Pancreatic cancer can be difficult to detect. Symptoms often don’t show until later stages, and there aren’t standard screening tests for this type of cancer.
Imaging tests — like MRIs, CT scans, and ultrasounds — are an important part of the diagnostic process.
Abdominal and endoscopic ultrasounds are often used to help diagnose pancreatic cancer. Neither of these tests is enough on their own to confirm a diagnosis, but they can help detect tumors, inflammation, and other signs of cancer.
In this article, we take a closer look at ultrasounds and how they’re used to detect and diagnose pancreatic cancer.
An ultrasound is an imaging test that uses sound waves to create detailed pictures of the inside of your body. The images created by an ultrasound allow doctors to see muscles, organs, blood vessels, tissues, and bones. They can help diagnose a variety of conditions, including cancer.
Ultrasounds are done with a machine that works on the outside of your body. Or, by using a device called an endoscope that goes inside your body. Doctors often use both types of ultrasounds when diagnosing pancreatic cancer.
Ultrasounds create images of the pancreas that can help doctors spot tumors. There are two types that are commonly used during the pancreatic cancer diagnostic process. If your doctor suspects you have pancreatic cancer, you might have one or both types performed.
- Abdominal ultrasound. An abdominal ultrasound can help doctors get a complete picture of your abdominal region. It’s a good way to rule out other conditions that could be causing your symptoms, and it might be one of the first tests you have done. If no other conditions are spotted on this ultrasound, you might have a CT scan or an endoscopic ultrasound.
- Endoscopic ultrasound. During an endoscopic ultrasound, a thin tube called an endoscope is inserted through your mouth, down your esophagus, and directly into your stomach and intestines. This allows doctors to see your digestive tract up close and to collect tumor cell samples for a biopsy.
Both tests use ultrasound sound wave technology to create images of your pancreas and digestive tract. They allow doctors to look for tumors, inflammation, bile duct enlargement, and other signs of pancreatic cancer.
Neither test is enough on its own to diagnose pancreatic cancer. But the data they can provide is important and can help doctors plan the next steps.
Only some parts of the pancreas are visible during an abdominal ultrasound. If signs of cancer, like a tumor mass or inflammation, are present in those sections, they might be visible in the images created by an abdominal ultrasound.
Tumors in other parts of the pancreas won’t be visible with an abdominal ultrasound. But endoscope ultrasounds can better detect these tumors. Tumors will appear as masses on endoscopic images.
Endoscopic ultrasounds can also detect enlarged bile ducts.
The procedure for an ultrasound depends on the type of ultrasound you’re having. Both types are generally done as outpatient procedures, but an endoscopic ultrasound is slightly more complex. This is primarily because you’ll receive sedation during an endoscopic ultrasound to prevent any discomfort.
Read more about each procedure below.
Abdominal ultrasound for pancreatic cancer procedure
An abdominal ultrasound generally takes less than an hour, and you don’t need to take any special steps before your appointment. You’ll be able to drive yourself to and from your ultrasound, and you can plan on returning to work or resuming any other standard daily activities.
At your appointment, you’ll be asked to change into a patient gown and remove any jewelry. You’ll lie on an examination table during the procedure, and gel will be applied to your abdomen. This gel is safe and won’t stain.
The ultrasound technician will use a device called a transducer against your stomach. This sends sound waves through your body and creates images. An ultrasound is generally painless.
You should have your results back as soon as a doctor reads and interprets the images. The exact timeframe for this can vary, but it shouldn’t be more than a week. You can ask the ultrasound technologist if they can estimate how long it might take before you receive your results.
Endoscopic ultrasound for pancreatic cancer procedure
Before an endoscopic ultrasound, it’s important to talk with your doctor about any medications — including vitamins and supplements — that you take. They might ask you to stop taking specific medications, like blood thinners, for a few days before the test.
Other test-day instructions will likely include not eating for several hours before the test and making sure you have a ride to and from your appointment. If you don’t have a ride, your doctor’s office might be able to help you arrange one.
During your appointment, you’ll be hooked to an IV line to receive sedative medication. You’ll also receive a throat numbing spray or gargle. Both of these medications will keep you relaxed and free of pain during the procedure.
Often, a mouthpiece will be placed in your mouth to help keep your lips and teeth apart. The endoscope tube will then be carefully passed into your mouth and down your throat. Air might be pumped into your throat to make it easier to see your digestive tract.
An endoscopic ultrasound can be done very quickly, in as little as 15 minutes. Or, it might take over an hour. It depends on how many images are taken, what doctors find, and if doctors are also taking cell samples to biopsy.
