Diagnosing Pancreatic Cancer

About Pancreatic Cancer

At Penn Medicine, patients with pancreatic cancer receive their care from a multidisciplinary team of nationally recognized experts in the diagnosis, treatment and research of gastrointestinal cancer.

Pancreatic cancer is cancer that develops within the pancreas, the gland about six inches long that is responsible for making hormones, including the enzymes responsible for the digestion of food and control of blood sugar.

Pancreatic cancer develops when cells within the pancreas begin to grow out of control. It may spread, or metastasize, to nearby lymph nodes and organs such as the liver and lungs.

The pancreas has three sections:

  • Head: Part of the pancreas adjacent to the small bowel and liver ducts
  • Body: Middle of the pancreas
  • Tail: End of the pancreas near the spleen

About 90 percent or more of pancreatic cancer develops in the head of the pancreas.

Penn Medicine's multidisciplinary approach to cancer diagnosis and treatment provides better outcomes and gives patients access to the most advanced treatment, surgical techniques and clinical trials.

Because navigating a new cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them simplify entry into Penn and make an appointment with the right physician.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN (7366).

Read more About Pancreatic Cancer

Diagnosing Pancreatic Cancer

An accurate cancer diagnosis from trusted cancer specialists is the first step in getting personalized treatment options to treat pancreatic cancer.

Patients who choose Penn's Abramson Cancer Center, benefit from a multidisciplinary team of cancer specialists including gastroenterologists, radiologists, pathologists and surgeons who work together to provide both a diagnosis and treatment plan individualized for each patient with pancreatic cancer.

Cancer specialists at Penn Medicine are highly experienced in using the most advanced techniques for diagnosing pancreatic cancer and are actively researching better and more precise ways to detect pancreatic cancer.

Because an accurate diagnosis is an important step in planning cancer treatment, it's important patients know that when they come to Penn Medicine, they are taking an important step in getting the best cancer treatment.

Navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right person. Penn Medicine's contact center has experienced cancer nurses available and ready to guide patients in finding the cancer specialist right for them.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN (7366).

Screening for Pancreatic Cancer

Currently, for the general population there are no recommended screening tests for pancreatic cancer, like mammograms for breast cancer or colonoscopies for colonic growths. For patients at high risk, such as those who have family members with pancreatic, breast or colon cancer, an assessment of the risk and screening should be considered.

The cancer risk evaluation programs at Penn Medicine can help patients determine if screening tests and possibly genetic testing may be needed.

Diagnostic Tools for Pancreatic Cancer

When physicians suspect pancreatic cancer, they may order several tests to make a diagnosis.

  • Physical exam. Physicians may feel the abdominal area to check for changes near the pancreas, or fluid buildup. They may also examine the skin for jaundice.
  • Blood tests. Blood tests may be ordered to look for antigens in the blood specifically created by pancreatic tumors.
  • Imaging tests. Pictures of the inside of the body can help find out whether a suspicious area might be cancerous, to learn how far cancer may have spread, and to help determine if treatment is working.
    • Endoscopic ultrasound (EUS). A thin, lighted tube is passed through to the small intestine, while ultrasound waves image tissue in the pancreas and other organs. Fine-needle aspiration (FNA) biopsies of the pancreas are commonly obtained this way. EUS combines the flexibility of an endoscope with the high resolution of an ultrasound and helps with staging. Penn’s EUS program has one of the largest patient volumes in the country and onsite rapid cytopathology interpretation is provided.
    • Endoscopic retrograde cholangiopancreatography (ERCP). An endoscope may be used in selected patients to examine the liver and pancreatic ducts and to obtain biopsies. Dye is injected to produce the images.
    • Computed tomography (CT). A CT scan creates a 3D X-ray of the inside of the body. A computer combines the images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (dye) is used to provide better detail.
    • Magnetic resonance imaging (MRI). Magnetic fields are used to create detailed images of the body. A contrast medium may be injected into a vein to create a clearer picture.
    • Positron emission tomography (PET) scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive substance is injected into the body. The tumor absorbs the radioactive substance at a different rate than normal cells, and a scanner detects this substance to produce images.
  • Needle biopsy. A thin needle is used to remove a small sample of the pancreas or surrounding tissue.

