My father may have pancreatitis or a pancreatic tumor. Why is it so hard to diagnosis?

Question

My father has had a endoscopy and a MRI. And they still don't know what the cause is? Why do the physicians have such a difficult time differentiating the two?

Answer 1

If a patient has symptoms that suggest pancreatic cancer, the doctor asks about the patient's medical history. The doctor may perform a number of procedures, including one or more of the following:
Physical exam -- The doctor examines the skin and eyes for signs of jaundice. The doctor then feels the abdomen to check for changes in the area near the pancreas, liver, and gallbladder. The doctor also checks for ascites, an abnormal buildup of fluid in the abdomen.

· Lab tests -- The doctor may take blood, urine, and stool samples to check for bilirubin and other substances. Bilirubin is a substance that passes from the liver to the gallbladder to the intestine. If the common bile duct is blocked by a tumor, the bilirubin cannot pass through normally. Blockage may cause the level of bilirubin in the blood, stool, or urine to become very high. High bilirubin levels can result from cancer or from noncancerous conditions.

· CT scan (Computed tomography) -- An x-ray machine linked to a computer takes a series of detailed pictures. The x-ray machine is shaped like a donut with a large hole. The patient lies on a bed that passes through the hole. As the bed moves slowly through the hole, the machine takes many x-rays. The computer puts the x-rays together to create pictures of the pancreas and other organs and blood vessels in the abdomen.

· Ultrasonography -- The ultrasound device uses sound waves that cannot be heard by humans. The sound waves produce a pattern of echoes as they bounce off internal organs. The echoes create a picture of the pancreas and other organs inside the abdomen. The echoes from tumors are different from echoes made by healthy tissues.

The ultrasound procedure may use an external or internal device, or both types:

o Transabdominal ultrasound: To make images of the pancreas, the doctor places the ultrasound device on the abdomen and slowly moves it around.

o EUS (Endoscopic ultrasound): The doctor passes a thin, lighted tube (endoscope) through the patient's mouth and stomach, down into the first part of the small intestine. At the tip of the endoscope is an ultrasound device. The doctor slowly withdraws the endoscope from the intestine toward the stomach to make images of the pancreas and surrounding organs and tissues.

· ERCP (endoscopic retrograde cholangiopancreatography) -- The doctor passes an endoscope through the patient's mouth and stomach, down into the first part of the small intestine. The doctor slips a smaller tube (catheter) through the endoscope into the bile ducts and pancreatic ducts. After injecting dye through the catheter into the ducts, the doctor takes x-ray pictures. The x-rays can show whether the ducts are narrowed or blocked by a tumor or other condition.

· PTC (percutaneous transhepatic cholangiography) -- A dye is injected through a thin needle inserted through the skin into the liver. Unless there is a blockage, the dye should move freely through the bile ducts. The dye makes the bile ducts show up on x-ray pictures. From the pictures, the doctor can tell whether there is a blockage from a tumor or other condition.

· Biopsy -- In some cases, the doctor may remove tissue. A pathologist then uses a microscope to look for cancer cells in the tissue. The doctor may obtain tissue in several ways. One way is by inserting a needle into the pancreas to remove cells. This is called fine-needle aspiration. The doctor uses x-ray or ultrasound to guide the needle. Sometimes the doctor obtains a sample of tissue during EUS or ERCP. Another way is to open the abdomen during an operation. Most of the time, biopsies are done without the need for surgery. Biopsies may not be required before proceeding with surgery if there is a high likelihood that a pancreatic cancer is present.

Many people diagnosed with pancreatic cancer want to take an active part in making decisions about their medical care. They want to learn all they can about their disease and their treatment choices. However, the shock and stress that people may feel after a diagnosis of cancer can make it hard for them to think of everything they want to ask the doctor. Often it helps to make a list of questions before an appointment. To help remember what the doctor says, patients may take notes or ask whether they may use a tape recorder. Some patients also want to have a family member or friend with them when they talk to the doctor-to take part in the discussion, to take notes, or just to listen.

Before starting treatment, a patient may want a second opinion about the diagnosis and the treatment plan. Some insurance companies require a second opinion; others may cover a second opinion if the patient requests it. Gathering medical records and arranging to see another doctor may take a little time. In most cases, a brief delay to get another opinion will not make therapy less helpful. Always feel free to seek a second opinion.
The UC Pancreatic Disease Center
Specialists In Pancreatitis & Pancreatic Cancer Treatment
Disease Of The Pancreas > Pancreatic Cancer



Pancreatic Cancer

What is Pancreatic Cancer?
What are the types of Pancreatic Cancer?
What are the symptoms of Pancreatic Cancer?
What procedures are used to diagnosis Pancreatic Cancer?
What causes Pancreatic Cancer?
What are the treatment options for Pancreatic Cancer?
What is the prognosis for Pancreatic Cancer?

About Pancreatic Cancer

Pancreatic cancer is now the 4th leading cause of cancer death in the United States. It will cause more than 30,000 deaths this year in the United States alone. Pancreatic cancer is difficult to detect, hard to diagnose, early to metastasize (spread) and resistant to treatment.

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Types Of Pancreatic Cancer

The most common type of pancreatic cancer is also known as pancreatic duct adenocarcinoma or simply pancreatic carcinoma. Other types of pancreatic cancer can occur as well including those arising from endocrine cells or exocrine cells. Endocrine cancers are also known as islet cell or neuroendocrine cancers. These tumors can produce hormones that produce a variety of symptoms such as changes in blood sugar or diarrhea. Exocrine pancreatic cancer is a disease in which cancerous cells originate within the tissues of the pancreas that produce digestive juices. The following information focuses mainly on pancreatic carcinoma, the most common cancer of the pancreas.

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Symptoms of Pancreatic Cancer

Pancreatic cancer is sometimes called a "silent disease" because early pancreatic cancer often does not cause symptoms. But, as the cancer grows, symptoms may include:

· Weight loss

· Pain in the upper abdomen or upper back

· Yellow skin and eyes, dark urine, and light stool

· Weakness

· Loss of appetite

· Nausea and vomiting

These symptoms are not sure signs of pancreatic cancer. An infection or other problem could also cause these symptoms. Only a doctor can diagnose the cause of a person's symptoms. Anyone with these symptoms should see a doctor so that the doctor can treat any problem as early as possible.

Answer 2

A Tumor Obstruction Should Have Been Easily Visible On the MRI. I don't Know Why There is a Problem. I Think (but don't Know fot Sure) that a Painful Pancreatitis Will Result from an Abbrupt Occlusion of the Common Bile Duct, Whereas the Slow Occlusion From a Tumor Will Not Result In Pain, the First Sign might Be Painless Jaundice (Courvosier's [Sp?] Sign?), So One Will Know From the History.

Answer 3

Very easy to differentiate. Pancreatitis is inflammation and gives severe pain abdomen. Tumor obstructs bile duct and causes obstructive jaundice. Serum amylase is high in pancreatitis not in tumor.

Answer 4

I hope it isn't cancer. I know somebody who had Hodgkin's disease, and when it metastasized, they got pancreatitis from the cancer, and died. <> Also, my girl friends son of 16 years developed pancreatic cancer and died soon after wards. Tell the Dr. you want to see his liver functions each day after testing. I wish you and your father good luck.

Answer 5

Sorry about your father, but hope that would help.
http://www.medicinenet.com/pancreatic_cancer/article.htm