Oncological diseases are the problem of the 21st century. Neoplasms can occur in almost all human organs and tissues. After a thorough examination, specialists determine ways to get rid of them, identifying the degree of risk and type of tumor. A number of benign formations are amenable to drug treatment, which cannot be said about malignant tumors. That is why the diagnosis of the disease plays an important role and determines the further viability of the organism as a whole and a particular organ in particular. Learn how pancreatic cancer is diagnosed.
How to identify the disease?
Most often, the pathology is determined by ultrasound. Pancreatic cancer may not manifest itself clearly for a long time. Development occurs either against the background of a decrease in immunity, or as a result of complications of existing chronic diseases of the organ. To problematicconditions in which the diagnosis of pancreatic cancer is mandatory include diabetes mellitus and pancreatitis. In this case, experts recommend an annual ultrasound examination of the abdominal cavity, and if any factors that increase the risks are identified, donating blood for tumor markers.
Risk factors
In addition to the problems described above, directly related to disorders of the pancreas, there are diseases that also increase the likelihood of a malignant tumor. These include:
- Smoking, the cessation of which significantly reduces the risk.
- Obesity, accompanied by an imbalance of sex hormones, can also be called a reversible factor. With a decrease in weight, adipose tissue disappears, which has a positive effect on both the general condition and individual organs.
- Cirrhosis of the liver several times increases the possibility of an adverse outcome of any he alth problems.
- Allergic diseases of the skin that have developed into a chronic form.
- Wrong diet, which contains a large amount of sausages, coffee, saturated fats, simple carbohydrates.
- Dental diseases.
Factors in which it is necessary to periodically diagnose pancreatic cancer also include:
- Age over 60.
- The presence of oncopathology in the next of kin.
- Male.
- DNA mutations.
Symptoms
Manifestations of cancerpancreas are similar to some other diseases. Therefore, the layman may not attach importance to them for a long time. You should pay special attention to your he alth if you have the following conditions:
- Pain in the abdomen, in the hypochondrium and in the center, radiating to the back. At night and when bending forward, it appears more acutely, and subsides when the patient presses his legs to his stomach.
- Arising blood clots in the veins, visible to the naked eye.
- Jaundice, which is manifested first by yellowing of the skin, and then the integument becomes brown with a green tint.
- The skin constantly itches due to bile stasis.
- Loss of appetite and weight loss.
- General weakness.
- Nausea and vomiting.
- Diarrhea, discoloration and odor of stools.
- Thirst, dry mouth.
- Large amount of urine with increased nighttime excretion.
- Changing the color of mucous membranes and tongue.
- Dermatitis in the form of ulcers that go away on their own and reappear, but in a different place.
- Edema.
- Decreased libido.
- Signs of an enlarged spleen, manifested by heaviness on the left in the hypochondrium.
- Flushing with heat in the face and body.
- Cramps in the limbs.
Where to start?
So, if you have found a number of signs that indicate the occurrence of serious problems with the pancreas, then it is imperative to visit a doctor. The specialist will begin the examination with a visual examination, taking an anamnesis and prescribing tests. Early diagnosis of pancreatic cancerincludes various laboratory tests that will allow you to understand if there are problems with this particular organ or if the functions of others are impaired.
Tests ordered for suspected cancer include:
Blood donation for CA-242 is carried out on an empty stomach, with the exclusion of the use of sugary drinks on the previous day, all liquid is replaced with plain water. This is the main marker, which is a complex of protein and carbohydrate and secreted by the cells of the digestive system. A feature of the substance is its constant value in benign tumors and a significant increase in oncological pathology. If the figure approaches zero, then no pathologies have been identified, if it does not reach 20 units / ml, then you should know that inflammation of the organ manifests itself this way. When the value is slightly higher, then additional studies are prescribed. An indicator that is too much in excess of 20 units / ml may indicate a malignant neoplasm in the stomach or pancreas. Analyzes for cancer, or rather its suspicion, detected in this way, include, in addition to CA-242, taking material for CA-19-9
- An analysis for the CA-19-9 antigen is prescribed precisely for the localization of the problem of the stomach and pancreas. CA-19-9 is a special substance released in cancerous pathologies in an increased amount. However, experts say that the data of this survey is not enough to make a diagnosis. If the analysis is repeated, since the cancer was detected earlier, and its value does not exceed 1000 units / ml, then they talk aboutthe possibility of resection, that is, the removal of part of the organ with the tumor. When the figure is more than 1000 units / ml, this in most cases means metastasis and the impossibility of a cure.
