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Having a biopsy to test for pancreatic cancer

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This page has information on biopsies for cancer of the pancreas. You can find the following information

 

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Having a biopsy to test for pancreatic cancer

The only certain way to diagnose a cancer is by getting a sample of cells (biopsy) and looking at them under a microscope. The easiest way to do this is by putting a needle into the area of suspected cancer, and taking out some cells. But specialists don’t usually take biopsies of the pancreas if they think the cancer is removable with surgery.

If it is likely that your cancer can be removed, your diagnosis will be made entirely by the doctor examining you and considering the results of your scans and tests. A confirmed diagnosis can be made when you have your surgery. If you have a cancer that is not removable with surgery, your specialist may want to biopsy it.

How to take a biopsy

There are several different ways your doctor can take a biopsy. Which one your doctor uses will depend on where the tumour is in the pancreas. One of the most common ways of taking a biopsy is during an endoscopic ultrasound. Other ways include during an ERCP, laparoscopy or a laparotomy. Or your doctor may use ultrasound or a CT scan to guide a needle into the tumour through your skin.
 

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Why you need a biopsy

The only certain way to diagnose a cancer is by getting a sample of cells (biopsy) and looking at them under a microscope.

The easiest way to do this is by putting a needle into the area of suspected cancer, and taking out some cells. But specialists do not usually take biopsies of the pancreas if they think it is a cancer which is removable with surgery (resectable). In this case, your diagnosis will be made entirely by the doctor examining you and considering the results of your scans and tests. A confirmed diagnosis can be made when you have your surgery.

If you have a cancer that is not removable with surgery, your specialist may want to biopsy it so that you can go on to have cancer treatment to try to slow down its growth. If all your other test results point to cancer and your consultant thinks there is no doubt that this is what you have, you may not need a biopsy before you have treatment.

 

Different ways of taking a biopsy

There are several different ways your doctor can take a biopsy. Which one your doctor uses will depend on where in the pancreas the tumour is. You may have a

Biopsy with endoscopic ultrasound (EUS)

If you have an EUS, you swallow a long thin tube called an endoscope. It has a camera so the doctor can watch what they are doing on a video screen. The tube also has an ultrasound probe at the tip. The ultrasound picture helps the doctor to see where the cancer is and to take a biopsy more accurately.

Biopsy during an ERCP

If your doctor can see an area that looks like cancer during an ERCP, they will take a sample of tissue. Your doctor may also take samples of pancreatic juice during the ERCP. These will go to the lab because they may contain cancerous cells.

Ultrasound or CT guided biopsy

The cancer may form a mass that can be reached with a needle through your skin. You have a local anaesthetic injection so that the area goes numb. Then using ultrasound or CT to see exactly where the tumour is, your doctor puts a fine needle through the skin and into the tumour. Using the needle, they can then take out a small piece of tissue. This should not be painful because of the local anaesthetic. But you will feel pressure when the needle goes in.

During a laparoscopy

A laparoscope is a bit like a flexible telescope. It is a tube with a light and camera attached. Your doctor can use it to look directly inside the abdomen.

You are most likely to have this done under a short general anaesthetic. Once you are asleep, you have several small cuts (incisions) in the skin of your abdomen. Gas is pumped into the abdomen to make it swell and give more room for your doctor to look around. This gas will not do any harm and will gradually disappear after the test. Your doctor may use an ultrasound through the laparoscope. This will help to show exactly where the cancer is, so that your doctor can take a biopsy more accurately. After this test is over, you will have stitches or steristrips holding the incisions closed. They will heal within a week or so.

During a laparotomy

If your disease cannot be diagnosed any other way, you will have a laparotomy. This is an operation to open the abdomen and take a tissue sample from the pancreas. This is not often done these days. You are more likely to have a laparoscopy because it is a much smaller operation. You usually have to stay in hospital for a few days after a laparotomy. Some surgeons will send the biopsy to the laboratory while you are still under anaesthetic. If the results confirm you have pancreatic cancer, they may continue to do the surgery you need.

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Updated: 28 May 2014