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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat Pancreatic Tumor?

I have had a pancreatic tumor (head/neck) diagnosed by abdominal CT. Approx. 1.5-2 cm. Also some liver lesions which turned out to negative for malignancy. I meet with oncologist tomorrow. (Past hx of Br CA x 2-18 yrs apart; family hx of multiple cancers including pancreatic). All enzymes normal. CA19-9 = 10. all other blood work nl. My question is: I suspect that I will next have the pancreatic tumor diagnosed to confirm malignancy and cell type. If this is the procedure used (rather than EUS) will it be usual to take samples of the tumor and other surrounding areas to determine if tumor has affected surrounding areas? Also is this procedure more used for this type of situation than EUS-how much difference? Thank you
Wed, 18 Mar 2015
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Radiologist,  's  Response
Hi,
Thanks for writing in.

Stage of the cancer is known by the size and extent of the tumor. Techniques like CAT scan and endoscopic ultrasound help a lot in staging of cancers in the pancreas. Since you have no other features of cancer spread other than the mass in the head of pancreas measuring 1.5 x 2 cm hence ultrasound or CT scan guided FNAC or biopsy is a must for making pathological diagnosis.

EUS is one of the ways to accurately target the mass and take out the cells. In a transabdominal USG or CT guided procedure also the abjective remains the same. The only difference is that EUS is a minimally invasive technique and transabdominal approach is an external technique. If a tumor is better accessible externally then this approach is used. However if the tumor is thought to be better sampled with EUS then that method is used. You will be given pain relief medications in both procedures.

The CA 19-9 level is normal and this means that there is less likelihood of the mass to be a cancer. It is a cancer marker and a high value indicates probability of cancer. However you should discuss the mater with doctors at the cancer hospital and get a biopsy scheduled quickly. This is because a normal CA 19-9 can rarely be a cancer and it must be treated should it be one.
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How To Treat Pancreatic Tumor?

Hi, Thanks for writing in. Stage of the cancer is known by the size and extent of the tumor. Techniques like CAT scan and endoscopic ultrasound help a lot in staging of cancers in the pancreas. Since you have no other features of cancer spread other than the mass in the head of pancreas measuring 1.5 x 2 cm hence ultrasound or CT scan guided FNAC or biopsy is a must for making pathological diagnosis. EUS is one of the ways to accurately target the mass and take out the cells. In a transabdominal USG or CT guided procedure also the abjective remains the same. The only difference is that EUS is a minimally invasive technique and transabdominal approach is an external technique. If a tumor is better accessible externally then this approach is used. However if the tumor is thought to be better sampled with EUS then that method is used. You will be given pain relief medications in both procedures. The CA 19-9 level is normal and this means that there is less likelihood of the mass to be a cancer. It is a cancer marker and a high value indicates probability of cancer. However you should discuss the mater with doctors at the cancer hospital and get a biopsy scheduled quickly. This is because a normal CA 19-9 can rarely be a cancer and it must be treated should it be one.