Pancreatic Cancer (cont.)
Pancreatic cancer is sometimes called a "silent disease" because early
pancreatic cancer often does not cause symptoms. But, as the cancer grows,
symptoms may include:
These symptoms are not sure signs of pancreatic cancer. An infection or other
problem could also cause these symptoms. Only a doctor can diagnose the cause of
a person's symptoms. Anyone with these symptoms should see a doctor so that the
doctor can treat any problem as early as possible.
If a patient has symptoms that suggest pancreatic cancer, the doctor asks
about the patient's medical history. The doctor may perform a number of
procedures, including one or more of the following:
- Physical exam -- The doctor examines the skin and eyes for signs of jaundice.
The doctor then feels the abdomen to check for changes in the area near the
pancreas, liver, and gallbladder. The doctor also checks for ascites, an
abnormal buildup of fluid in the abdomen.
- Lab tests -- The doctor may take blood, urine, and stool samples to check for
bilirubin and other substances. Bilirubin is a substance that passes from the
liver to the gallbladder to the intestine. If the common bile duct is blocked by
a tumor, the bilirubin cannot pass through normally. Blockage may cause the
level of bilirubin in the blood, stool, or urine to become very high. High
bilirubin levels can result from cancer or from noncancerous conditions.
- CT scan (Computed tomography) -- An x-ray machine linked to a computer takes
a series of detailed pictures. The x-ray machine is shaped like a donut with a
large hole. The patient lies on a bed that passes through the hole. As the bed
moves slowly through the hole, the machine takes many x-rays. The computer puts
the x-rays together to create pictures of the pancreas and other organs and
blood vessels in the abdomen.
- Ultrasonography -- The ultrasound device uses sound waves that cannot be
heard by humans. The sound waves produce a pattern of echoes as they bounce off
internal organs. The echoes create a picture of the pancreas and other organs
inside the abdomen. The echoes from tumors are different from echoes made by
The ultrasound procedure may use an external or internal device, or both
- Transabdominal ultrasound: To make images of the pancreas, the doctor places
the ultrasound device on the abdomen and slowly moves it around.
- EUS (Endoscopic ultrasound): The doctor passes a thin, lighted tube
(endoscope) through the patient's mouth and stomach, down into the first part of
the small intestine. At the tip of the endoscope is an ultrasound device. The
doctor slowly withdraws the endoscope from the intestine toward the stomach to
make images of the pancreas and surrounding organs and tissues.
- ERCP (endoscopic retrograde cholangiopancreatography) -- The doctor passes an
endoscope through the patient's mouth and stomach, down into the first part of
the small intestine. The doctor slips a smaller tube (catheter) through the
endoscope into the bile ducts and pancreatic ducts. After injecting dye through
the catheter into the ducts, the doctor takes x-ray pictures. The x-rays can
show whether the ducts are narrowed or blocked by a tumor or other condition.
- PTC (percutaneous transhepatic cholangiography) -- A dye is injected through
a thin needle inserted through the skin into the liver. Unless there is a
blockage, the dye should move freely through the bile ducts. The dye makes the
bile ducts show up on x-ray pictures. From the pictures, the doctor can tell
whether there is a blockage from a tumor or other condition.
- Biopsy -- In some cases, the doctor may remove tissue. A pathologist then
uses a microscope to look for cancer cells in the tissue. The doctor may obtain
tissue in several ways. One way is by inserting a needle into the pancreas to
remove cells. This is called fine-needle aspiration. The doctor uses x-ray or
ultrasound to guide the needle. Sometimes the doctor obtains a sample of tissue
during EUS or ERCP. Another way is to open the abdomen during an operation.
A person who needs a biopsy may want to ask the doctor the following
- What kind of biopsy will I have?
- How long will it take? Will I be awake? Will it hurt?
- Are there any risks?
- How soon will I know the results?
- If I do have cancer, who will talk to me about treatment? When?