How Pancreatic Cancer Is Diagnosed: Imaging, Endoscopy & Biopsy

What are the diagnostic methods used for Pancreatic cancer?

In most cases, pancreatic cancer cannot be diagnosed in the early stages because it’s difficult to detect. Studies have suggested that healthcare professionals can’t feel the pancreas during routine examinations, and it’s difficult to see any kind of tumors on regular imaging tests. 

If your medical team finds any symptoms of pancreatic cancer, they might recommend a combination of pancreatic function tests, these may include:

Imaging tests

Imaging tests play an important role in recognizing any type of abnormality in the pancreas. Performing these tests helps to locate tumors, assess their size, and determine whether the cancer has spread into other body parts. 

Common imaging tests may include: 

• CT Scan: This is an imaging test, also referred to as computed tomography, that provides detailed cross-sectional images. This is often the first imaging test recommended for suspected cancer patients. 
• MRIs: This is another imaging test, also referred to as magnetic resonance imaging, which is especially useful for diagnosing any types of small tumors and examining blood vessels often found near the pancreas. 
• PET Scan: This is another significant imaging test, also referred to as positron emission tomography, this scan offers a much clearer view from inside the body. 
• Endoscopic ultrasound (Abdominal or Endoscopic): Studies have shown that standard ultrasound might miss any type of deep tumors, while endoscopic ultrasound offers a clearer view from the inside. 

Endoscopic procedures

Studies have shown that imaging tests such as CT scans and MRIs reveal a suspicious area in the tests, whereas an endoscopy procedure provides an internal examination and tissue sampling for the diagnosis. 

Here are some of the key endoscopic tools used for diagnosis:

• Endoscopic Ultrasound: This is a medical procedure combining an endoscopy with ultrasound. It is a flexible tube attached to a camera and ultrasound equipment inserted into the mouth to get close to the pancreas. It also allows for tissue sampling with the help of fine-needle aspiration. 
• ERCP: This is a medical procedure also referred to as endoscopic retrograde cholangiopancreatography. This is a significant diagnostic method used to collect procedures of the pancreas along with the digestive tract. 
• SpyGlass Cholangioscopy: This is an highly advanced technique used to detect and analyse certain pancreatic conditions including cancer. 

Biopsy: Confirming the cancer diagnosis

Studies have claimed that scans and tests can only suggest cancer in people, while only a biopsy can confirm the presence of cancer. 

There are few types of biopsies recommended. 

These may include:

• Fine Needle Aspiration Biopsy (FNAB): This type of biopsy is often performed during endoscopic ultrasounds (EUS); a small needle mostly collects a sample directly from the tumor developed in the pancreas. 
• Core Needle Biopsy: A core needle biopsy helps to collect large samples, and it is often preferred if more tissue is needed for the pancreatic cancer diagnosis. This type of biopsy is often performed during endoscopic ultrasounds. 
• Laparoscopic Biopsy: This is a minimally invasive surgical procedure that can be mostly used to detect cancer by collecting sample tissues for the examination. 

Blood tests

Studies claim that performing a pancreas blood test can detect the tumor markers in the suspected cancer patients. 

Types of blood tests performed for cancer diagnosis:

CA 19-9 Tumor markers:

An increased level of carbohydrate antigen (CA) 19-9 may indicate cancer. CA 19-9 is a type of protein released by the pancreatic cancer cells.

Liver function tests:

These tests are often performed if there’s a suspicion of cancer in patients. Doctors often recommend this test if jaundice is present in people. It helps to understand if bile ducts are blocked due to the tumor or due to any liver issues.

Genetic and molecular testing

The genetic and molecular testing for this cancer diagnosis helps to identify if there’s any hereditary factor that has caused the cancer. These tests are crucial to determine what type of treatment plans are helpful and effective for the patients.

An oncologist might suggest undergoing genetic testing to recognize any genetic mutation, such as BRCA1, BRCA2, or KRAS, which often influences many treatment decisions and also helps to identify any history of cancer in the families.

Studies suggest that, anyone who is a first-degree relative such as parent, child or sibling of someone with this cancer should consider getting a genetic testing. These results can tell you if you have any BRCA1 and BRCA2 mutations in the body. 

However, keep in mind that if you have any mutation, it doesn’t mean you have cancer. But understanding the risk can reduce the chance of developing cancer by taking precautionary steps.