Best Test for Detecting Pancreatic Cancer Explained

The pancreas is a nondescript gland in the abdomen that produces digestive enzymes and hormones. It forms part of the digestive and endocrine systems. Pancreatic cancer is a deadly type of cancer that happens when the cells in the pancreas experience out-of-control growth and form a tumour.

The rate of pancreatic cancer in India is low, with an incidence of 0.5–2.4 per 100,000 men and 0.2–1.8 per 100,000 women. However, the rate is slightly higher in the male urban populations of northern and western India. The issue with pancreatic cancer is that it is tough to detect this cancer in its early stages because there aren’t any symptoms.

If the doctor suspects pancreatic cancer, he/she will ask you to carry out certain tests. Given below are the best tests for pancreatic cancer screening, ranked in order of efficacy, least efficacy to the highest efficacy.

Percutaneous Transhepatic Cholangiography (PTC)

In this method, an x-ray of the liver and bile duct is taken. A special dye is injected into the liver and bile ducts. If blocks are found, a thin stent is put in the liver to drain bile into a bag.

This test is done only if Endoscopic Retrograde Cholangiopancreatography (ERCP) isn’t possible. It detects bile duct cancer, or gall bladder cancer, and unblocks bile ducts, removing stones from them.

Abdominal Ultrasound

In this method, pictures of the inside of the abdomen are taken. An ultrasound transducer is held against the stomach to send high energy sound waves into the stomach, which bounce off inside tissues and organs and make echoes, received by the transducer before it sends them to a computer to make photos called a sonogram.

This test is usually the first performed to check for pancreatic cancer. It is more accurate and can help diagnose and stage pancreatic cancer. This is, however, not the best test for pancreatic cancer.

Blood Chemistry Study

This lab test checks a blood sample to detect bilirubin in the body. Whether the levels of bilirubin are higher or lower than normal could mean the sign of a disease. This test also checks for high levels of CA 19-9 (Cancer antigen 19-9).

It can also predict how the cancer will act over time and if remission has occurred post-treatment. When it comes to how to detect pancreatic cancer, this method does fairly well.

Tumour Marker Test

This test involves checking blood, urine, or sample tissue for CA 19-9 and carcinoembryonic antigen (CEA) created by organs, tissues, or tumour cells in the body. Certain substances are linked to certain types of cancer, located in our body at increasing levels, which are known as tumour markers.

This test looks for proteins in the blood that indicate pancreatic cancer. Specifically, it looks for CA 19-9 (cancer antigen 19-9), high levels of which are a sign of pancreatic cancer. Doctors might administer this test for cancer treatment but not to screen or diagnose cancer.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Doctors take an x-ray of the ducts that transport bile from the liver to the gallbladder, then from the gallbladder to the small intestine. Pancreatic cancer narrows and blocks the flow of bile, resulting in jaundice.

A thin, lighted tube, known as an endoscope, is passed orally down the oesophagus and stomach into the duodenum. A catheter is inserted through this endoscope into the pancreatic ducts, after which an X-ray is taken.

If a tumour is there, another tube is inserted into the duct to unblock it, and it is left there so the duct remains open. This method treats gallstones, infections, pancreatitis and narrow or blocked bile or pancreatic ducts.

Laparoscopy

In this surgical procedure, doctors glance at the organs in the abdomen to check for signs of ailments. Small cuts are made in the abdomen wall, and a laparoscope is inserted into the incisions.

This might have an ultrasound probe at the end to bounce high-energy sound waves off internal organs like the pancreas. This is called laparoscopic ultrasound. Other instruments might be passed through, or tissue samples might be taken to judge for cancer.

When imaging tests aren’t enough, a laparoscopy is used. It can avoid unnecessary laparotomy and find distinct or occult metastases. It can also tell you which surgery could be best.

PET SCAN - (Positron Emission Tomography Scan)

In this test, a tiny amount of radioactive sugar (also known as glucose) is injected into a vein. Post this, a scanner revolves around the body, taking detailed, computerised pictures of areas in the body where this glucose travels.

Cancer cells take up more glucose than regular cells; the resultant pics can be used to detect cancer cells in the body. In fact, a PET and CT scan are done together. This scan can find abnormal metabolic activity - an indication of cancer.

It can also find out how much this cancer has spread. This scan is great for finding pancreatic cancer but with low specificity. Combining PET and CT scans can improve test accuracy.

MRI - Magnetic Resonance Imaging

In this procedure, a magnet, radio waves and a computer are used to take detailed snaps of areas in the body. This procedure is also known as nuclear magnetic resonance imaging (NMRI).

It is great for tumours that aren’t visible on other scans. It can find the extent of a tumour and can detect metastases, especially if they’re in the liver.

CT-CAT Scan

In this method, a computer linked to an x-ray machine takes snaps inside the body. The pictures are taken from various angles, creating 3-D views of tissues and organs. Doctors might insert a dye into a vein to show the insides more clearly. Great for staging, finding out tumour location, size and whether it has spread anywhere else.

Endoscopic Ultrasound (EUS)

Doctors insert an endoscope into the body. This endoscope has a light and a lens. It might also carry a probe to bounce high-energy sound waves (ultrasound) off internal organs or tissues and create echoes, which form a picture of body tissues also known as a sonogram.

The procedure itself is called endosonography. This can find tumours inside the pancreas, and tissue samples can also be taken. It is great for early detection of pancreatic cancer, including T-staging, N-staging and M-staging.

It can help with treatments like stereotactic body radiation therapy and injecting medicine into tumours.

Biopsy

In this procedure, doctors remove cells or tissues from the body, viewing them under a microscope to check for cancer signs. There are many ways a biopsy can be done for pancreatic cancer.

A thin needle or core needle might be inserted into the pancreas while an X-ray or ultrasound is being done to get rid of cells. Biopsies are the best for finding pancreatic cancer because they give you a direct tissue sample that can be observed to send a confirmed diagnosis.

In conclusion, a biopsy is the best way to check for signs of pancreatic cancer. This is because doctors actually look at cells and tissues from the body under a powerful microscope. You get a direct tissue sample that can be checked for a proper diagnosis. Once a proper diagnosis is done, you can tell for sure whether there is cancer or not.

A tumour was observed in my CT-SCAN. Should I be worried?

If a tumour was observed in your CT scan, it would be best to get a biopsy done to check whether that tumour is cancerous or not.

I have just recovered from jaundice. Should I get checked for pancreatic cancer?

Recovering from jaundice is quite an ordeal. You must get a second diagnosis of pancreatic cancer just to be sure.

My appetite has fallen drastically. Should I be worried?

Loss of appetite is a sign of pancreatic cancer. Getting the required tests would be a good way to judge whether or not you have pancreatic cancer.

An MRI revealed a tumour in my body. Should I get checked?

If an MRI has revealed a tumour in the pancreas, get a biopsy done to ascertain whether that tumour is cancerous or not.

My Endoscopic Ultrasound came back unfavourable. Should I be worried?

An Endoscopic Ultrasound can find tumours inside the pancreas and get a biopsy of that tumour to assess whether it is pancreatic cancer or not.