Tissue sampling for pancreatic NETs
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 pancreatic cancer it is.
The sample may be collected with a needle (fine needle or core biopsy) or during keyhole surgery (laparoscopy). If you are having surgery to remove the tumour, your doctor may take the tissue sample at the same time. A pathologist will examine the sample under a microscope to check for signs of cancer.
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A fine needle biopsy removes some cells from the pancreas, while a core biopsy uses a thicker needle to remove a sample of tissue. This is done during an endoscopy or endoscopic ultrasound.
An ultrasound or CT scan can help the doctor guide the needle through the abdomen and into the pancreas. You will be awake during the procedure, but you will be given a local anaesthetic so you do not feel any pain.
A laparoscopy, also called keyhole surgery, 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.
This procedure 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 are diabetic, 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.
A laparoscopy is done with an instrument called a laparoscope, which is a long tube with a light and camera attached. 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 belly button. 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-relieving 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 operation.
I went to the doctor because I was itchy and had constant diarrhoea. My GP initially thought it was gallstones and sent me for routine tests. After the CT scan I went into hospital for a laparoscopy and then had a biopsy, which confirmed I had cancer.
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Dr Lorraine Chantrill, Head of Department, Medical Oncology, Illawarra Shoalhaven Local Health District, NSW; Marion Bamblett, Nurse Unit Manager, Cancer Centre, Fiona Stanley Hospital, WA; Prof Katherine Clark, Clinical Director of Palliative Care, Northern Sydney Local Health District Cancer and Palliative Care Network, and Conjoint Professor, Northern Clinical School, The University of Sydney, NSW; Lynda Dunstone, Consumer; Kate Graham, Accredited Practising Dietitian – Upper GI Dietitian, Peter MacCallum Cancer Centre, VIC; Dr Gina Hesselberg, Radiation Oncologist, St George Hospital Cancer Centre, NSW; Dr Marni Nenke, Endocrinologist and Mary Overton Early Career Research Fellow, Royal Adelaide Hospital, SA; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; A/Prof Nicholas O’Rourke, Head of Hepatobiliary Surgery, Royal Brisbane Hospital and The University of Queensland, QLD; Rose Rocca, Senior Clinical Dietitian – Upper GI, Peter MacCallum Cancer Centre, VIC; Gail Smith, Consumer. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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