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 Liu Liang
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How to screen for pancreatic cancer

Pancreatic cancer is a common malignant tumor of the digestive tract. Due to its high malignancy and rapid progression, it severely affects human health. So how should pancreatic cancer patients be screened? Generally, abdominal ultrasound examination is the primary screening method. Another method is the examination of tumor markers, mainly carcinoembryonic antigen (CEA) and CA19-9. CA19-9 is a tumor marker with relatively high specificity and sensitivity for the diagnosis of pancreatic cancer. Therefore, during physical examinations, we can draw blood to check these tumor markers. If there is a significant increase in CA19-9 or CEA, further examinations of the pancreas, such as ultrasound or CT of the pancreas, should be conducted to further investigate whether there is a tumor in the pancreas.

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Written by Liu Liang
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What to do about pancreatic cancer pain?

Pancreatic cancer pain is common in clinical practice, with some patients presenting with abdominal pain as their initial symptom. Pain management can be symptomatic, using analgesics for relief. For mild pain, tramadol can be chosen for pain relief. For severe pain, opioid analgesics such as morphine sustained-release tablets, oxycodone sustained-release tablets, or morphine tablets can be used for pain relief. These are merely symptomatic treatments. The fundamental approach involves surgical or oncological treatments like chemotherapy or radiotherapy to treat pancreatic cancer. Only when the tumor is controlled will the symptoms of pain be alleviated.

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Written by Liu Liang
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Dietary Taboos for Patients with Pancreatic Cancer

Regarding the dietary restrictions for pancreatic cancer patients, there are no specific prohibitions. The main recommendation is to avoid what we typically refer to as junk food, such as barbecued foods and pickled products. Aside from avoiding these foods, it is important to focus on a nutritious and balanced diet, with a good mix of both meat and vegetables. Additionally, because pancreatic cancer patients may experience symptoms like abdominal pain, nausea, vomiting, and a feeling of fullness or discomfort in the upper abdomen, the diet should primarily consist of light and easily digestible foods. In doing so, while ensuring that the patient receives sufficient nutrition, it is best to consume foods that are easy to digest and nutritionally balanced.

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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
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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.