Pancreatic Cancer Blood Test

Pancreatic cancer blood test - Making the diagnosis of pancreatic cancer is not always easy. Often several studies are needed. Which these depend on the treating specialist and the hospital. A treatment is selected after the diagnosis.

Blood test
The GP can do a blood test (or have it done) if there is a suspicion of jaundice, a possible symptom of pancreatic cancer. A blood test can also be used to detect diabetes, another possible symptom of this type of cancer.

CT-scan
In a CT scan three-dimensional photographs of organs and/or tissues are made. Because these photos are very detailed, a possible tumor can be well located. It can also be examined whether the tumor can be removed surgically. Furthermore, metastases can be brought to light.

A CT scan can be used with a contrast fluid to make the blood vessels clearly visible. This is necessary to see how large the tumor is and to be able to determine whether it has grown in other organs.



Ultrasound
In ultrasound, the organs and/or tissues are visualized on a screen by means of sound waves. Any tumors and/or metastases are brought to light in this way. An ultrasound is particularly useful to find out if the bile ducts have been expelled and if there are any metastases to the liver.

MRCP (Magnetic Resonance Cholangiopancreatography)
In an MRCP, an MRI scan of pancreas and bile ducts is made using a magnetic field. Often a contrast fluid is injected into the bloodstream via the arm. An MRCP is a good alternative for a CT scan.

ERCP (Endoscopic Retrograde Cholangiopancreatography)
With an ERCP an endoscope (a flexible tube) with a small camera is used to look at a closure of the bile ducts. The tube is inserted through the stomach through the stomach into the papilla of Vater. A contrast image is injected into a clear image.

When a tumor is found, tumor cells can be removed with a small brush for further investigation. If the tumor occludes the bile duct, a plastic tube (a stent) can be placed to allow the bile to flow back to the small intestine. As a result, jaundice that resulted from the blockade will disappear.

Laparoscopy (viewing operation)
A viewing operation can be chosen if metastases are suspected. After the patient is under general anesthesia, the liver and abdominal cavity are checked for the suspicious tissue. If necessary, some tissue (biopsy) is removed for further inspection.

The treatment of pancreatic cancer
Which treatment for pancreatic cancer is chosen depends on:

• The type of cells that make up the tumor
• The stage of the disease (size of the tumor, possible growth in surrounding tissue, possible metastases)
• How malignant the cells are
• The location of the cancer
• Personal characteristics (age, overall condition)

Curative or palliative treatment
Depending on the severity of the disease, it is determined whether the treatment will focus on healing ( curative treatment ) or, if that is no longer possible, on curbing the disease and reducing complaints ( palliative treatment ).

Curative treatment is often no longer possible with this aggressive type of cancer. It also happens that during the operation it appears that the tumor is in too advanced a stage in order to be removed, despite earlier examinations. Approximately one-fourth of the patients are eligible for a curative treatment plan.

Surgery
When healing is possible, surgery always takes place. Usually, this is in the form of a PPPD ( Pylorus-Preserving Pancreaticoduodenectomy ). The following is removed:

• The part of the pancreas that contains the tumor
• The duodenum
• The gallbladder
• Part of the bile ducts
• The lymph nodes around the pancreas

Although the lymph nodes can be clean, they have removed anyway. This happens because during the surgery it can not be said with certainty whether they contain metastases. With a PPPD the stomach is spared.

If the stomach is (largely) removed, this is called a whipple surgery. A disadvantage of this is that the food ends up in the intestines faster than normal, which leads to complaints such as abdominal pain, vomiting, and diarrhea.

After the surgery, there may be symptoms such as bloating, nausea and weight loss. This is because the pancreas no longer produces sufficient enzymes necessary for proper digestion. The treating physician can prescribe special pancreatic enzymes.



Chemotherapy
For chemotherapy is chosen if healing is no longer possible - so as palliative treatment - or as an additional treatment before or after surgery. In the first case, the chemo will only temporarily slow down the disease.

During the chemo, the patient receives so-called cytostatics: cell-killing or cell-division-inhibiting medicines. These are able to destroy the malignant cells via the blood. Because cytostatics also treat healthy cells, they have a number of side effects, including hair loss, nausea, and fatigue.

Radiotherapy (irradiation)
Irradiation is usually used to reduce the pain caused by the tumor itself or by metastases. A possible side effect is that the tumor becomes smaller. Radiotherapy is a local treatment in which healthy cells are spared as much as possible. A common side effect of radiation is fatigue.

*Image source : Pixabay

References :

1. National Cancer Institute
2. MaagDarmLever.nl
3. American Cancer Society