Timely and accurate diagnosis - the key to effective pancreatic cancer treatment . A team of doctors in Israeli hospitals, working with the patient, uses the latest technology and includes pathologists, radiologists, gastroenterologists and surgeons with extensive experience in the diagnosis of pancreatic cancer. If the diagnosis is confirmed, an individual program of treatment.

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In some cases, pancreatic cancer is difficult to diagnose, since its symptoms resemble symptoms of other more common diseases. If the observed symptoms that may indicate the disease, the doctor examines the patient in an Israeli hospital, he asks questions about health status, lifestyle, family history.

The following types of tests can be performed to diagnose pancreatic cancer. Let us consider in detail what are these types of surveys in Israeli hospitals, how they operate, to prepare them to action.

Ultrasound scan

Ultrasound examination uses sound waves to create images of internal body structures. In just a few hours before the test will need to stop taking food and liquids. Ultrasound is also activated during the biopsy.

Endoscopic ultrasonography (EUS)

EUS in the diagnosis of pancreatic cancer is more accurate in comparison with the conventional ultrasound. It is administered with a view to investigate the amount of malignancy and to determine whether the pathological process penetrated close to the tissue disposed.

About 6 hours before the test will need to stop taking food and fluids to the stomach and duodenum were empty. The patient will make an injection to help relax and spray a local anesthetic on the back of the throat. EUS is performed by a small ultrasound probe equipped with an endoscope which doctors use to inspect the inside of the digestive tract. The probe passed through the mouth (or nose) to the small intestine. It is fed close to the pancreas, it is good to examine it. For small tumors rezultativen this method more than CT. During the procedure, using a small, hollow needle can take a tissue sample.

CT

CT performs a series of X-rays, which create a three-dimensional image of internal body structures. This basic test, which is assigned to determine the stage of pancreatic cancer. CT scans can help determine whether the operation is a viable option.

The scanning process takes 10-30 minutes and is painless. It uses a small amount of radiation that is not harmful either to the patient, or anyone who comes into contact with him. 4 hours will need to stop taking fluids and food.

Did the patient a contrast offered beverage injection or drip in order to more clear visualization of individual sections, in particular intestinal area to some of the segments are not mistaken as malignancies. The injection can cause flushing. If you have asthma or an allergy to iodine, can be an adverse reaction to the contrast.

CT also uses as a guide during the biopsy. However, in general prefer EUS.

MRI

This test uses radio waves and magnetic properties to build a detailed picture of the different internal structures of the body.

Scanner is a powerful magnet, so patients are encouraged to respond to a checklist of questions to make sure that the diagnosis is safe for him. The survey comes to metal objects. If the body is a metal (pins, implants, clips), the patient will probably not be able to undergo an MRI. another type of scanning is used.

Some patients injections of a contrast agent, which will facilitate a more accurate picture, but much less than at RT. Duration of the procedure often comes to one hour. Most experts prefer CT in pancreatic research.

In some cases, also involves specific types of MRI - magnetic resonance cholangiopancreatography (MRCP) for the study of the pancreatic and bile ducts, and magnetic resonance angiography to examine the state of the blood vessels.

PAT

During the PET in the diagnosis of pancreatic cancer in the blood of injected radioactive substance known as fluorodeoxyglucose or FDG. The level of radioactivity it is low, the body is released from it for about a day. Because cancer cells are rapidly growing, they absorb a large amount of radioactive glucose. About an hour later to produce scans that takes about thirty minutes when a special camera creates an image of areas of radioactivity in the body. Less detailed images than CT or MRI, but provide useful information.

PET-CT

PET-CT allows the doctor to receive the image area with higher radioactivity using PET and more detailed by CT. This test in the diagnosis of pancreatic cancer makes it possible to set the stage of the disease. Especially effective against exocrine cancer that has spread beyond the prostate boundaries, is not amenable to surgical treatment.

Angiography

This X-ray examination of blood vessels, which is used in the diagnosis of pancreatic cancer. Contrast is introduced into the artery for greater clarity, and then connect the X-ray.

