How Pancreatic Cancer Is Diagnosed
There are many tests used for diagnosing pancreatic cancer. Not all tests described here will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:
The type of cancer suspected
Your signs and symptoms
Your age, general health, and family history
The results of earlier medical tests
If a doctor suspects that a person has pancreatic cancer, they will first ask about the person’s medical history and family history. Then, they will examine the person to look for signs of the disease. An appropriate and timely diagnosis is very important. If possible, tests should be done at a medical center that has experience with the disease. The tests described below may be used when pancreatic cancer is suspected. However, the diagnosis should be confirmed with a sample of tissue from the tumor taken during a biopsy, fine needle aspiration, or surgery. These tests are described more below.
New Combination Blood Test For Pancreatic Cancer May Catch Disease Earlier
GRAND RAPIDS, Mich. A new approach to pancreatic cancer screening may help doctors detect the disease in people at high risk before it reaches more advanced and difficult-to treat stages.
A team led by Van Andel Research Institute scientists has developed a new, simple blood test that, when combined with an existing test, detects nearly 70 percent of pancreatic cancers with a less than 5 percent false-positive rate. The results of the blinded study were published in Clinical Cancer Research, a journal of the American Association for Cancer Research.
Pancreatic cancer is difficult to diagnose because it often doesnt have obvious early symptoms. By the time the disease is found, it typically is quite advanced, complicating treatment and leading to poorer outcomes. Only 8.5 percent of people with pancreatic cancer survive past five years, a figure that has risen just slightly since the early 1990s.
Pancreatic cancer is an aggressive disease made even more devastating by its tendency to spread before detection, which is a serious roadblock to successful medical treatment, said Brian Haab, Ph.D., a VARI professor and the studys senior author. We hope that our new test, when used in conjunction with the currently available test, will help doctors catch and treat pancreatic cancer in high-risk individuals before the disease has spread.
What Research Has Been Done
A recently published study found that one of these tests is capable of identifying over 50 types of cancer, and can give information on whether someone has cancer, and where that cancer is.
This study looked at 4,077 people altogether, comprising of 2,823 people with cancer and 1,254 without. Of the 2,823 people who had already been diagnosed with cancer, the test accurately identified these cancers in 51.5% of people.
This might seem low on the surface of things, but that could mean that 50% of people get their cancer picked up earlier than they would have done otherwise. Thus, allowing them to start treatment quickly and giving them the best possible chance of survival.
When this test was used in the group of 1,254 people without cancer, the test accurately identified that these individuals didnt have cancer in 99.5% of cases. This means the âfalse positiveâ rate the rate of which the test shows someone has cancer when they actually dont is only 0.5%.
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Pancreatic Cancer Blood Test
Researchers are working on creating an effective screening blood test for early detection of tumor markers associated with pancreatic cancer. The protein CA 19-9 is a tumor marker that can be detected by a blood test however, levels of this protein do not reliably reflect the presence of pancreatic cancer. Doctors may use the test for patients who have symptoms or require assessment while undergoing treatment.
What Is Cancer And How Does It Occur
Cancer is actually a group of diseases that begin in the bodys basic units of life the cells. There are trillions of cells in the human body that combine to form skin, muscle, bone, breast and blood. In normal cell behavior, cells grow and divide to produce more cells as needed. After a limited number of divisions, the cell is programmed to die, replaced by new, younger cells. What happens, however, when cancer develops, is a loss of control in normal cell growth. In simple terms, cancer is the overgrowth of abnormal cells. Over time, these abnormal cells form a mass of tissue a growth or a tumor that invades and destroys normal tissue. These abnormal cells can also spread throughout the body, resulting in metastatic cancer.
Research continues on the many causes of cancer, a complex disease that develops as a step-by-step process before it becomes lethal. What researchers know for certain is that while exact causes of many cancers are not yet known, both external and internal factors play a role in cancer developing, including genetics, aging, lifestyle choices, exposure to carcinogens and infections.
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New Blood Test Detects Early Stage Pancreatic Cancer
- Lund University
- Pancreatic cancer is currently very difficult to detect while it is still resectable. A new blood test can detect pancreatic cancer in the very earliest stages of the disease.
Pancreatic cancer is currently very difficult to detect while it is still resectable. A new blood test developed by researchers at Lund University in Sweden, Herlev Hospital, Knight Cancer Center and Immunovia AB, can detect pancreatic cancer in the very earliest stages of the disease. The results have been published in the Journal of Clinical Oncology.
Due to diffuse symptoms, pancreatic cancer is usually diagnosed very late in the disease progression. Therefore, despite pancreatic cancer representing less than 3% of all cancer cases, more people currently die from it than breast cancer. By 2030, pancreatic cancer is expected to be the second deadliest type of cancer in the world.