Patients diagnosed with pancreatic cancer may find this new patient information helpful.

Staging Pancreatic Cancer

Staging systems provide doctors with a common language for describing tumors. After cancer is first diagnosed, a series of tests are used to investigate the extent of the cancer and to see whether it has spread to other parts of the body from where it started. Staging is a way of uniformly describing the size and location as well as aiding in determining the plan for treatment. By understanding the stage of their cancer, patients can make informed decisions about their treatment.

When pancreatic cancer spreads, cancer cells may be found in nearby lymph nodes or the liver. When cancer spreads to another part of the body, this is called metastatic pancreatic cancer. The spread may be local (lymph nodes) or distant (liver or other organs).

The “staging diagnosis” depends on the type of cancer and the staging system the doctor is using, but in general there are four stages of pancreatic cancer:

  • Stage I. The cancer is relatively small and completely contained within the pancreas.
    • Stage IA. Tumor is 2 cm or less
    • Stage IB. Tumor is larger than 2 cm.
  • Stage II. The tumor has invaded tissue adjacent to the pancreas. Cancer may have spread to lymph nodes.
    • Stage IIA. Tumor has spread to nearby tissues and organs, but not lymph nodes.
    • Stage IIB. Tumor has spread to nearby lymph nodes and may have spread to nearby tissues and organs.
  • Stage III. The tumor has invaded nearby blood vessels, and may have spread to nearby lymph nodes.
  • Stage IV. The cancer has spread (metastasized) from where it started to other distant organs, such as the liver, lungs and peritoneal cavity.

Pancreatic Cancer Treatments

Following the diagnosis and staging of pancreatic cancer, cancer specialists at Penn Medicine's Abramson Cancer Center develop a personalized treatment plan. Penn's treatment options for pancreatic cancer include:

  • Surgery
    • Whipple procedure
    • Pylorus-sparing Whipple
    • Total pancreatectomy
    • Distal pancreatectomy
    • Enucleation (for certain rare types of cancer)
  • Palliative surgery
    • Surgical biliary drainage
    • Endoscopic stent placement for bilary drainage
    • Endonsocoic stent placement for gastric outlet obstuction
    • Surgical gastrojejunostomy
  • Radiation therapy
    • Three-dimensional conformal radiation therapy
    • Intensity-modulated radiation therapy (IMRT)
    • Proton therapy
    • Volumetric-modulated arc therapy (VMAT)
  • Chemotherapy and biologic therapies
    • Photodynamic Therapy (PDT)
  • Clinical trials
  • Other treatments
    • Integrative medicine and wellness
    • Palliative care
    • Penn Home Care and Hospice

Because navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the correct cancer specialist.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN.

Read more Pancreatic Cancer Treatments

Pancreatic Cancer Survivorship

Survivorship programs at Penn Medicine are a distinct phase of pancreatic cancer care and are designed to help patients' transition from their cancer treatment routine to a post-cancer care lifestyle. There are more than 12 million cancer survivors living and thriving today as a result of advances in cancer treatment. However, cancer treatments can result in physical, emotional and financial complications long after the therapy is complete.

Read more Pancreatic Cancer Survivorship

Stand Up to Cancer

Peter O'Dwyer, MD, professor of Hematology-Oncology and program director of Development Therapeutics in the Abramson Cancer Center, was interviewed on NBC10's 10! Show about Penn's work as part of the Stand Up to Cancer Dream Team... Read more

Clinical Trials

Pancreatic Cancer Trials

A Phase I/II/Pharmacodynamic Study of Hydroxychloroquine in Combination With Gemcitabine/Abraxane to... more