Pancreatic Cancer-Diagnosing Pancreatic Cancer

Pancreatic cancer is a disease in which malignant (cancer) cells form in the tissues of the pancreas.

The pancreas is a gland about 6 inches long that is shaped like a thin pear lying on its side. The wider end of the pancreas is called the head, the middle section is called the body, and the narrow end is called the tail. The pancreas lies behind the stomach and in front of the spine.

The pancreas has two main jobs in the body:

• To produce juices that help digest (break down) food.
• To produce hormones, such as insulin and glucagon, that help control blood sugar levels. Both of these hormones help the body use and store the energy it gets from food.

The digestive juices are produced by exocrine pancreas cells and the hormones are produced by endocrine pancreas cells. About 95% of pancreatic cancers begin in exocrine cells.

Diagnosing cancer

The following tests and procedures may be used to diagnose and stage cancer of the pancreas:

• Physical exam and history 
• Chest X-ray 
• Biopsy Tissue samples are examined under the microscope to determine what types of cells are present.
• CT or CAT (computerized axial tomography) scan The CT scan is the primary study used to diagnose and stage pancreatic tumors. This procedure uses a computer connected to an X-ray machine to obtain detailed pictures of areas inside the body. A dye may be used to help visualize organs or tissues more clearly.
• MRI (magnetic resonance imaging) MRI creates a series of detailed pictures of areas inside the body, using the combination of a powerful magnet, radio waves and computer imaging.
• PET (positron emission tomography) scan This scan is used to identify malignant cells even before an actual “lump or bump” can be detected in a physical exam, or on CAT or MRI scans. A small amount of radionuclide glucose (sugar) is injected into a vein prior to the scan. Because cancer cells divide more frequently than normal cells, they take up more glucose than normal cells and appear brighter in the scan.
• Endoscopic ultrasound A thin, lighted tube called an endoscope is inserted into the body. The device emits ultrasound waves that create images of internal organs and structures.
• Laparoscopy This surgical staging procedure is used to examine internal organs. An incision is made in the abdominal wall and a thin, lighted tube called laparoscope is inserted into the abdomen where various organs can be visualized by the surgeon, and tissue samples and lymph nodes can be removed for biopsy.
• Endoscopic retrograde cholangiopancreatography (ERCP) This procedure is an X-ray examination of the bile ducts which is aided by a video endoscope. Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject dyes into the ducts in the biliary tree and pancreas so they can be better visualized to determine if there has been a blockage or other abnormality.
• Percutaneous transhepatic cholangiography (PTC) PTC is used to X-ray the liver and bile ducts in cases where an ERCP is not possible. A thin needle is inserted through the skin, below the ribs and into the liver. Dye is injected into the liver or bile ducts, and an X-ray is taken. If a blockage is found, a stent may be left in the liver to drain bile into the small intestine, or alternatively, into a collection bag outside the body.