Some tests will confirm the specific type of pancreatic cancer and whether it has spread beyond pancreas to other parts of the body.This can include:
- Blood tests
- Ultrasound scan of the abdomen
- Computerised tomography (CT) scan
- Positron emission tomography (PET) scan
- Magnetic resonance imaging (MRI) scan
- Magnetic resonance cholangio-pancreatography
- Endoscopic ultrasound
- Endoscopic retrograde cholangio-pancreatography (ERCP)
You can find more information about the tests and investigations routinely used to diagnose pancreatic cancer on the Pancreatic Cancer UK website. The website also has details of the treatments that might be offered to patients. These include surgery, chemotherapy or radiotherapy.
Surgery can, in some cases, be used to remove the cancer or relieve some of the symptoms.
Chemotherapy is often given after surgery to either minimise the chance of the cancer growing or to reduce the symptoms.
Radiotherapy is commonly used to try to slow the cancer growing or to control or minimise the pain that it causes.
Because the pancreas is positioned amongst other major organs in the body, it needs major surgery to access it. The size and position of your tumour within your pancreas and whether you are well enough to cope with a major operation are key factors that your surgeon will consider carefully before deciding if it might be possible to remove your cancer. Your doctor will also think about whether the cancer has spread outside of your pancreas to other areas of the body before deciding if surgery is the best option for you.
Removal of the cancer is called a resection. This is normally only possible with early stage (stage I or II) cancer - see our section on pancreatic cancer for more information on cancer stages.
To remove the tumour completely, your surgeon may suggest removing all or part of your pancreas along with other nearby tissues.
A pancreatectomy means that only the whole pancreas is removed and if the lower end of the pancreas (the body and tail) is removed then this is called a distal pancreatectomy.
Surgery to remove the head of the pancreas, most of the small bowel (duodenum), the bile duct, gall bladder and nearby lymph nodes is called a pylorus-preserving pancreatoduodenectomy (PPPD) or a modified Whipple’s operation.
If the lower part of the stomach is also removed, then this is called a pancreatoduodenectomy or Whipple’s operation.
It is also possible to have surgery that aims to relieve your symptoms (such as jaundice) that are caused by a blockage in your bile duct or small bowel. In the case of a blocked bowel, the surgeon will join part of the small bowel directly to the stomach. When the bile duct is blocked, it is cut and then reconnected to a different place in the small bowel. As an alternative to surgery, a small tube called a stent can be inserted to help to clear a blockage or help relieve jaundice symptoms.
Using drugs to kill cancer cells is one of the most common approaches to the treatment of pancreatic cancer. It is normally used if surgery to remove the cancer is not possible.
Chemotherapy can be given in an attempt to shrink the tumour and/or control it’s growth for a little while or it can be given to help control symptoms caused by the cancer. Or, it may be given after surgery to reduce the chance of the cancer growing back. Chemotherapy can also be combined with radiotherapy (known as chemoradiation) in some cases.
Most chemotherapy is given to the patient by direct injection into a vein but some can be given in tablet form. The drugs travel through the blood stream of the patient to target the cancer cells that are present anywhere within body. After treatment, there will be a rest period to allow patients to overcome any side effects they have developed during the course of the treatment. The period of time that chemotherapy is given for will vary depending on which drugs have been prescribed. There are a range of side effects associated with chemotherapy that may include sore mouth, diarrhoea, hair loss, dry skin and sore, tingly or numb hands and feet. Patients are also have a higher than usual risk of infection. This is because chemotherapy can reduce the number of white blood cells present in the patient’s blood. White blood cells identify and destroy infection and when their numbers are reduced, the body is unable to fight infection effectively.
Compared to chemotherapy or surgery, radiotherapy is less commonly used in the treatment of pancreatic cancer because it is unlikely to cure it when used alone.
It is used to treat pancreatic cancer that is contained within in the pancreas but cannot be removed by surgery. It can be mixed with chemotherapy in order to control the growth of the tumour as long as possible. It can be used alone (and at a lower dose) to combat some of the symptoms of the cancer. The side effects of radiotherapy treatment include mild sickness, diarrhoea and tiredness. It does not make you radioactive or pose a risk to other people.