The clinic Assuta employs the most advanced and accurate technology for the diagnosis of pancreatic cancer, including endoscopic ultrasound. Highly skilled pathologists, radiologists and other specialists reveal the exact extent of the disease, improving the chances of successful treatment .
Pancreatic cancer is often difficult to diagnose. Symptoms usually do not appear in the early stages, and if they are detected, it is mistaken for symptoms of other conditions. In addition, the pancreas is deep, slightly behind the other organs inside the body. It is difficult to see or feel out without adequate equipment. Usually it takes several medical tests to determine the stage of disease. Accurate diagnosis and determine the stage of the disease is very important because they help doctors choose the best treatment option.
In the process of diagnosis in Assuta typically the following types of tests:
- Medical examination and medical history.
- Clinical and biochemical blood tests.
- Blood tests for tumor markers.
Interviewing the patient in the course of diagnosis of pancreatic cancer, the doctor will ask questions about:
- symptoms characteristic of the disease;
- smoking habits;
- occupational exposure to chemicals;
- percolation chronic disease of the pancreas - pancreatitis (inflammation or infection).
Also, the doctor asks questions related to family history or factors that increase the risk of this type of cancer:
- Hereditary breast and ovarian cancer;
- syndrome familial atypical multiple mole-melanoma or FAMMM syndrome;
- ; Jeghers - Peutz Syndrome
- hereditary nonpolyposis colorectal cancer (HNPCC)
- hereditary pancreatitis.
The doctor examines the presence of any symptoms of pancreatic cancer. In the course of a medical examination:
- check the color of the skin and whites of the eyes;
- probes possible swellings and seals in the abdomen; and gallbladder dimensions, liver, or spleen;
- examines whether leg edema;
- check the lymph nodes above the collarbone, and in other places.
Clinical blood test
A complete blood count examines the quantity and quality of white and red blood cells, platelets. The overall analysis is performed to find out how well the bone marrow and some other organs. These results are also used to create a database that was later to compare blood parameters during and after treatment.
The analysis of chemical substances in the blood, showing how well organs are working, for example, the liver.
- alkaline phosphatase;
- lactic dehydrogenase (LDH);
- alanine aminotransferase (ALT);
- aspartate transaminase (AST);
And also it is used to detect anomalies.
Increasing any of these substances may refer to:
- blocking the common bile duct or pancreatic duct;
- pancreatitis caused by inflammation or infection of the pancreas;
- Pancreatic cancer that has spread to the liver.
CT uses a special x-ray equipment to create 3-D images of bundle structures of the body (organs, blood vessels, bone), which then converts the computer into detailed images.
CT is most frequently used in the diagnosis of pancreatic cancer:
- to find the tumor;
- to find out its size;
- find out whether the tumor is possible to completely remove by surgery;
- determine whether secondary centers;
- use as a conductor in the process of fine-needle aspiration biopsy to obtain tissue samples.
Ultrasound uses high-frequency sound waves to create images of internal body structures. In the process of diagnosis of pancreatic cancer is carried out in order to:
- find the tumor;
- set up different types of malignant tumors;
- to use as a control in the fine-needle aspiration biopsy.
Abdominal ultrasound may be one of the first tests to be carried out if the patient has pain in the present art. It is also used to examine the liver.
Endoscopic ultrasonography (EUS) - is the latest procedure, which allows you to diagnose pancreatic cancer more accurately than an abdominal ultrasound. The endoscope is a thin tool provided with the lamp and the lens. During the procedure, the doctor inserts an endoscope through the mouth and promotes to the pancreas. We study also located near bodies.
EUS provides a very accurate picture, effectively detects smaller tumors. Simultaneously, a biopsy may be performed.
Examines internal body structures using a physical phenomenon of nuclear magnetic resonance, creating layered images, which are then converted into the 3D-pictures. The main objectives of MRI in the diagnosis of pancreatic cancer:
- Find tumor.
- To find out whether the tumor process spread.
Endoscopic retrograde cholangiopancreatography (ERCP)
ERCP is similar to endoscopic ultrasound. This is a procedure that uses an endoscope (a thin tube equipped with a light and lens) and X-ray tool to study the pancreas, liver and gall bladder. Using probe dye is introduced into the bile ducts to visualize them on a roentgen. After that make x-rays.
ERCP in the diagnosis of pancreatic cancer is carried out to:
- detect tumors that can cause blockage of the bile duct or pancreatic duct;
- take a sample of tissue;
- install a stent to relieve blockage of the bile duct.
Laparoscopy - a procedure in which an endoscope is introduced through a small incision in the abdominal cavity. The use of laparoscopy can help avoid the need for a larger abdominal surgery. It is prescribed:
- To explore the pancreas and the surrounding area.
- Take a sample of tissue.
This procedure involves removing a sample of cells for further testing in the laboratory and the establishment of benign or malignant.
For a sampling of pancreas fine-needle aspiration biopsy. The physician uses a thin needle or syringe, to remove the small amount of fluid or cells.
This type of biopsy can be performed transcutaneously with CT or ultrasound to guide the needle to the tumor, or during laparoscopy or EUS ERCP. Also it is used for collecting samples from the liver to confirm metastases therein.
PET uses radioactive materials called radiopharmaceuticals, to search for changes in metabolic activity of body tissues. The computer analyzes the radioactive structure and creates colored 3-D image of the scanned area. PET in the diagnosis of pancreatic cancer is carried out to find the tumor and to determine whether a malignant process spread.
Analysis of tumor markers
Tumor markers indicate the presence of cancer. If they were higher than normal before treatment, the doctor prescribes this test to check the body's response to therapy.
In the process of diagnosis of pancreatic cancer is checked by:
- Carbohydrate antigen 19-9 (CA 19-9) - a protein found in very small amounts on the surface of some cancer cells. CA 19-9 levels above the norm of 70% -80% seen in people with pancreatic cancer.
- Carcinoembryonic antigen (CEA) is a protein which is located in the tissues of the developing fetus. CEA levels in the blood decreases after birth. The amount of the antigen above normal in about 50% of people with pancreatic cancer.
It is an x-ray of the bile duct and liver. The doctor inserts a thin needle through the skin in the area of the bile duct, which introduces a contrast agent or a special dye. It outlines the structure of the bile ducts and the liver on the radiograph.
This kind of diagnosis of pancreatic cancer is also used to determine whether biliary obstructions and for installation of the stent to remove the blockage.