Angiography visualizes blocking or restriction of blood flow in a specific area, as well as the abnormal vessels (feed cancer). In addition, this test shows the tumor invasion through the artery wall. Basically, it helps to decide whether to remove a malignancy may completely without damaging the vital blood vessels, as well as to plan the operation.

Angiography reveals mesh iron vessels too small, that they can be detected by other imaging tests. They nourish the tumor.

The procedure is not very comfortable, because the doctor inserts a small catheter into an artery in the thigh, and leads him to the pancreas. Used local anesthetic. Enter contrast and perform X-rays.

Angiography is also conducted by CT scanner (CT angiography) or MRI scanner (MR angiography). These methods in diagnosing a given time is used most pancreatic cancer, because they are able to give information on the blood vessels of the body and situated near the art without the need for a catheter. Establish a dropper for injection of contrast.

Biopsy

Medical history, physical examination, visualization tests help in the diagnosis of pancreatic cancer, but as a rule, the only way to be sure - to remove a small sample of malignancy and examine it under a microscope - a biopsy, which is done through a variety of approaches.

percutaneous biopsy

The procedure is performed during EUS or ERCP. The surgeon inserts a thin, hollow needle through the skin into the tumor to obtain a cell sample. This type of biopsy called fine needle. For anesthesia portion anesthetic is administered. The doctor guides the needle to the tumor using ultrasound or CT scan.

endoscopic biopsy

It is carried out in the course of endoscopy. The doctor inserts the endoscope into the throat and leads to the pancreas, or by applying EUS ERPG. Use of general anesthesia.

surgical biopsy

Currently running less frequently in the course of diagnosis of pancreatic cancer than in the past. It is recommended if the surgeon is concerned that the disease has spread beyond the affected organ, and wants to look at other organs in the abdominal cavity. Most often, a surgical biopsy is performed during laparoscopy. In the past, surgeons have often turned to laparotomy to examine internal organs and do a biopsy. But this type of operation requires a long recovery, and in rare cases, is currently in use.

Sometimes a biopsy is not performed. This occurs when the imaging tests show tumor, which can be removed during surgery. Therefore the doctor immediately proceed to surgery. If he finds out during the operation, the cancer has spread too far to sample the tumor completely removed, is taken to confirm the diagnosis, and the remaining part of the planned surgical intervention stops.

If surgery is planned to treatment, such as chemotherapy or radiation, requires a biopsy to confirm the diagnosis.

cholangiopancreatography

Cholangiopancreatography - this imaging test, which gives an opportunity to examine the pancreatic and bile ducts if they are blocked, narrowed or expanded. The survey in diagnosing pancreatic cancer malignancy will reveal if it blocks the duct. Also it is used in the planning of the operation. Cholangiopancreatography carried out in different ways, each of which has its pluses and minuses.

ERCP (Endoscopic retrograde cholangiopancreatography)

This test is performed to take a biopsy. Six hours stop taking food and fluids. The patient is injected, so that he could relax. The doctor inserts an endoscope through the mouth, pushed down to the stomach and duodenum. Grasping at the bottom of the endoscope takes a sample of the tumor, which is then sent to the laboratory. In addition, if the duct is blocked malignancy, mounted stent.

Magnetic resonance cholangiopancreatography (MRCP)

This non-invasive method of diagnosing pancreatic cancer by means of which it is possible to investigate the pancreatic and bile ducts, requires no contrast. It is recommended, if the main task - to examine the ducts. With MRCP can not take a sample or to place a stent.

