Diagnosis and Treatment

Diagnosis and Treatment

Diagnosis and Treatment of Pancreatic Cancer

Signs and symptoms of pancreatic cancer include
  • Jaundice
  • Weight loss
  • Decreased appetite
  • New onset diabetes
  • Abdominal or back pain

Tests done to diagnose pancreatic cancer include:

  • Blood tests: pancreatic cancers can produce certain types of chemicals called tumor markers like Carbohydrate Antigen 19-9 (CA19-9) or Carcinoembryonic Antigen (CEA), these are not diagnostic but can be used to track tumors.
  • Scans: Computed Tomography (CT), Magnetic Resonance Imaging (MRI), or Positron Emission Tomography (PET) are multiple imaging techniques used to detect pancreatic tumors including size and location, in addition to sites of disease spread to other areas of the body.
  • Endoscopic Retrograde Cholangiopancreatography (ERCP): this is an endoscopic test done by your gastroenterologist, usually used to diagnose and sometimes treat blocked bile ducts by placing a stent inside of the duct in order to drain the liver and treat jaundice.
  • Endoscopic Ultrasound and Fine Needle Aspiration (EUS/FNA): this is also an endoscopic test done to visualize the tumor using an ultrasound probe mounted on the tip of an endoscope, this can scan the pancreas from inside the stomach or the intestine and get biopsies for diagnosis.

Treatment of pancreatic cancer should be performed by a team of specialists in various medical disciplines, including surgeons/surgical oncologists, medical oncologists, radiation oncologists, gastroenterologists, endocrinologists, radiologists, nutritionists and support groups. Pancreatic cancer treatment is a multimodality treatment and includes surgery, chemotherapy and sometimes radiation therapy. Recent advances include immunotherapy if other treatments fail, in addition to palliative therapy.

Chemotherapy

  • Most pancreatic cancer patients will require chemotherapy at some point in their treatment. Current recommendations suggest chemotherapy being given after surgical resection is achieved, in tumors that can be surgically resected. We have moved to give chemotherapy to patients who have a tumor that cannot be fully removed by surgery, and then offer surgery if the tumor responds to chemotherapy.

Radiation Therapy

  • Similar to chemotherapy, radiation therapy is an important part of the multimodality approach to pancreatic cancer, it might be given before or after surgery depending on the stage of the disease.

Surgery

  • Surgery pancreatic cancer is done for curative or palliative reasons. As a curative surgery, the goal is to surgically remove the cancer in its entirety. Palliative surgery is done of the tumor cannot be fully removed, then bypass procedures will be done to correct the bile duct obstruction and the stomach obstruction that are resulted from involvement by the neighboring tumor.