If your doctor suspects pancreatic cancer, he or she may have you undergo one or more of the following tests:
- Imaging tests that create pictures of your internal organs. These tests help your doctors visualize your internal organs, including the pancreas. Techniques used to diagnose pancreatic cancer include ultrasound, computerized tomography (CT) scans, magnetic resonance imaging (MRI) and, sometimes, positron emission tomography (PET) scans.
- Using a scope to create ultrasound pictures of your pancreas. An endoscopic ultrasound (EUS) uses an ultrasound device to make images of your pancreas from inside your abdomen. The device is passed through a thin, flexible tube (endoscope) down your esophagus and into your stomach in order to obtain the images.
- Removing a tissue sample for testing (biopsy). A biopsy is a procedure to remove a small sample of tissue for examination under a microscope. Your doctor may obtain a sample of tissue from the pancreas by inserting a needle through your skin and into your pancreas (fine-needle aspiration). Or he or she may remove a sample during EUS, guiding special tools into the pancreas.
- Blood test. Your doctor may test your blood for specific proteins (tumor markers) shed by pancreatic cancer cells. One tumor marker test used in pancreatic cancer is called CA19-9. But the test isn't always reliable, and it isn't clear how best to use the CA19-9 test results. Some doctors measure your levels before, during and after treatment.
If your doctor confirms a diagnosis of pancreatic cancer, he or she tries to determine the extent (stage) of the cancer. Using information from staging tests, your doctor assigns your pancreatic cancer a stage, which helps determine what treatments are available to you.
Stages of pancreatic cancer
The stages of pancreatic cancer are:
- Stage I. Cancer is confined to the pancreas and can be removed using surgery.
- Stage II. Cancer has spread beyond the pancreas to nearby tissues and organs and may have spread to the lymph nodes. At this stage, surgery may be possible to remove the cancer.
- Stage III. Cancer has spread beyond the pancreas to the major blood vessels around the pancreas and may have spread to the lymph nodes. Surgery may or may not be possible to remove the cancer at this stage.
- Stage IV. Cancer has spread to distant sites beyond the pancreas, such as the liver, lungs and the lining that surrounds your abdominal organs (peritoneum). Surgery isn't an option at this stage.
Don't hesitate to ask your doctor about his or her experience with diagnosing pancreatic cancer. If you have any doubts, get a second opinion.
Nov. 18, 2016
- AskMayoExpert. Pancreatic cancer. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
- Pancreatic adenocarcinoma. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed June 3, 2016.
- Niederhuber JE, et al., eds. Carcinoma of the pancreas. In: Abeloff's Clinical Oncology. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2014. http://www.clinicalkey.com. Accessed June 3, 2016.
- What you need to know about cancer of the pancreas. National Cancer Institute. http://www.cancer.gov/cancertopics/wyntk/pancreas. Accessed June 3, 2016.
- Distress management. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed June 3, 2016.
- Palliative care. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed June 3, 2016.
- Clark KL, et al. Psychological distress in patients with pancreatic cancer — An understudied group. Psycho-Oncology. 2010;19:1313.
- Tee MC, et al. Laparoscopic pancreaticoduodenectomy: Is it an effective procedure for pancreatic ductal adenocarcinoma? Advances in Surgery. 2015;49:143.
- Sugumar A, et al. Distinguishing pancreatic cancer from autoimmune pancreatitis. Current Gastroenterology Reports. 2010;12:91.
- Pancreatic SPOREs. National Cancer Institute. http://trp.cancer.gov/spores/pancreatic.htm. Accessed. June 10, 2016.
- Pancreatic cancer genetic epidemiology (PACGENE) study. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT00526578. Accessed June 10, 2016.
- Riggin ER. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Sept. 20, 2016.
- Ramanathan RK (expert opinion). Mayo Clinic, Scottsdale/Phoenix, Ariz. Aug. 30, 2016.