Diagnosis & staging
These are tests that may be used to diagnose this type of cancer.
- Physical examination
- Stool examination to look for hidden blood
- Blood tests to evaluate liver function. Sometimes pancreatic cancer can affect the liver and this can be detected on blood tests.
- Abdominal ultrasound uses sound waves to produce a picture of the organ which can locate a tumour.
- CT scan can show a cross section view of the organ. It can pinpoint the size and location of the tumour.
- Biopsy. A small amount of tissue is removed for examination under a microscope.
- Fine needle aspiration. A type of biopsy using a small needle inserted into a mass to withdraw tissue.
- Laparoscopy. A thin instrument is inserted into the abdomen to view the pancreas; used to biopsy and stage the cancer.
- Endoscopic ultrasound (EUS). An ultrasound probe is inserted via your mouth under sedation and sound waves are used to see the tumor and take a biopsy.
- Endoscopic retrograde cholangiopancreatography (ERCP) A small camera is inserted via your mouth. This test is done while you are sedated. Images of of the pancreatic duct and bile ducts are taken. This is not routinely used for diagnosis, but is often used to help with an obstruction which causes jaundice.
For more information on tests used to diagnose cancer, see our Recommended Websites, Diagnostic Tests
Types and Stages
- Pancreatic tumours can be of exocrine or endocrine origin.
- Exocrine tumours are the most common type of pancreatic cancer.
- Most (90%) of exocrine pancreatic cancers are adenocarcinomas.
- Adenosquamous, undifferentiated small cell carcinomas, cystadenocarcinomas and lymphomas are rare types of exocrine pancreatic cancer.
- Cystadenomas are a rare type of tumour of the exocrine pancreas; most are benign.
- Islet cell tumours or insulin secreting tumours are pancreatic cancers of endocrine origin. They are uncommon and can be less aggressive than exocrine tumours.
Staging describes the extent of a cancer. The TNM classification system is used as the standard around the world. In general a lower number in each category means a better prognosis. The stage of the cancer is used to plan the treatment.
T describes the site and size of the main tumour (primary)
N describes involvement of lymph nodes
M relates to whether the cancer has spread (presence or absence of distant metastases)
- In pancreatic cancer, staging has limited impact on survival.
Limited to the pancreas, 2 cm or smaller in size.
Limited to the pancreas, bigger than 2 cm in size.
Has spread outside the pancreas, but not into large blood vessels, lymph nodes or other parts of the body.
Stage IIB May have spread outside the pancreas but not into nearby large blood vessels. It has spread to nearby lymph nodes, but not to other parts of the body.
Stage III Has spread into nearby large blood vessels, may or may not have spread to nearby lymph nodes, has not spread to other parts of the body.
Has spread to other parts of the body.