- Diagnosis of pancreatic cancer by blood testing involves determining the amount of pancreatic amylase. The so-called enzyme enters the pancreatic juice that the pancreas produces and moves to the intestine, where it breaks down carbohydrates. Most often, urine amylase analysis is added to this study. The norm of the first indicator should not exceed 53 units / ml, and the second - 200 units / ml. If cancer is suspected, the numbers can increase tenfold.
- Blood alkaline phosphatase is also mandatory for determination if laboratory diagnosis of pancreatic cancer is carried out. This enzyme is involved in phosphorus-calcium metabolism, being an accelerator of chemical reactions. The norm in the blood is from 20 to 120 units / l. The exceptions are newborns, pregnant women and patients over 75 years of age, whose rate is several times higher. In other cases, a high value indicates the presence of a disease associated with stagnation of bile, including stage 4 pancreatic cancer.
- Stool testing for pancreatic elastase helps to distinguish a number of pathologies and differentiate the disease from other possible problems, such as cystic fibrosis and malabsorption. The norm is an indicator from 200 to 500 mcg / g.
To complete the picture, experts and standard analyzes do not exclude. In case of pancreatic cancer or suspicion of this disease, the doctor will definitely prescribelaboratory study of both general blood parameters and individual ones, such as the level of insulin, gastrin, glucagon, C-peptide.
Operation: pros and cons
Despite the fact that the differential diagnosis of pancreatic cancer is diverse and allows you to identify a lot of pathologies by submitting material for laboratory testing, surgery does not always confirm the development of a fatal disease.
The rationale for the invasion of the body are the data obtained by clinical, instrumental and other types of analyzes. However, all of them can only in one way or another indicate cancer. Determining the exact diagnosis and distinguishing chronic pancreatitis from early oncology is often impossible, since benign tumors can show similar symptoms and look identical. Only according to the results of resection and examination of the removed parts, it is possible to speak with a 100% probability of pancreatic cancer. The 4th stage is the only stage that is unambiguously determined by radiation research methods, since it manifests itself as metastasis to the following organs:
- kidneys;
- liver;
- light;
- intestines;
- spleen
- brain;
- bones.
Thus, making the decision to have surgery is sometimes the only way to save a person's life. Of course, the doctor pays special attention to the results of the tests and only in case of emergency suggests a resection. However, at the first stages of the examination, the role of oncomarkers should not be underestimated, according to indicatorswhich determine the need for a thorough study and subsequent radiation diagnosis.
Instrumental Methods
How to determine pancreatic cancer, or rather to make sure that resection is necessary or to build a different treatment strategy, experts know. Pre-operative methods for detecting pathology include:
- Ultrasound.
- CT.
- MRI.
- ERCP.
- CHHG
- PET.
- Laparoscopy.
- Biopsy.
Ultrasound
When the manifestation of pancreatic cancer, symptoms that clearly indicate the problems of this organ, begin to disturb the patient, he goes to the doctor. In the first stages of the examination of the patient, the specialist includes not only a survey and the delivery of general tests, but also an ultrasound of the abdominal cavity. Sometimes painful sensations point to one organ, but in fact another, located nearby, suffers. This method allows you to localize a possible focus of the disease and help the doctor choose further methods of diagnosis or therapy.
Ultrasound examination may show an increase in any part of the pancreas or a change in its contour. Particular attention during ultrasound is paid to the head of the gland, since in 80% of cases it is in it that a new formation is observed. In the tail part, cancer manifests itself much less frequently. However, it happens that the examination reveals a tumor of the entire tissue, which in fact may not be an oncological disease, but an acute form of pancreatitis.
Ultrasound also helps to visualize the nature of the changes and the structure of the gland. Usually with this form of cancer, the tumoris hypoechoic and has no internal echo structures.
Computed tomography
This study is carried out using x-rays that pass through organs and tissues. Since they all have different densities, as well as oncological formations, the device manages to transmit the image in layers. The final display allows you to visualize those organs that were subjected to tomography, and their structure. A specialist can evaluate not only the size of the pancreas, but also various deposits, inflammation and swelling. It should be noted that the degree of radiation of CT is much less than that of conventional X-rays. When preparing for this type of examination, it must be borne in mind that contrast is often used. Therefore, the presence of contraindications to the use of iodine-containing drugs must be announced to the attending physician. You should also tell your doctor if you have any allergic reactions to medicines.
