Diagnosing pancreatic cancer
In the early stages, pancreatic cancer often causes no symptoms. This can make it difficult to diagnose.
If you visit your GP with symptoms of pancreatic cancer, they will probably examine your eyes and skin for signs of jaundice.
They may also test your urine for bile, or carry out a blood test. This is because jaundice can sometimes be a sign of pancreatic cancer.
Your GP may also examine your tummy (abdomen) to feel for any swelling or abnormality. The pancreas is quite well-hidden within the body because it's covered by part of the bowel. This can make it difficult to feel for tumours during a physical examination.
If your GP suspects pancreatic cancer, you'll be referred for further testing at a hospital. Some of the tests you may need are outlined below.
In 2015, the National Institute for Health and Care Excellence (NICE) published guidelines to help GPs recognise the signs and symptoms of pancreatic cancer and refer people for the right tests faster. To find out if you should be referred for further tests for suspected pancreatic cancer, read the NICE 2015 guidelines on Suspected Cancer: Recognition and Referral.
An ultrasound scan is a painless procedure that uses high-frequency sound waves to produce an image of the inside of your body.
If pancreatic cancer is suspected, you'll be referred for an ultrasound scan of your abdomen to see if your pancreas appears abnormal.
However, this type of scan can often miss pancreatic cancer, because ultrasound waves aren't very good at penetrating deep into body tissues.
Computerised tomography (CT) scan
A computerised tomography (CT) scan produces a detailed image of the inside of your body using a series of X-ray images.
Your doctor can use the results of a CT scan to check for abnormalities and assess the size of the tumour.
Magnetic resonance imaging (MRI) scan
A magnetic resonance imaging (MRI) scan also produces an image of the inside of your body, but it uses strong magnetic and radio waves instead of X-rays.
MRI scans are carried out in a tube-shaped MRI scanner. It's a noisy procedure that can feel claustrophobic. It also takes longer than other types of scans.
Like a CT scan, an MRI scan allows your doctor to check for signs of cancer in other parts of the body.
Positron emission tomography (PET) scan
A positron emission tomography (PET) scan can help to show where the cancer is and whether it has spread to other parts of the body.
Before the scan, you'll be given an injection of a very small amount of a radioactive medication, known as a tracer. The amount of radiation is very small and no more than you would receive from a normal X-ray.
The most common tracer used is a radioactive form of glucose (sugar). You'll then rest for about an hour to allow the tracer to travel to areas in your body where glucose is used for energy.
The scan itself can take up to an hour and produces an image of the tracer in your body. The tracer shows up cancers because they use glucose in a different way to normal tissue.
Endoluminal ultrasonography (EUS)
If a small shadow is seen on a CT or MRI scan but it's not obvious what it is, another test called endoluminal ultrasonography (EUS) can be carried out.
During EUS, a thin, flexible instrument called an endoscope is passed through your mouth and guided towards your stomach.
An ultrasound probe attached to the tip of the endoscope will then be used to take close-up pictures of your pancreas.
Before the procedure, you may be given a sedative to help you relax. EUS can also be used to take a biopsy (see below) for further examination.
Endoscopic retrograde cholangiopancreatography (ERCP)
Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure used to insert a plastic tube or stent into the bile duct if someone has jaundice.
During ERCP, an endoscope is passed through your mouth and guided towards your stomach. The endoscope can then be used to inject a special dye into your bile and pancreatic ducts.
After the dye has been injected, an X-ray will be taken. The dye will show up on the X-ray and will highlight any tumour that's blocking the bile and pancreatic ducts.
During the procedure, tissue samples may be taken. These samples can be looked at under a microscope to see whether the cells are cancerous.
ERCP can take 30-60 minutes. As with EUS, you'll usually be given a sedative to help you relax.
A laparoscopy is a surgical procedure that allows the surgeon to access the inside of your abdomen and pelvis.
During the procedure, a small incision will be made in your abdomen, and a laparoscope (a thin, flexible microscope) will be inserted.
This will allow the surgeon to see inside your body and make sure the tumour hasn't spread before recommending its removal.
This procedure will be carried out under a general anaesthetic (where you're put to sleep so you don't feel any pain or discomfort).
A biopsy involves taking a sample from a suspected tumour, which can then be tested to see if it's cancerous (malignant) or non-cancerous (benign).
A biopsy can be carried out during an EUS, ERCP or laparoscopy using a small instrument attached to the endoscope to collect a number of cells.
It's also possible for a biopsy to be carried out using a long, thin needle that's passed through your abdomen. The needle will be guided towards the tumour using an ultrasound or CT scan.
Page last reviewed: 10/07/2014
Next review due: 10/07/2016