Feature article

Detecting and monitoring pancreatic cancer

Magnetic resonance imaging, or MRI, is one method health care teams can use to detect and monitor pancreatic cancer, and the images can also be used by doctors and surgeons to plan the most appropriate treatment methods. While MRI isn't the sole diagnostic tool used in detecting pancreatic cancer, imaging does play a role in early diagnosis, which can be life-saving for individuals with the condition.

The critical nature of early diagnosis

Early diagnosis is always paramount to increasing the risks of positive outcomes in cancer treatment, but it's especially important with pancreatic cancer, which is still considered one of the most deadly cancers in the world. That's in part because the condition is difficult to catch early because it doesn't tend to come with symptoms that would drive individuals to doctors for tests or imaging. The nature of a pancreatic cancer diagnosis is so dire that as of 2014, it had a five-year survival rate of only 5 percent.1

Newer published five-year survival rates are only seven percent, however, when cancer has not spread to lymph nodes and can be removed entirely via surgical procedures, that rate rises substantially to 20 to 35 percent.2

Around 53,000 Americans are diagnosed with pancreatic cancer each year, but only between 15 and 20 percent meet requirements for such life-extending surgeries.3 This disparity is in large part due to the fact that patients are diagnosed after the cancer has spread to other areas and can't be removed.

Some benefits of MRI for patients

Yi-Xiang J. Wang and co-authors writing for the Chinese Journal of Cancer Research as early as 2015 point to imaging, including MRI, as an effective way to increase survival rates for pancreatic cancer patients. This is especially true, say the authors, given that new medical research has provided clinicians with some knowledge about genetic markers that may predispose individuals to such cancer.

The research team points to several technologies that may be of growing benefit in early detection, including both serum testing and MRI, specifically concluding that "MR imaging is becoming faster, and the cost-effectiveness is likely to further improve."4

Other benefits to patients of MRI use in pancreatic cancer screening and monitoring include:

  • MRI is a noninvasive procedure, which means no recovery time and less prep time
  • MRI is safe and doesn't come with any of the same infection or other risks that many more invasive tests do
  • MRI doesn't use the levels of radiation required in other forms of imaging, making it a safe option for ongoing monitoring
  • MRI can be used in place of CT scans when patients are allergic to the contrast substance required for other types of scans

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MRI's effectiveness in pancreatic cancer detection and monitoring

But how effective is MRI in helping health care teams identify and monitor pancreatic cancer?

The American Cancer Society lists imaging tests, including MRI, as an important tool in pancreatic cancer detection and treatment. Imaging is used to evaluate areas where cancer might be, determine how cancer may have spread and evaluate the efficacy of cancer treatments. It's also used during remission periods to ensure cancer hasn't returned.5

Most experts note that a combined approach to diagnostics and monitoring, which includes MRI as well as other imaging, may be most appropriate when dealing with pancreatic cancer (or the potential for such a diagnosis). By staying aware of all imaging options available, doctors can choose the tests that provide the best possible accuracy and picture of the problem.

Eun Sun Lee and Jeong Min Lee, in writing for the World Journal of Gastroenterology, conclude that a multi-modality approach can be powerful in pancreatic imaging, though "each imaging modality has its own role, advantages, and disadvantages, not only for diagnosis but also for the treatment and follow-up of pancreatic cancer."1 The authors urge radiologists and clinicians to be familiar with the characteristics of each modality, including MRI, for optimal results.

Erwin Santo, of the Department of Gastroenterology and Liver Diseases at Tel Aviv Sourasky Medical Center, comes to a similar conclusion in writing for the Journal of the Pancreas. He writes that the main role in CT, MRI and PET scanning is "in the detection of distant metastases" and that best results may be gained from a combination of good imaging, modalities such as endoscopic ultrasound and tissue diagnosis.6

Conclusion

Pancreatic cancer comes with some mighty challenges, both for patients and the health care community. But early detection and monitoring is one of the best tools doctors have in the fight against this deadly condition. Patients who feel they are at risk of pancreatic cancer because of genetics or other predispositions may want to talk to their health care providers about the role of MRI and other imaging tests in early detection.

1. Eun Sun Lee and Jeong Min Lee. "Imaging diagnosis of pancreatic cancer: A state-of-the-art review." World Journal of Gastroenterology. 28 June 2014. Web. 19 November 2018. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4069314/>.

2. "Prognosis." Hirshberg Foundation for Pancreatic Cancer Research. Web. 19 November 2018. <http://pancreatic.org/pancreatic-cancer/about-the-pancreas/prognosis/>.

3. "Inoperable Pancreatic Cancer." Healthline. Web. 19 November 2018. <https://www.healthline.com/health/inoperable-pancreatic-cancer>.

4. Wang, Yi-Xiang J. et al. "On pancreatic cancer screening by magnetic resonance imaging with the recent evidence by Del Chiaro and colleagues." Chinese Journal of Cancer Research. August 2015. Web. 19 November 2018. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560739/>.

5. "Tests for Pancreatic Cancer." American Cancer Society. Web. 19 November 2018. <https://www.cancer.org/cancer/pancreatic-cancer/detection-diagnosis-staging/how-diagnosed.html>.

6. Santo, Erwin. "Pancreatic Cancer Imaging: Which Method?" Journal of the Pancreas. Web. 19 November 2018. <http://pancreas.imedpub.com/pancreatic-cancer-imaging-which-method.php?aid=2891>.