The early diagnosis of pancreatic cancer is difficult. Symptoms are often subtle and are not specific until the disease is advanced. When a tumor of the pancreas is suspected, the evaluation should be systematic with the goals of clarifying the diagnosis, staging the disease accurately and directing therapy.
Staging - TNM
The diagnosis and staging of pancreatic cancer includes an assessment of the tumor itself.
T - tumor - the size and relationship to surrounding structures
N - lymph nodes
M - metastatic spread
Diagnostic tests
Pancreas protocol CT
This test is a CT scan focused on the pancreas and liver. The study gives essential information about the location of the tumor and it’s relationship with important blood vessels and other tissues in the area. The study is also important to evaluate for the presence of spread (metastases). The findings on CT (or MRI is used at some institutions) help direct further evaluation and the appropriateness of surgery.
Endoscopic ultrasound (EUS)
EUS has several benefits in the evaluation of patients with pancreatic disease and tumors. EUS is very accurate at evaluating blood vessel involvement and it allows a safe method for biopsy of the tumor and lymph nodes. This is a critical test in determining the diagnosis, stage and feasibility of surgery.
Endoscopic retrograde cholangiopancreatography (ERCP) / Stent
A stent is used to relieve blockages of the bile duct caused by a tumor. Placement of a stent is not essential before surgery but it may be necessary to improve the symptoms of the blockage (i.e. itching or poor digestion). Plastic stents are temporary and are removed at surgery. For patients who prove not to be candidates for surgery a metal stent is often placed as metal stents stay open longer and tend to function better.
Virginia Piper Cancer Institute
Abbott Northwestern Hospital
800 E. 28th St. Minneapolis, MN 55407
612-863-4633
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