Gastrointestinal (GI) Oncology Program

Pancreatic Cancer

Symptoms and Diagnosis

Cancer of the pancreas is hard to find (diagnose) because the organ is hidden behind other organs and is not readily felt in routine exams. The signs of pancreatic cancer are like many other illnesses, and there may be no signs in the early stages.

When symptoms do occur, they may include the following:

nausea
digestive problems or loss of appetite
unexplained weight loss
pain in the upper or middle of the abdomen or back
yellowing of the skin (jaundice)

Symptoms of cancer of the endocrine pancreas also include diarrhea, fatigue, faintness, and unexplained weight gain. A person who experiences any of these symptoms should see a doctor.

If a patient has symptoms of pancreatic cancer, the doctor may order an ultrasound, a test that uses sound waves to find tumors. A computed tomographic (CT) scan, a special type of X-ray that uses a computer to make a picture of the inside of the abdomen, may also be done.

If the doctor is looking for evidence of cancer in the endocrine pancreas, he or she will also order blood and urine tests to check the levels of hormones in the body. If the doctor needs to assess whether the blood supply to unaffected organs has been partially blocked by the cancer, he or she may also order another special scan called magnetic resonance imaging (MRI), which uses magnetic waves to make a picture of the inside of the abdomen.

Another test for pancreatic cancer is called an endoscopic retrograde cholangiopancreatography (ERCP). During this test, a flexible tube is put down the throat, through the stomach, and into the small intestine. The doctor can see through the tube and inject dye into the drainage tube (duct) of the pancreas so that the area can be seen more clearly on an X-ray.

During the ERCP, the doctor may also put a fine needle or a brush like a pipe cleaner into the pancreas to take out some cells for examination under a microscope. This procedure is called a biopsy, and it is used to confirm a cancer diagnosis. If the patient has jaundice, a catheter or fine tube may be inserted into the bile duct through the pancreas duct to relieve the jaundice.

Percutaneous transhepatic cholangiography (PTC) is another test that can help find cancer of the pancreas. During this test, a thin needle is put into the liver through the right side. Dye is injected into the bile ducts in the liver so that blockages can be seen on x-rays. To relieve jaundice, a fine tube is sometimes left in the right side of the liver to drain it. In some cases, a needle can be inserted into the pancreas during an X-ray or ultrasound so that cells can be taken out to see if they contain cancer.

Sometimes a doctor will do surgery to look for cancer of the pancreas. The doctor will cut into the abdomen and look at the pancreas and the tissues around it. If he or she finds cancer but it looks like it has not spread to other tissues, the doctor may remove the cancer or relieve blockages caused by the tumor.

This page was last updated on: March 4, 2008.

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