-ray technique that produces detailed cross-sectional images of internal organs and tissues.
• Ultrasound–This test uses high frequency sound waves that bounce off structures in the patient's body. A computer translates these echoes into a sonogram image.

If imaging tests detect an abnormality that warrants further investigation, a biopsy may be performed. In a biopsy, a sample of tissue is removed and examined for cancer cells.

One method of obtaining a tissue sample is a needle biopsy. In this procedure, the surgeon inserts a needle into the abdomen, guided by an imaging technique, and removes a small sample of pancreatic tissue. Laparoscopy, which involves using a device called a laparoscope to remove a small piece of tissue from the pancreas, also may be performed.

In the laboratory, pathologists (doctors who specialize in diagnosing diseases) can evaluate the specimen for abnormal growth. If there is a tumor (an abnormal mass of cells), it may be benign (not cancer) or malignant (cancerous).

When a patient is diagnosed with pancreatic cancer, an oncology team determines the best course of action. This health care team may include medical oncologists (doctors who specialize in diagnosing and treating cancer), radiation oncologists (doctors who perform radiation therapy), and endocrinologists (doctors who specialize in hormones and the glands that produce them).

Staging
Staging is a method of determining the progress of cancer in a patient. Once doctors know how far along the cancer is, they can decide on the best course of treatment. In the staging process, the tumor characteristics and the extent to which the cancer has spread to other parts of the body is evaluated. There are a number of aspects to staging. A simplified approach puts patients into three groups, or stages, based on how far the cancer has advanced:

Other staging approaches evaluate the tumor and its behavior in greater detail:

Stages of the tumor itself:

Stages of spread to the lymphatic system:

Metastasis:
The lymphatic system can transport cancer cells to distant parts of the body, where they can grow into new tumors. This is the process of metastasis. Another aspect of staging classifies cancers based on the extent to which they have metastisized.

Pancreatic Cancer Resources

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