If there’s a chance that you or a loved one may have pancreatic cancer, finding out for sure is an important first step. At Banner MD Anderson Cancer Center, we use some of the most advanced imaging and diagnostic tools available to detect cancer early, understand how far it has spread and build the best possible treatment plan for you.
When to test for pancreatic cancer
Your health care provider may recommend testing for pancreatic cancer if you have certain symptoms, like:
- Weight loss for no clear reason
- Jaundice (yellowing of the skin or eyes)
- Pain in your belly that doesn’t go away
- Changes in your abdomen your provider can feel during a physical exam
Your provider may also suggest testing if you have a strong family history or a genetic condition linked to higher cancer risk.
Early detection of pancreatic cancer can give you better treatment options. That’s why it’s important to speak with your provider if you notice any symptoms or know you’re at higher risk.
Imaging tests for pancreatic cancer
We use a range of imaging tests to look for pancreatic cancer and see how it may be affecting nearby areas of your body.
- CT scan (computed tomography): A CT scan is usually the first imaging test done. It creates detailed cross-sectional pictures of your pancreas and nearby organs.
- MRI (magnetic resonance imaging): This test uses magnets and radio waves to capture images of soft tissues. It’s helpful if your providers need more details after a CT scan.
- Endoscopic ultrasound (EUS): This test uses a small camera on a flexible tube to get close-up views of the pancreas. It can also help guide a biopsy.
- Endoscopic retrograde cholangiopancreatography (ERCP): This test uses a scope and contrast dye to create images of the pancreas.
- PET scan (positron emission tomography): Sometimes, this test is used to spot cancer that has spread to other parts of the body.
What these tests can show
These imaging tools help us understand:
- How big the tumor is and where it’s located
- Whether cancer is affecting nearby blood vessels
- If the cancer has spread to the lymph nodes and/or other organs
Blood tests and tumor markers
Blood tests can help confirm a diagnosis and track how well treatment is working:
- CA 19-9: This is the most common tumor marker for pancreatic cancer. High levels may mean cancer is more likely, but this test is not used alone to diagnose it.
- Other lab tests: Your doctor may check for anemia, liver function or blood sugar levels, especially if you have diabetes or jaundice.
Tumor markers give us helpful information but they can’t confirm cancer on their own.
Confirming a pancreatic cancer diagnosis with a biopsy
A biopsy is the only way to confirm pancreatic cancer. It involves taking a small sample of tissue and looking at it under a microscope.
Common ways to get a biopsy for pancreatic cancer include:
- Fine-needle aspiration (FNA): This method uses a thin needle to remove a sample of the suspicious area. It’s often done during an endoscopic ultrasound, since the ultrasound can guide providers to the right location.
- Core or Tru-Cut needle biopsy: This method uses a larger needle, which gets a bigger sample. Your provider may recommend it if they need to examine more of the tumor to make a diagnosis.
- Surgical biopsy: In some cases, your provider may remove a sample surgically.
A pathologist reviews the sample to figure out what type of cancer it is and how aggressive it might be.
Staging pancreatic cancer
After confirming a pancreatic cancer diagnosis, your care team will figure out the cancer stage. Staging shows how far the cancer has spread and helps your care team recommend the best treatment options.
How pancreatic cancer staging is determined
Your doctor will use several tools to understand where the cancer is located, including:
- Imaging tests like CT, MRI and PET scans
- Endoscopic ultrasound (EUS)
- Biopsy results
- Laparoscopy, which is a minimally invasive surgery to check whether cancer has spread to the abdomen
Providers might describe pancreatic cancer with both surgical categories and numbered stages.
Surgical staging terms
- Resectable: It looks like the cancer could be removed with surgery.
- Borderline resectable: Surgery might be possible after treatment like chemo or radiation.
- Locally advanced: Cancer has grown into nearby structures, which means surgery is usually not an option at first.
- Metastatic: Cancer has spread to organs that are further away in the body, such as the liver, lungs, bones or lining of the abdomen.
Number stages: Stage 0 to Stage 4
- Stage 0 (carcinoma in situ): Abnormal cells (precancer) are only found in the lining of the pancreas. They could become cancerous.
- Stage 1: The tumor is only in the pancreas.
- Stage 1A: The tumor is two centimeters or smaller.
- Stage 1B: The tumor is larger than two centimeters.
- Stage 2: Cancer has spread to nearby tissue or lymph nodes.
- Stage 2A: The tumor is larger than four centimeters.
- Stage 2B: The cancer has spread to nearby areas.
- Stage 3: Cancer has reached nearby major blood vessels or more lymph nodes (metastasized).
- Stage 4: Cancer has spread to parts of the body that are further away.
Why staging matters
Knowing the stage helps your team recommend the best approach, whether that’s surgery, chemotherapy, radiation or a combination of treatments. It also helps you understand what’s realistic for your outcomes and treatment goals.
What to expect during testing at Banner MD Anderson
From your first appointment for pancreatic cancer diagnosis at Banner MD Anderson, our team is here to support you.
- Nurse navigators help schedule your tests and explain what to expect
- Care coordinators help coordinate your team of specialists to ensure they are working together to give you the best care possible
- Your care team will explain your test results clearly and help you plan and understand the next steps
We know this process can feel overwhelming. Our goal is to use patient-centered testing and care to make it as smooth as possible while giving you the information you need.
Next steps after a diagnosis
Once we confirm your diagnosis, your care team will meet with you to talk about your pancreatic cancer treatment options. We may refer you to:
- A surgical oncologist to consider surgery options
- A medical oncologist for chemotherapy or targeted therapies
- A radiation oncologist if radiation may be part of your plan
- A support team including dietitians, counselors and social workers
We’ll work with you on treatment planning that fits your needs and goals and helps you live longer and better.
When pancreatic cancer is advanced
Usually, pancreatic cancer isn’t diagnosed until it’s in more advanced stages, which can make treatment options more limited. Our caring team of cancer experts is here to help you through your diagnosis and understand all your options and results.
If your cancer is not treatable, we’ll be beside you every step of the way. That includes honest conversations, pain and symptom relief, emotional support and help deciding if hospice care is right for you or your family.
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