“Our test can detect pancreatic cancer with 96% accuracy at stage I and II, while there is still the possibility of successful surgical intervention. There is currently no cure and few treatment options for advanced pancreatic cancer, which is the late stage when pancreatic cancer is usually diagnosed,” explains Carl Borrebaeck, professor at the department of Immunotechnology at Lund University.
The study used samples from patients in both Denmark and the US, at different stages of the disease.
What Are Some Measures I Can Take To Avoid Breast Cancer Or Minimize The Disease
Most experts agree that screening is the best way to catch breast cancer in its early stages. It doesnt prevent cancer but it can lead to quick detection and a better outcome. There is still some debate about when or whether to get screened for breast cancer, stemming from a study that showed more deaths from breast cancer occurred in younger women who didnt get regular mammograms. Arguments arose about false positives and over-treatment. In addition, different surveys can lead to different answers, so the best advice is to consult with your healthcare provider about your individual situation and relevant risk factors. An annual mammogram for women over 40 is still a good guide. The CA 27.29 is a blood test, a tumor marker, specific for screening for breast cancer. Other ways to boost your chances of not getting breast cancer and improve your overall health:
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What Do Your Test Results Mean
Your test results will confirm if you have pancreatic cancer or not. If you do have pancreatic cancer, the test results will give your doctor detailed information on your cancer and its stage. The stage of your cancer describes the size of the cancer and whether it has spread around the pancreas, or to other parts of the body. This information helps your doctor work out the best treatment for you.
It can take time to come to terms with a diagnosis of pancreatic cancer. You and your family should be given information and support to help you deal with your diagnosis and the emotional impact of pancreatic cancer.
If you have recently been diagnosed with pancreatic cancer, find out more about what your diagnosis means.
How Long Will I Have To Wait For My Test Results
It may take from a few days to a couple of weeks to get the test results ask how long it will be when you go for the test. You can also ask who to contact if you dont hear anything. You will need an appointment with your consultant to find out what the results show and discuss what happens next.
Your test results should also be sent to your GP, and you may be sent a copy of the letter. If theres anything in the letter thats not clear, your GP or medical team can help explain what it means.
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What Is It Used For
CA 19-9 blood tests may be used to:
- Monitor certain types of cancer and cancer treatment. CA 19-9 levels often go up as cancer grows and go down as tumors shrink.
- Help predict how cancer may behave over time.
- Check whether cancer has returned after treatment.
- Help diagnose certain cancers and other diseases when used with other tests.
Some people do not make CA 19-9 even when they have a cancer that usually produces high levels of CA 19-9. For these people, a CA 19-9 tumor marker test is not useful.
Why Is Pancreatic Cancer Hard To Find Early
- The pancreas is deep in the abdomen. Doctors usually cannot see or feel the tumor during a physical exam.
- Pancreatic cancer symptoms are not always obvious and usually develop over time.
- Tests used to diagnose pancreatic cancer do not always detect small lesions, pre-cancers or early-stage cancers well.
- Researchers have had a hard time figuring out which people to screen. Broad screening can cause medical, emotional and financial challenges.
- Doctors use several tests to diagnose pancreatic cancer, but there is no standard, single test.
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Is It Hard To Catch Pancreatic Cancer Early
Pancreatic cancer is difficult to diagnose early. Pancreatic cancer very rarely causes early symptoms, and people without an elevated risk for pancreatic risk arent typically screened for cancer.
Often, pancreatic cancer isnt found until symptoms appear unless its found during testing for another, unrelated, condition. As more early-detection tests are developed and become available, this might change, and screening for pancreatic cancer could become standard.
Imaging Tests: A Look Inside The Body
Imaging tests can help doctors look for pancreatic cancer and determine how far the disease has spread.
There are a number of different imaging tests that doctors can utilize if they suspect pancreatic cancer. A few of the key ones:
- Computed Tomography These scans create cross-sectional images of the body that show the pancreas in detail. There are also specialized CT scans aimed at diagnosing pancreatic disease.
- Magnetic Resonance Imaging MRIs employ radio waves and strong magnets to visualize soft tissue in the body. Doctors can use specialized MRI scans to get a good look at the pancreas.
- Ultrasound This test produces images by creating sound waves and detecting echoes within the body. Endoscopic ultrasound involves a small probe placed at the end of an endoscope that is threaded through your mouth, esophagus, and stomach into the small intestine, close to the pancreas.
- Endoscopic Retrograde Cholangiopancreatography Using an endoscope, doctors thread a tiny video camera into the small intestine to help place a catheter into the common bile duct. By injecting a small amount of contrasting dye through the catheter, the physician can take X-rays of the bile and pancreatic ducts that may indicate any narrowing or blockages potentially caused by cancer.