Magnetic resonance imaging
This is a proven method based on magnetic radiation. It gives complete information about the tissues, since it is carried out by exposing the body to a magnetic field. As a result, the oscillation of atoms in human cells allows a special program to create a three-dimensional image, which is much better than two-dimensional images. The examination is carried out in a supine position, when the patient is motionless, and magnetic coils and the detector of the device rotate around him. For a fewIn minutes, about a hundred images are taken in different planes, providing an image through software processing, and a radiologist describes the state of the organ under study and hands out a disk with the results of magnetic resonance imaging of the pancreas.
Endoscopic retrograde cholangiopancreatography
The method works with the use of a contrast agent. It can be called combined because it combines endoscopic and X-ray examination. An endoscope is inserted into the duodenum. Through it, a special preparation is fed into the Vater papilla, and then several shots are taken.
The use of high-tech equipment allows tracking the process at all its stages, and the method is also characterized by low irradiation. The quality of the cholangiopancreatogram makes it possible to judge the problems of the pancreas and bile ducts with a high degree of accuracy.
Percutaneous transhepatic cholangiography
This method is also a fluoroscopic examination using an iodine-containing substance. Unlike the previous version, the drug enters through the skin. The patient is placed on the x-ray table and fixed.
The place where the needle is planned to be inserted is treated and separated from the rest of the surface with sterile materials, after which an injection is made with a local anesthetic. On exhalation, the patient is asked to hold his breath and the needle is inserted into the intercostal space. Having penetrated into the liver parenchyma, the needle begins to slowly withdraw, simultaneously releasingcontrast agent until the bile duct is found, into which the remaining drug is injected. The equipment screen allows you to evaluate the filling of the ducts, after which several pictures are taken.
Positron emission tomography
In this case, a substance that performs the function of a contrast agent is injected into a vein. The difference from previous methods is the use of isotope labeled sugar. Here, the research is based on the ability of cancer cells to accumulate radioactive substances. In the images, malignant tumors, if any, will differ significantly in color from other tissues, which will allow them to be localized and make a decision on further therapy or surgical intervention.
Laparoscopy
As a surgical method, it is prescribed when it is necessary to exclude the presence of cancer cells in the pancreas. A resection of a benign tumor is also performed. Removal of malignant tumors in this way is unacceptable.
During this procedure, despite the tiny incisions, the patient needs anesthesia. In this case, an anesthetic-air composition is chosen, which is fed through a special tube. The essence of the technique of surgical intervention is the implementation of three or four small incisions, after which carbon dioxide is pumped into the abdominal cavity. Then, instruments are introduced through the punctures and the necessary manipulations are performed.
If the results of the examination reveal that laparoscopy will not help, surgeons may decide to perform an open laparotomy.
Biopsy
The most difficult for the patient and at the same time the most informative method is a biopsy of pancreatic cancer. Such a study involves the excision of a piece of tissue or the collection of a small number of cells for subsequent examination with a laboratory microscope. After taking the tissue, it is stained with a special compound and a histological examination is carried out.
There are 4 ways to collect cells:
- Intraoperative, when cells are obtained through a conventional laparotomy. Direct, transduodenal, and aspiration fine-angle biopsies can be used here.
- Laparoscopic, where material is taken by making small incisions.
- Percutaneous, where cells for research are obtained under the control of ultrasound and CT. It is this method of all listed that is considered the safest and least traumatic, but it can not always be used.
- Aspiration biopsy is used in most possible cases of material sampling. The accuracy of the study is 96%.
Patients who, according to the results of tests and studies, have cancer, should know that this is not a sentence.
Firstly, it happens that after resection and subsequent histology, it is revealed that the result was a false positive. And this means that the excised tissue could not be an oncological formation, but was a benign tumor.
Secondly, the decision on surgical intervention is made by a specialist. Therefore, after examinations, find a good doctor and read reviews about him.
Third, after getting rid of malignant tissues, you can live happily ever after.
Remember that early detection of cancer is half the battle. Monitor your he alth and see a doctor if you experience bad symptoms.
