The diagnosis is most often made at a late stage due to the late clinical signs of the disease: pain in the epigastric region of the abdomen, jaundice, weight loss, fatigue, and general deterioration.
Diagnostic scanning is carried out mainly in the thoraco-abdominal-pelvic areas with an iodine-contrast product. Tumor markers CA 19-9 and ACE are analyzed for diagnosis. The diagnosis is confirmed by the anatomopathological analysis of the removed tissue if the tumor is operable or by biopsy for unresectable tumors using echo-endoscopy.
Whenever possible, treatment always involves surgery. Neoadjuvant chemotherapy (FOLFORINOX protocol) is performed to improve surgical conditions during tumor removal.
In the case of obstruction and jaundice, a multidisciplinary treatment approach will include bile drainage, which is necessary before endoscopic chemotherapy (possibly stent placement) or duct clearing with surgical intervention. Radiotherapy for pain relief can be performed in the tumor area. According to some indications, in the case of a localized inoperable tumor, radio-chemotherapy or stereotactic radiotherapy is proposed. In any case, maintaining a quality of life is crucial. In particular, pain and malnutrition should be detected and treated effectively.