Why Is Early Detection Important
For eligible patients, surgery is the best option for long-term survival of pancreatic cancer. It can increase a patients survival by about ten-fold. But most patients are diagnosed at later stages and cannot have surgery.
In addition, although 15-20% of pancreatic cancer patients may be eligible for surgery, data shows that up to half of those patients are told they are ineligible. The Pancreatic Cancer Action Network strongly recommends you see a surgeon who performs a high volume of pancreatic surgeries to determine eligibility.
Ways to find pancreatic cancer in the earliest stages are urgently needed. The Pancreatic Cancer Action Network, other advocacy organizations and the scientific community are working to find pancreatic cancer earlier through:
- Studies focused on biomarkers that could help doctors diagnose, monitor and treat the disease
- Efforts to improve how people at high risk are found and monitored
Blood Tests For Early Detection
In addition to tumor marker tests, some newer tests are geared toward detecting pancreatic cancer early. This is important since the outlook for pancreatic cancer declines sharply if the diagnosis is only made once the cancer has progressed to a more advanced stage.
- The GalleriTM test can detect more than 50 types of cancer, including pancreatic cancer. It does this by looking for DNA from cancer cells that are shed into the blood. DNA from cancer cells can look different than the DNA of healthy cells.
- The PanCan-d test is specific for pancreatic cancer. It detects for pancreatic cancer, including CA19-9. The measurements from these biomarkers are then combined into an equation to produce your result.
There are, however, some drawbacks to these tests:
- Neither test has received approval from the Food and Drug Administration .
- Testing can be costly, about $1,000, and isnt covered by insurance, although payment plans may be available.
- Who can get the tests may be restricted based on age, pancreatic cancer risk factors, and location.
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New Ai Blood Test Technology To Detect Liver Cancer
The blood test, called DELFI detects fragmentation changes among DNA from cancer cells shed into the bloodstream, known as cell-free DNA . In the most recent study, investigators used the DELFI technology on blood plasma samples obtained from 724 individuals in the U.S., the European Union and Hong Kong to detect hepatocellular cancer , a type of liver cancer.
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Genetic Testing For People Who Might Be At Increased Risk
Some people might be at increased risk of pancreatic cancer because of a family history of the disease . Sometimes this increased risk is due to a specific genetic syndrome.
Genetic testing looks for the gene changes that cause these inherited conditions and increase pancreatic cancer risk. The tests look for these inherited conditions, not pancreatic cancer itself. Your risk may be increased if you have one of these conditions, but it doesnt mean that you have pancreatic cancer.
Knowing if you are at increased risk can help you and your doctor decide if you should have tests to look for pancreatic cancer early, when it might be easier to treat. But determining whether you might be at increased risk is not simple. The American Cancer Society strongly recommends that anyone thinking about genetic testing talk with a genetic counselor, nurse, or doctor before getting tested. Its important to understand what the tests can and cant tell you, and what any results might mean, before deciding to be tested.
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Biopsy And Tissue Tests
Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis for most cancers. A pathologist then analyzes the sample. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. For pancreatic cancer, the pathologist may often have specific experience in looking at pancreatic cancer biopsy samples. There are a couple of different ways to collect a tissue sample:
Fine needle aspiration . An FNA uses a thin needle that is inserted into the pancreas to suction out cells. This is typically done by EUS or through the skin, called percutaneously, guided by a CT scan.
Core needle biopsy. This is used to collect a larger piece of tissue, which may be helpful for biomarker or genetic testing of the tumor . However, a core biopsy has higher risks than an FNA, including pancreatitis and bleeding. It should be performed by a gastroenterologist who has been specifically trained and has significant experience in performing EUS.
After diagnostic tests have been performed, your doctor will review the results with you, including the exact type of cancer you have, how much the cancer has grown and spread , and the options for treatment. You may request copies of all test results and images for your own files.
Stages Of Pancreatic Cancer
- Localized and Resectable The cancer is confined to the pancreas and is resectable, meaning that in most cases, it can be surgically removed. After surgical removal, most patients receive additional treatment such as cancer drugs or radiation therapy.
- Locally Advanced and Unresectable When cancer cannot be removed entirely by surgery, it is termed unresectable. Although the cancer has not yet spread to distant organs, the involvement of local structures, usually major blood vessels, make surgical removal technically impossible. In some cases, surgery might be done to relieve symptoms or problems caused by the cancer. Treatment generally includes drugs and sometimes radiation.
- Metastatic The cancer has spread to distant organs. In this case, surgery might be done to relieve symptoms or problems caused by the cancer. More often, drug therapy is used.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
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