Question

Discuss the current and future strategies for detection of pancreatic carcinoma. make it clear which are future and which are current.

Answer 1

Since pancreatic cancer can go undetected until it's advanced, by the time symptoms occur, diagnosing the cancer is pretty straightforward. Unfortunately, a cure is rarely possible at that point. Diagnosing usually happens after experiencing weeks or months of the symptoms. After that the doctor will take a medical history to learn the story of the illness such as the time of onset, nature and location of pain, smoking history and other medical problems. During a physical exam the doctor may feel a mass in the abdomen and notice swollen lymph nodes in the neck, yellowing skin or weight loss. Lab tests may show evidence that bile flow is being blocked, or other abnormalities. A doctor may often order an imaging test. CT scan (an x-Ray procedure that combines many x-Rays with the aid of a computer to generate cross sectional views), MRI (test that uses a magnetic field and pulses of radio wave energy to take pictures of organ and structures in the body), ultra sound or PET scan(an imaging test that uses a radioactive substance to look for disease in the body, called a tracer). If studies detect a mass in the pancreas, a pancreatic diagnosis is likely but not definite. Only a biopsy can diagnose pancreatic cancer.

#. Current strategies for detection of pancreatic cancer are :-

- Imaging tests that create pictures of your internal organs. These tests help your doctors visualize your internal organs, including the pancreas. Techniques used to diagnose pancreatic cancer include ultrasound, computerized tomography (CT) scans, magnetic resonance imaging (MRI) and, sometimes, positron emission tomography (PET) scans.

- Using a scope to create ultrasound pictures of your pancreas. An endoscopic ultrasound (EUS) uses an ultrasound device to make images of your pancreas from inside your abdomen. The device is passed through a thin, flexible tube (endoscope) down your esophagus and into your stomach in order to obtain the images.

- Removing a tissue sample for testing (biopsy). A biopsy is a procedure to remove a small sample of tissue for examination under a microscope. Your doctor may obtain a sample of tissue from the pancreas by inserting a needle through your skin and into your pancreas (fine-needle aspiration). Or he or she may remove a sample during EUS, guiding special tools into the pancreas.

- Blood test. Your doctor may test your blood for specific proteins (tumor markers) shed by pancreatic cancer cells. One tumor marker test used in pancreatic cancer is called CA19-9. But the test isn't always reliable, and it isn't clear how best to use the CA19-9 test results. Some doctors measure your levels before, during and after treatment.

# Despite the best attempts, it remains a general consensus that the early diagnosis of pancreatic cancer remains a clinical challenge and further research is needed to validate the utility of the newly suggested assays and biomarkers in the literature that could be used in the future as a screening tool for early detection and possibly monitoring the treatment of pancreatic cancer