Percutaneous transhepatic cholangiography (CHCHHG)

During this procedure the physician establishes a hollow needle through the skin into the hepatic bile duct, injecting a contrast agent therethrough. Then by X-ray examining ducts. During the procedure to take a sample of fluid or tissue, to place a stent to maintain an open flow path. As the pancreatic cancer diagnosis method is more invasive, and may cause more pain, usually it is not used unless ERCP can not be made due to any cause.

somatostatin receptor scintigraphy (SSR)

This type of survey in Israel recommended for neuroendocrine tumors. It uses octreotide, a hormone-like substance associated with the radioactive element - indium - 111. He joins the proteins of tumor cells. In the diagnosis of insulinoma this test less useful. Intravenously administered a low dose of octreotide. It spreads through the bloodstream and accumulates. Four hours later scans. This type of pancreatic cancer diagnosis is useful in making treatment decisions.

Blood tests

Several types of blood tests may be useful to help diagnose disease or determine the treatment options.

Blood tests for exocrine pancreatic cancer

Tests checking liver

Jaundice (yellowing of eyes and skin) is often one of the symptoms of pancreatic cancer, but the causes can be many, in addition to oncology. A blood test to determine what caused the symptom.

tumor markers

Tests on tumor markers in the diagnosis of pancreatic cancer aimed at measuring the levels of proteins produced by malignant cells. They are detected by a blood test.

Many types of pancreatic tumors produced substance - CA19-9 which is known as a tumor marker carbohydrate antigen. In some patients with the diagnosis of the content is correct, that does not mean that the disease is not present. Approximately eighty percent of patients its level increased.

Another well-known marker is carcinoembryonic antigen, which can help find pancreatic cancer in some people. But it is carried out less frequently than CA 19-9.

None of the tests for tumor markers is not precise enough to establish certain disease. The levels of tumor markers can be increased for other reasons.

To a large extent, this test is effective in order to monitor how the disease responds to treatment and during follow-up.

other tests

Blood tests in the diagnosis of pancreatic cancer make it possible to evaluate the function of the kidneys and other organs may be affected by a pathological process, to assess the overall state of health. They help determine whether the patient is able to move a complex operation.

Blood tests for neuroendocrine tumors

Blood tests that measure the levels of certain hormones of the pancreas, often help in the diagnosis of these tumors.

When insulinoma measured fasting insulin levels of glucose and C-peptide. Blood sampling performed every six - eight hours until the patient begins to have symptoms of low blood sugar. Diagnosis is confirmed insulinoma if set reduced amount of glucose and a high content of insulin and C-peptide.

When carcinoid tumors measured amount of serotonin, chromogranin A, neyroenolazy, gastrin.

Laparoscopy

It is performed when other tests have not confirmed the diagnosis of pancreatic cancer, or planned surgery to remove the tumor. Laparoscopic surgery is a small surgical procedure performed under general anesthesia, which means shorter hospitalization. It allows the doctor to look at the pancreas, to assess the possibility of surgery to remove a malignancy, not used for the diagnosis of pancreatic cancer. The main task - to find out, does not apply if the pathological process to other organs - intestines, liver, lymph nodes and stomach.

During laparoscopic surgery used general anesthesia, the surgeon performs incision small size in the umbilicus, introduces therethrough the laparoscope to examine the gland and surrounding tissue. If necessary, a biopsy. The abdominal cavity is pumped gas, in order to better examine the gland.

laparotomy

When laparoscopy may not be considered in the diagnosis of pancreatic cancer, the possibility of laparotomy. This operation is performed under general anesthesia using cavity, a long incision. Larotomiyu carried out very rarely, when other types of surveys do not give an accurate diagnosis. The vast majority of patients recommend laparoscopy.

ERCP, laparoscopy and biopsy may cause some problems. Doctors discuss with the patient any possible risks before they will be assigned.

prices for treatment

Arriving in Israel, the patient always goes diagnostics to clarify the earlier diagnosis.

The cost of the screening program:

  1. Advisory welcome oncologist - $ 610.
  2. The test for tumor markers - $ 240.
  3. KLA - $ 260.
  4. Biochemistry of blood - 280 $.
  5. PET-CT - 1670 $.

Total: 3730 $ .

Additional procedures:

  1. US - $ 310.
  2. EUS - $ 1000.
  3. MRI - $ 1470.
  4. Angiography - 4 $ 800.
  5. Biopsy - $ 600.

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