Pancreatic Cancer Diagnosis  

There is no systematic screening for pancreatic cancer. Your doctor will collect samples of blood; perform medical imaging techniques, including ultrasound, CT scan, MRI, endoscopy, endoscopic ultrasonography and percutaneous transhepatic cholangiography (PTHC or PTC). However, to confirm the diagnosis with certainty, a biopsy is also necessary. 

Blood tests - Your doctor may recommend a sampling of your blood to detect anomalies and the presence of cancerous signs in the pancreas. Certain biomarkers levels such as antigen CA19.9 are increased in most cases of large tumors in the liver and pancreas. It is an important examination in the diagnosis of pancreatic cancer; however, CA19.9 is not sensitive for detecting small tumors. In addition it is not completely reliable; its elevation may be due to a benign but not malignant tumor. CA19-9 can be realized before, during or/and after the treatment.  

Ultrasound - this medical imaging technique uses painless high-frequency sound waves to visualize various organs in your body including pancreas. It involves applying an ultrasound sensor (transducer) on your upper abdomen in order to obtain images of the pancreas. The transducer emits ultrasonic through the tissues of the pancreas and are returned as an echo. The result is then collected and analyzed by a computer system that transmits a live image on a video screen.  

Ct scan - a scanner is the use of x-rays to create images of your internal organs. It can detect abnormalities not visible on standard x-ray and ultrasound. The CT scan allows not only to confirm the presence of the tumor but also to highlight lymph nodes or liver metastases. 

Magnetic Resonance Imaging (MRI) - an MRI with injection of contrast allows your physician to visualize organs of the inside of your body. In the case of a pancreatic cancer diagnosis, it can analyze the structure of your pancreas, to search for abnormalities, inflammation, and highlight the presence of the tumor. In addition, the MRI can help your doctor to know the exact size and extent of the tumor. 

Endoscopic retrograde cholangiopancreatography (ERCP) – with this imaging technique, your doctor can see inside your stomach and duodenum, and possibly detect diseases; it combines the use of endoscopy and fluoroscopy. ERCP is used to diagnose and treat certain problems of the liver, gallbladder, bile ducts, and pancreas: gallstones, inflammatory tissues and cancer. During the procedure, your doctor injects dyes into the ducts in the biliary tract and pancreas so they can be visible on x-rays. 

Endoscopic ultrasound - an endoscopic ultrasound is an exploration of the digestive system that combines endoscopy and ultrasound; this exam is very important in cases of small-size pancreatic tumor. During the procedure, a miniaturized ultrasound probe - attached to the end of a flexible endoscope - is positioned near the body to examine which allows your doctor to search or explore lesions in the gastrointestinal tract or adjacent organs including the pancreas. Endoscopic ultrasound also allows, when it is appropriate, puncture to the tumor to obtain sample for lab analysis (biopsy).  

Percutaneous transhepatic cholangiography (PTHC or PTC) - PTC is a radiological technique often performed to examine the anatomy of the biliary tract. During the exam, your doctor injects a contrast agent (dye) into the bile in the liver. Afterwards, a special X-ray machine called fluoroscopy is used to track the travel of the dye. With a PTC, your physician can determine whether there is a blockage in the liver or the bile ducts.  

Biopsy - even if the other diagnostic techniques have revealed the cancer, a biopsy is usually required to confirm the diagnosis with certainty. A biopsy of the pancreas is to remove cells or pancreatic tissue to examine under a microscope. There are many types of biopsies; the type used depends on where the tumor is located. However, whatever the method used, it must be done carefully so it does not promote the spread of cancer cells. 

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