How Is Pancreatic Cancer Diagnosed?
Noninvasive Imaging Tests To get a better look at the pancreas, your doctor may order tests such as an ultrasound, computerized tomography (CT) scans, magnetic resonance imaging (MRI), or positron emission tomography (PET) scans.
Cancer: What Tests Are Involved in the Diagnosis?
Endoscopic Ultrasound To see images of the pancreas taken from inside the abdomen, you may get an endoscopic ultrasound (EUS). This test involves inserting a thin, flexible tube into the mouth and through the digestive track all the way into the small intestine, close to the pancreas. A probe at the end of the endoscope uses sound waves to create an image of the pancreas that may reveal cancer.
Biopsy Your doctor may remove a small tissue sample to examine under a microscope. This is typically done during an endoscopic ultrasound, but can also be performed by inserting a needle through the skin and into the pancreas.
Blood Tests You may get blood tests to look for certain proteins — tumor markers that are shed by cancer cells — that can help determine what type of pancreatic cancer you have, whether it might respond to targeted therapy, and what treatment approach works best.
Learn More About Diagnosing Pancreatic Cancer
Stages and Prognosis of Pancreatic Cancer
After a Cancer Diagnosis Comes the 'Staging'
Resectable Staging One system that doctors use for pancreatic cancer staging focuses on whether it's possible to surgically remove the entire tumor. With this staging system, a tumor is described as "resectable" when it's contained within the pancreas and small enough to remove, "borderline resectable" when it's possible surgery won't get the entire tumor, or "nonresectable" when the tumor within the pancreas is too large or because it has metastasized and spread to other organs and tissue.
TNM Staging This stands for tumor, node, and metastasis staging.
- Tumor When doctors see at least some evidence of a tumor, T category staging ranges from "Tis," for carcinoma in situ that is limited to the outer layers of pancreatic duct cells and easiest to treat, to "T4" for cancer that has spread beyond the pancreas to surrounding organs and tissue as well as nerves or large blood vessels.
- Node When doctors can assess lymph nodes, they will assign N categories: N0 is the stage when they don't see cancer in the nodes and N1 is when cancer has spread to surrounding lymph nodes.
- Metastasis When doctors can assess whether the cancer has spread beyond the pancreas, the staging is M0 for cases when it has not reached surrounding tissue, organs or lymph nodes, and M1 when it has.
Numerical Staging After doctors do TNM staging, they may combine these categories in a numerical staging system from 0 to 4, with lower stages indicating easier to treat tumors with a better prognosis.
When pancreatic cancer is caught early, the five-year survival rate for "localized" tumors that haven't spread to surrounding tissue and organs is about 39 percent. For so-called "regional" tumors that have spread only to tissue near the pancreas, the five-year survival rate is about 13 percent. Once pancreatic cancer spreads to distant organs, tissue, nerves, and blood vessels, the five-year survival rate drops to slightly below 3 percent.
