How is it Diagnosed?
Pancreatic cancer is diagnosed through a combination of clinical evaluation, imaging,
endoscopy, and biopsy. Early diagnosis is challenging because symptoms often appear
late and are non-specific—such as jaundice, weight loss, abdominal pain, or back pain.
Initial blood work may reveal elevated bilirubin or liver enzymes if biliary obstruction is
present. Tumor markers, especially CA 19-9, can support diagnosis but are not definitive.
Their levels may also be elevated in other conditions or normal in early disease.
Imaging studies are crucial. Abdominal ultrasound is often the first step, particularly if
jaundice is present. However, contrast-enhanced CT scan of the abdomen is the
preferred modality for assessing pancreatic masses, their size, location, and potential
metastasis. MRI and MRCP (magnetic resonance cholangiopancreatography) provide
detailed images of the pancreatic and biliary ducts.
Endoscopic ultrasound (EUS) is particularly useful for small or non-visible tumors on CT
and allows fine-needle aspiration biopsy for histological confirmation. In cases involving
biliary obstruction, endoscopic retrograde cholangiopancreatography (ERCP) may be
used to place stents and collect brushings for cytology.
A definitive diagnosis relies on pathological examination of tissue obtained via EUSguided biopsy or surgical exploration. Staging with PET-CT or other scans helps guide
treatment decisions. Given its poor prognosis, early detection in high-risk groups (family
history, chronic pancreatitis, genetic syndromes) is crucial.