Indiana University Melvin and Bren Simon Cancer Center

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Pancreatic Cancer ProgramOur Services

Diagnostic Tools

 

Many gastrointestinal diagnostic procedures that are now commonplace were first pioneered at the IU Simon Cancer Center. Our pancreas program is perhaps best known for its expertise in endoscopy, which involves inserting a long, flexible tube via the mouth to visualize the upper digestive tract, endoscopic ultrasonography which allows for the detailed visualization of the pancreas and surrounding structures and assessment of pancreatic lesions, and for obtaining biopsy samples by fine needle aspiration, and endoscopic retrograde cholangiopancreatography (ERCP) which allows for visualization of the pancreatic duct, biopsies, and for collection of pancreatic juice samples. Treatment of structural problems of the pancreas is also possible with ERCP.

Pancreatic cancer diagnosis may be aided by one or more of the following tools:

• clinical examination to check for lumps or other changes
• blood testing
• endoscopy to examine the inside of the gastrointestinal tract
• endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP), spiral CT, PET scan, MRI, and X-rays to take pictures of the gastrointestinal tract and look for cancer cells. EUS combines endoscopy with the imaging capabilities of ultrasound to obtain high-quality images of organs deep inside the body. ERCP, a minimally invasive imaging procedure, is used to diagnose conditions of the liver, gallbladder, bile ducts, and pancreas. It is also used to treat anatomic obstructions of these organs.
• fine needle aspiration biopsy to remove tissue or fluid with a needle for examination under a microscope
• genetic counseling to discuss personal and family medical history of certain gastrointestinal conditions, including pancreatic cancer, and the possibility of genetic testing
• genetic testing to identify specific genetic factors that put individuals at greater risk for developing pancreatic cancer

Treatment Options

 

Treatment options for pancreatic cancer include one or more of the following, based on the most current treatment recommendations and the needs of the patient:

 

• surgery to remove the cancer
• chemotherapy to kill cancer cells with drugs (new chemotherapy medications may be available through clinical trials)
• radiotherapy to kill cancer cells and shrink tumors with powerful X-rays (clinical trials may use radiation therapy in combination with new agents to potentially increase efficacy)
• immunotherapy to use the patient immune system to fight cancer (part of clinical trials using cancer vaccines)
• palliative procedures, such as EUS-guided celiac plexus block, to relieve pain and symptoms and improve quality of life, stent placement in the gastrointestinal tract to allow food passage and maintain a good nutritional state, and stent placement in the bile duct and pancreatic duct to relieve jaundice, reduce pain and improve quality of life