Endoscopic procedures play an important role in diagnosing and managing pancreatic cancer. Tools like Endoscopic Ultrasound (EUS) and Endoscopic Retrograde Cholangiopancreatography (ERCP) allow doctors to closely examine the pancreas and surrounding organs. These minimally invasive techniques help detect cancer, guide treatments, and relieve symptoms without requiring major surgery.
What is Endoscopic Ultrasound (EUS)?
EUS uses sound waves to create high-resolution images of the pancreas, bile ducts, and digestive tract. During the procedure, a thin, flexible tube called an endoscope is guided through the mouth, down the esophagus, and into the stomach and small intestine. At the tip of the endoscope is an ultrasound probe that produces detailed pictures of internal tissues.
This outpatient procedure, typically done in a hospital or surgery center, usually lasts 15 to 45 minutes. It is mildly uncomfortable for most patients, and you can return home shortly afterward with minimal restrictions.
Why is EUS Used for Pancreatic Cancer?
EUS is especially helpful for pancreatic cancer care, offering the following benefits:
- Locating tumors: EUS provides highly detailed images that can detect tumors too small to be seen on CT or MRI scans.
- Assessing tumor size and spread: It helps doctors determine the size of a tumor and whether it has spread to nearby tissues or lymph nodes.
- Guiding biopsies: EUS can guide fine needle aspiration (FNA) to collect tissue samples for diagnosis and genetic testing.
- Managing pain: Doctors can use EUS to perform celiac plexus blocks, which relieve pain caused by pancreatic tumors pressing on nerve clusters.
- Screening high-risk individuals: Studies are exploring how EUS can be used to screen people at higher risk for pancreatic cancer.
ERCP
Endoscopic Retrograde Cholangiopancreatography (ERCP) combines endoscopy and X-ray imaging to examine and treat problems in the bile and pancreatic ducts. These ducts can become blocked or narrowed due to pancreatic cancer, leading to symptoms like jaundice or digestive issues.
How Does ERCP Work?
- An endoscope is guided through the mouth into the stomach and small intestine.
- A catheter is inserted through the endoscope to inject contrast dye into the ducts.
- X-rays capture images of the bile and pancreatic ducts to identify blockages or abnormalities.
Why is ERCP Used in Pancreatic Cancer Care?
ERCP offers both diagnostic and therapeutic benefits:
- Relieving blockages: Doctors can place stents to open narrowed ducts, improving bile flow and relieving symptoms like jaundice.
- Collecting tissue samples: Brush cytology or biopsy tools can collect samples for diagnosis.
- Draining fluid collections: ERCP can manage complications like fluid buildup caused by tumors.
Preparing for Endoscopic Procedures
Your healthcare team will provide specific instructions before your EUS or ERCP. Typically, you will need to avoid food and drink for six hours before the procedure. Sedatives are given to keep you comfortable, and you’ll need someone to drive you home afterward.
Safety and Recovery
Complications from EUS and ERCP are rare but may include mild side effects like bloating or soft stools after the procedure. Serious risks, such as infection or pancreatitis, are uncommon. Recovery is generally quick, and your healthcare team will provide guidance for any follow-up care.
These minimally invasive procedures are important tools for diagnosing, staging, and treating pancreatic cancer, helping healthcare teams provide tailored care for each individual.