Risk factors

Factors that may increase your risk of pancreatic cancer include:

• Smoking.
• Being overweight or obese.
• Personal or family history of chronic inflammation of the pancreas (pancreatitis).
• Personal or family history of pancreatic cancer.
• Being black. pancreatic cancer occurs more frequently in blacks than in whites.
• Family history of certain genetic syndromes, such as the BRCA2 gene mutation, Lynch syndrome, Peutz-Jeghers syndrome, and familial atypical mole-malignant melanoma (FAMMM), which can raise the risk of developing cancer.
• Older age. pancreatic cancer occurs most often in older adults. Most people diagnosed with pancreatic cancer are in their 70s and 80s.

How is cancer of the pancreas diagnosed?

To diagnose pancreatic cancer, the doctor does a complete physical exam and asks about the patient's personal and family medical history. The doctor typically orders blood, urine, and stool tests in addition to checking general health indicators (temperature, pulse, blood pressure, and so forth). The doctor might also request a "upper GI series" or a "barium swallow." Before getting x-rays of the upper digestive system for this test, the patient drinks a barium solution. On the x-rays, the barium reveals the pancreas' outline.

Other tests may be ordered, such as:

• An angiogram, a special x-ray of blood vessels.
• CT scans, x-rays that give detailed pictures of a cross- section of the pancreas. These pictures are created by a computer
• Transabdominal ultrasound to view the pancreas. In this procedure, an instrument that sends out high-frequency sound waves, which cannot be heard, is passed over the abdomen. The sound waves echo off the pancreas. The echoes form a picture on a screen that looks like a television
• A special x-ray of the common bile duct is called an ERCP (endoscopic retrograde cholangiopancreatogram). An endoscope, a long, flexible tube, is inserted into the small intestine after being inserted down the patient's throat, through the stomach. A dye is injected into the common bile duct, and x-rays are taken. The endoscope can be used by the doctor to examine patients and collect tissue samples.
• A relatively recent procedure that can be used to identify pancreatic cancer is endoscopic ultrasound . Similar to ERCP, an endoscope is inserted during the procedure; however, an ultrasound probe attached to the endoscope's tip scans the pancreas for cancer. Because the ultrasound probe is closer to the pancreas than with transabdominal ultrasound, it is possible to identify small cancers within the pancreas. The cancers also can be biopsied through the endoscope.

Biopsy

biopsy is the only sure way for the doctor to know whether cancer is present. In a biopsy, the doctor removes some tissue from the pancreas. It is examined under a microscope by a pathologist, who checks for cancer cells.
One way to remove tissue is with a long needle that is passed through the skin into the pancreas. This is called a needle biopsy. Doctors use x-rays or ultrasound to guide the placement of the needle. Another type of biopsy is a brush biopsy. This is done during the ERCP. The doctor inserts a very small brush through the endoscope into the bile duct to rub off cells to examine under a microscope. Sometimes an operation called a laparotomy may be needed. During this operation, the doctor can look at organs in the abdomen and can remove tissue. The laparotomy helps the doctor determine the stage, or extent, of the disease. Knowing the stage helps the doctor plan treatment. Tissue samples that are obtained with one kind of biopsy may not give a clear diagnosis, and the biopsy may need to be repeated using a different method.