Your doctor will ask you about your symptoms, and medical and family history. The abdomen and surrounding areas will be carefully examined. Your doctor may look for other possible causes of your symptoms. If cancer or other gastrointestinal conditions are suspected, a specialist may be recommended.
If you are having symptoms that suggest problems with the pancreas, further testing will be done. Tests can help confirm a cancer diagnosis or another condition, such as pancreatitis. Tests may include:
Diagnosis of pancreatic cancer is confirmed with a biopsy. A biopsy is the removal of an area of suspicious tissue. A pancreatic biopsy is done during an ERCP, laparoscopy, or through a fine needle aspiration (FNA). With FNA, a small needle is inserted through the abdomen and into the pancreas. The tissue sample is then examined under a microscope. A biopsy will not only confirm that cancer is present, but can also show what type of cancer is there.
If pancreatic cancer is confirmed, results from completed tests and new tests will help determine the stage of cancer. Staging is based on the characteristics of the tumor. It will help develop the prognosis and treatment plan. Factors that play a role in staging include where the tumor is found, how far the original tumor has spread, whether lymph nodes are involved, if cancer has spread to other tissue, and microscopic cellular details.
Tests that may help determine pancreatic cancer stage:
Pancreatic cancer is staged from 0-IV:
For planning treatment, sometimes another staging method is used. In this method, staging is based on whether or not the tumor can be surgically removed. These stages include:
Prognosis is a forecast of the probable course and/or outcome of a disease or condition. Prognosis is most often expressed as the percentage of patients who are expected to survive over 5 or 10 years. Cancer prognosis is an inexact process. This is because the predictions are based on the experience of large groups of patients with cancer in various stages. Using this information to predict the future of an individual patient is always imperfect and often flawed, but it is the only method available.
Pancreatic cancer is often relatively advanced at the time that it is diagnosed. As a result, the number of patients who survive for 5 years or more after diagnosis is very small, perhaps as low as 5%. About 21% of all patients diagnosed with pancreatic cancer survive for a year after diagnosis.
De La Cruz MD, Young AP, Ruffin MT. Diagnosis and management of pancreatic cancer. Am Fam Physician. 2014;89(8):626-632.
General information about pancreatic cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq#section/_110. Updated December 23, 2016. Accessed March 23, 2017.
Pancreatic cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114527/Pancreatic-cancer. Updated July 6, 2016. Accessed March 23, 2017.
Pancreatic cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gastrointestinal-disorders/tumors-of-the-gi-tract/pancreatic-cancer. Updated January 2017. Accessed March 23, 2017.
Stages of pancreatic cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq#section/_139. Updated December 23, 2016. Accessed March 23, 2017.
Tests for pancreatic cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/pancreatic-cancer/detection-diagnosis-staging/staging.html. Updated May 31, 2016. Accessed March 23, 2017.
Last reviewed September 2017 by Mohei Abouzied, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.