Tissue sampling for pancreatic cancer
If imaging scans show there is a tumour in the pancreas, your doctor may remove a sample of cells or tissue from the tumour (biopsy).
This is the main way to confirm if the tumour is cancer and to work out exactly what type of cancer it is. A specialist doctor called a pathologist will examine the sample under a microscope to check for signs of cancer.
A biopsy can be taken with a needle or during different types of surgical procedures:
A sample of cells may be collected with a fine needle (fine needle biopsy), or a tissue sample may be collected with a larger needle (core biopsy). A fine needle or core biopsy can be done during an endoscopic scan. Another method is to insert the needle through the skin of the abdomen, using an ultrasound or CT scan for guidance. You will be awake during the procedure, but you will be given a local anaesthetic so you do not feel any pain.
During a laparoscopy
Also called keyhole or minimally invasive surgery, a laparoscopy is sometimes used to look inside the abdomen to see if the cancer has spread to other parts of the body. It can also be done to take tissue samples before any further surgery.
A laparoscopy is done under general anaesthetic, so you will be asked not to eat or drink (fast) for six hours beforehand. If you take blood-thinning medicines or have diabetes, let your doctor or nurse know before the laparoscopy as they may need to adjust your medicines in the days leading up to the procedure.
The procedure uses an instrument called a laparoscope, which is a long tube with a light and camera on the end. The camera projects images onto a TV screen so the doctor can see the inside of your body. The doctor will guide the laparoscope through a small cut near your bellybutton. The doctor can insert other instruments through other small cuts to take the biopsy.
You will have stitches where the cuts were made. You may feel sore while you heal, so you will be given pain medicine during and after the operation, and to take at home. There is a small risk of infection or damage to an organ with a laparoscopy. Your doctor will explain the risks before asking you to agree to the procedure.
During surgery to remove the tumour
If you are having a larger operation to remove the tumour, your surgeon may take the tissue sample at that time.
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Dr Benjamin Loveday, Hepato-Pancreato-Biliary (HPB) Surgeon, Royal Melbourne Hospital and Peter MacCallum Cancer Centre, VIC; Dr Katherine Allsopp, Palliative Medicine Physician, Crown Princess Mary Cancer Centre, Westmead Hospital, NSW; Hollie Bevans, Senior Dietitian, Radiotherapy and Oncology, Western Health, VIC; Dr Lorraine Chantrill, Head of Department Medical Oncology, Illawarra Shoalhaven Local Health District, NSW; Amanda Maxwell, Consumer; Prof Michael Michael, Medical Oncologist, Lower and Upper GI Oncology Service, Co-Chair Neuroendocrine Unit, Peter MacCallum Cancer Centre and University of Melbourne, VIC; Dr Andrew Oar, Radiation Oncologist, Icon Cancer Centre, Gold Coast University Hospital, QLD; Meg Rogers, Nurse Consultant Upper GI/NET Service, Peter MacCallum Cancer Centre, VIC; Ady Sipthorpe, 13 11 20 Consultant, Cancer Council WA.
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