How is pancreatic cancer diagnosed?

Written by Zhou Chen
Oncology
Updated on September 19, 2024
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Ultrasound, CT, MRI, ERCP (Endoscopic Retrograde Cholangiopancreatography), PTCD (Percutaneous Transhepatic Cholangio Drainage), angiography, laparoscopy, tumor markers measurement, cancer gene analysis, etc., are significantly helpful in confirming the diagnosis of pancreatic cancer and determining whether it is resectable surgically. Generally, ultrasound, CA199, and CEA can be used as screening tests. Once pancreatic cancer is suspected, a CT scan is necessary. If the patient has jaundice, especially severe, and a CT scan cannot confirm the diagnosis, ERCP and PTCD can be considered. If internal drainage is successful, surgery can be delayed for one to two weeks for patients with severe jaundice. The diagnostic value of MRI for pancreatic cancer is not superior to CT. If pancreatic cancer has been confirmed but it is uncertain whether it can be surgically removed, choosing angiography and laparoscopy is also clinically meaningful.

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Written by Zhou Zi Hua
Oncology
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Reasons for the low resection rate of pancreatic cancer

The resection rate for pancreatic cancer is relatively low because the pancreas is located behind the peritoneum in a deep position. In the early stages of pancreatic cancer, there are often no specific clinical symptoms. Therefore, by the time pancreatic cancer is detected in patients, it is usually already in the advanced stages. The pancreas is surrounded by blood vessels and nerves. Therefore, if it is found in the late stage, the surgical difficulty is very high, making it difficult to remove surgically, which is why the surgical resection rate for pancreatic cancer is low.

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Written by Zhou Chen
Oncology
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What are the symptoms of pancreatic cancer?

The clinical manifestations of pancreatic cancer mainly depend on the location of the cancer, the stage of the disease, whether there is metastasis, and the involvement of adjacent organs. The clinical characteristics include a short disease course, rapid progression, and swift deterioration. The most common symptom is upper abdominal distension and discomfort, pain, though not all patients experience tenderness; if tenderness is present, it aligns with the area of pain felt. Pain is a primary symptom of pancreatic cancer, present whether the cancer is located in the head or the body/tail of the pancreas. Jaundice is a main symptom of cancer in the head of the pancreas, and patients often exhibit more severe gastrointestinal symptoms, most commonly loss of appetite, followed by nausea and vomiting. There might also be diarrhea or constipation, even melena. Diarrhea is often steatorrhea. In the early stages of pancreatic cancer, common symptoms include weight loss and fatigue.

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Written by Liu Liang
Oncology
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How is pancreatic cancer diagnosed?

The most common symptoms of pancreatic cancer are pain in the upper abdomen and jaundice. During physical examination, a mass in the upper abdomen can be felt, which is a common symptom. When these symptoms appear, further abdominal ultrasound or CT scans should be performed, as these two are the most commonly used imaging methods for diagnosing pancreatic cancer. Additionally, pancreatic MRI or PET-CT can also help enhance the diagnostic accuracy for pancreatic cancer. MRCP and ERCP are also used to assess the bile ducts and to evaluate the feasibility of surgery. Blood tests for pancreatic cancer-related tumor markers, such as carcinoembryonic antigen (CEA) and CA19-9, are commonly performed, with CA19-9 being particularly sensitive and specific for the diagnosis of pancreatic cancer.

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Written by Yan Chun
Oncology
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What are some symptoms of early pancreatic cancer?

Patients with early-stage pancreatic cancer generally do not exhibit many symptoms, as the tumors are relatively small. Clinically, many patients may experience intermittent mild abdominal pain that does not affect their daily lives. A small number of early-stage patients may exhibit symptoms of general fatigue, mild loss of appetite, nausea, mild acid reflux, or other symptoms of indigestion. Additionally, a few patients in the early stages may experience intermittent episodes of diarrhea. Because these symptoms are not distinctive, patients rarely seek medical attention early. When symptoms like significant epigastric pain and jaundice become apparent, it often indicates that the pancreatic cancer has progressed to a more advanced stage.

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Written by Yan Chun
Oncology
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Five Early Symptoms of Pancreatic Cancer

The five major symptoms of early pancreatic cancer patients include abdominal pain, jaundice, abdominal distension, diarrhea, fatigue, and more, among which the occurrence of abdominal pain is higher. Many patients with early pancreatic cancer experience persistent and hidden abdominal pain without other clinical symptoms, which often leads to missed opportunities for early diagnosis; Secondly, jaundice is also a main manifestation of early pancreatic cancer, particularly in the head of the pancreas, mainly due to the tumor causing obstructive jaundice; Thirdly, abdominal distension, which is generally a mild distension and often does not significantly attract clinical attention; Fourthly, patients often feel a general fatigue, which is difficult to alleviate with ordinary treatment methods; Lastly, diarrhea, which is often due to abnormal secretion of digestive fluids caused by the pathology, leading to diarrhea.