Pancreatic Cancer

Diagnosis

Pancreatic cancer is diagnosed using several tests that help identify the disease and determine how far it has progressed. Imaging tests are often the first step. These tests provide detailed pictures of the pancreas and nearby structures. Common imaging options include ultrasound, CT scans, MRI scans and sometimes PET scans. Each test offers unique advantages in identifying tumors or abnormal growths.

Endoscopic ultrasound, also called EUS, is another important tool. During EUS, a long, flexible tube with a camera is inserted through the throat and into the stomach. An ultrasound device on the end of the tube creates images of the pancreas from inside the body. This provides clearer and more detailed views than standard ultrasound.

A biopsy is usually required to confirm the diagnosis. Most commonly, a tissue sample is taken during EUS using special instruments passed through the endoscope. In some cases, a fine needle is inserted through the skin and into the pancreas to collect the sample. The tissue sample is studied in a lab to determine whether cancer is present. Additional testing can identify DNA changes in the cancer cells, helping guide treatment decisions.

Blood tests may also be used. They can detect tumor markers such as CA19-9. While this marker is not elevated in all pancreatic cancers, it can help track how the cancer responds to treatment when it is present.

Genetic testing is recommended for most people diagnosed with pancreatic cancer. A blood or saliva sample is examined for inherited DNA changes that increase cancer risk. These results can guide treatment choices and help identify whether family members may also have a higher risk.

After diagnosis is confirmed, the next step is staging. Staging shows how far the cancer has spread. Stages range from 0 to 4. In early stages, the cancer is limited to the pancreas. Higher stages indicate that the cancer has extended into nearby tissues or organs, and stage 4 means it has spread to distant parts of the body. Staging helps your care team determine your outlook and plan your treatment.

Treatment

Pancreatic cancer treatment depends on the stage of the cancer, its location and your overall health. Treatment plans may aim to cure the cancer when possible. If cure is not possible, the focus shifts to controlling the cancer, slowing its growth and improving quality of life.

Surgery is the main treatment for pancreatic cancer that has not spread beyond the pancreas. One common operation is the Whipple procedure, which removes the head of the pancreas along with parts of the small intestine and bile duct. A distal pancreatectomy is used when the cancer is in the body or tail of the pancreas and often includes removal of the spleen. In rare cases, the entire pancreas is removed. When the cancer involves nearby blood vessels, highly specialized surgery may be needed to remove and reconstruct those blood vessels. Recovery from pancreatic surgery takes time and may involve complications such as delayed stomach emptying.

Chemotherapy uses strong medicines to kill cancer cells. It may be used before surgery to shrink tumors or after surgery to help remove any remaining cancer cells. Chemotherapy is also used when the cancer has spread and surgery is not an option. It may help control symptoms and slow disease progression. Some chemotherapy medicines are given through a vein, while others are taken as pills.

Radiation therapy uses high-energy beams to target and destroy cancer cells. It may be used before surgery, after surgery or alongside chemotherapy. When surgery is not possible, radiation combined with chemotherapy may help shrink the tumor. In advanced cases, radiation can also reduce pain.

Immunotherapy may be an option for people whose cancer cells have specific DNA changes that respond to these treatments. This approach helps the immune system find and destroy cancer cells that would otherwise hide from detection.

Clinical trials may offer access to new treatments not yet widely available. These studies help researchers understand which therapies work best. Your care team can tell you whether a clinical trial may be appropriate for your situation.

Palliative care is a key part of pancreatic cancer management. This specialized medical support focuses on improving comfort and quality of life. Palliative care teams help manage symptoms such as pain, fatigue and digestive issues. They also support emotional and practical needs. Palliative care can be used at any stage of cancer and can be provided along with treatments such as surgery, chemotherapy or radiation. This approach can help people feel better and may even lead to longer survival.