Symptoms/Physical Exam
A diagnosis of pancreatic cancer is usually first suggested by certain symptoms. One common symptom of cancer of the pancreas is jaundice, which causes yellowing of the skin and of the whites of the eyes, as well as darkening of the urine. Pancreatic cancer can also cause pain in the abdomen or in the lower back. Because pancreatic cancer can disrupt the body's ability to digest food, patients may experience unusually bulky and greasy stools as a result of undigested fat. Some patients experience sudden unexplainable weight loss and develop blood clots in their legs. Doctors will do a thorough physical exam on patients with these symptoms and look for the presence of tissue masses or fluid in the abdomen as well as enlargement of the gall bladder and the liver.
Imaging
Once a patient is suspected of having pancreatic cancer, the next step will be to use various imaging modalities to see if there is anything wrong with the pancreas. CT scans and MRIs are two different types of imaging that physicians can use to take a look inside the abdomen and look for any abnormalities. Two other options use special dyes to more accurately look for tumors. One, called a somatostatin receptor scintigraphy, involves injecting the patient with a radioactive compound that will bind to cancer cells in the pancreas. This radioactivity can then be detected using a special camera. Another option is a positron emission tomography scan (PET scan) which involves the injection of radioactive glucose molecules into the patient. The cancer cells will use more of this glucose than other cells and will become slightly radioactive, allowing physicians to better visualize the tumor.
Biopsy
Although physical exams and imaging techniques can strongly suggest that a patient has cancer of the pancreas, the only definitive test is a biopsy. Biopsies involve a physician taking a small sample of the tissue that is suspected of being cancerous and then looking at it under a microscope. Typically, pancreatic tumors are biopsied using fine needle aspiration, in which a needle is inserted into the pancreas to suck up some cells. Some doctors use laparascopy to obtain tissue samples. With laparoscopy, a surgeon makes a small incision and then uses a small flexible camera and special surgical tools to find and then cut away a small tissue sample for examination under a microscope.