After the endoscope and mouthpiece are removed, you’ll be monitored for a few hours. Your throat will be numb, and you’ll still feel the effects of the sedative. You won’t be permitted to eat or drink anything until the numbing medication wears off.
You should be able to come home within a few hours, and you should have results in less than a week.
An abdominal ultrasound isn’t the best way to diagnose pancreatic cancer. This test is best at ruling out other causes of very similar symptoms. Although an abdominal ultrasound can sometimes spot masses in the pancreas, its primary use is to look at other structures in the abdomen.
An endoscopic ultrasound is much more accurate for diagnosing pancreatic cancer. One of the main benefits of an endoscopic ultrasound — and the reason for its accuracy — is that a fine needle aspiration can be used during the scan. This allows doctors to obtain biopsy samples of any abnormalities seen during the imaging.
Exact numbers vary, but multiple studies have found that they have a tumor detection accuracy rate of about
Endoscopic ultrasounds do have a margin of error. They can miss some tumors due to unclear images, tumor location, or other factors. But their overall high accuracy rate makes them very useful.
Neither type of ultrasound can confirm a pancreatic cancer diagnosis. If your doctor suspects you have pancreatic cancer, you’ll likely have a range of other tests. They could include:
- CT scan. Doctors use them to see the inside of the pancreas and get an idea of the size, location, and scope of tumors.
- PET scan. During a PET scan, you’ll receive an injection of radioactively marked sugar. Cancer cells consume more sugar than healthy cells. The radioactive markers in the sugar substance make the cancerous cells appear brighter in images, allowing doctors to easily identify their location.
- An MRI. MRIs use magnetic imaging to create detailed images of organs, muscles, bones, and tissues. During the pancreatic cancer diagnostic process, doctors use a specialized type of MRI, called an MRI cholangiopancreatography, that creates detailed images of the pancreatic and bile ducts.
- An endoscopic retrograde cholangiopancreatography (ERCP). During an ERCP, you’ll receive contrast dye that will make your bile ducts visible. An ERCP uses an endoscope to take images. Sometimes, a biopsy is done during an ERCP.
- A percutaneous transhepatic cholangiography (PTC). A PTC test is an invasive procedure that isn’t done unless an ERCP isn’t possible. This test is done by placing a long needle into the liver and injecting contrast dye directly. Images are then taken.
What’s the first diagnostic test typically done for pancreatic cancer?
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What are the first symptoms of pancreatic cancer and when should you see a doctor?
It’s important to see a doctor right away if you have any symptoms of pancreatic cancer, especially if you’ve had them for more than a week or two.
Although it’s very likely that your symptoms are caused by another, less serious, condition, it’s always best to get checked out. Pancreatic cancer is most treatable when it’s caught early.
Additionally, there are often no symptoms in the early stages of pancreatic cancer. This means that by the time symptoms show, cancer might have already spread.
It’s best to make a medical appointment if you’ve experienced any symptoms of pancreatic cancer, including:
- jaundice
- unintentional weight loss
- itchy skin
- back pain
- stomach pain
- blood clots, especially in the legs
- loss of appetite
- nausea and vomiting
- light-colored or greasy stools
- dark-colored urine
- depression
Who’s at most risk for pancreatic cancer?
There are a few known risk factors for pancreatic cancer. Some risk factors are things you can’t change, like your genetics or age. But there are other risk factors you can control, like smoking and weight management.
Risk factors for pancreatic cancer include:
- a family history of pancreatic cancer
- inheriting family cancer syndrome
- being over 65
- being assigned male at birth
- obesity
- smoking
- diabetes
- chronic or hereditary pancreatitis
- workplace exposure to pesticides or chemicals used in metalwork
In the United States, Black Americans are diagnosed with pancreatic cancer
Are there yearly recommended screening tests for pancreatic cancer?
Currently, there are no recommended yearly screening tests for pancreatic cancer. There are a few tests available to people who are at high risk for pancreatic cancer, but these tests aren’t covered by insurance companies or available to people who aren’t considered high risk.
Researchers are working to develop additional tests, and standard screenings might be available in the future.
Ultrasounds are diagnostic imaging tests that can help detect pancreatic cancer. They use sound waves to create detailed images of the inside of your body.
There are two types of ultrasound used in the detection of pancreatic cancer: abdominal ultrasounds, and endoscopic ultrasounds.
An abdominal ultrasound is primarily used to rule out other conditions that cause similar symptoms, while an endoscopic ultrasound can be used to be used obtain biopsy tissue (via a fine needle aspiration) to accurately diagnose pancreatic cancer.