NCCN Guidelines for Patients
Pancreatic Cancer, Version 1.2014
Locally advanced unresectable pancreatic cancer
bile—a digestive fluid made in the liver. A tumor can
cause jaundice by blocking a duct that drains bile
and bilirubin from the liver. If you have jaundice, your
doctor may place a stent to unblock the bile duct.
But, a stent is not needed if you had a biliary bypass
during a previous surgery or laparoscopy. (Read
Part 4 on page 36 for details on supportive care for
treating jaundice and other cancer symptoms.)
If the first biopsy doesn’t confirm pancreatic
then the next step is to treat symptoms such
as jaundice as described in the previous paragraph.
However, when placing the biliary stent, your doctor
may also take samples—called brushings—of the
duct for testing. Then, at least two more biopsies
should be done to try to confirm pancreatic cancer.
There is more than one type of biopsy that can be
used, but EUS-FNA is preferred. Read Part 2 on
page 19 for biopsy details.
After confirming pancreatic cancer
with a biopsy and treating jaundice,
see Chart 5.4.2 for treatment