This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science at CTCA.
This page was updated on May 10, 2022.
Accurately diagnosing pancreatic cancer often requires different types of tests.
Your care team will likely consist of a:
The team may use blood tests, imaging tests, biopsies and possibly molecular testing to obtain as complete a picture as possible. This process also helps doctors identify appropriate treatment options.
It’s challenging to detect pancreatic cancer early because there’s currently no standard diagnostic screening test for patients at average risk. For those with an above-average risk—such as those who have a family history of pancreatic cancer or a diagnosed genetic syndrome known to raise their predisposition, doctors may use screening tools such as an endoscopic ultrasound or magnetic resonance imaging (MRI).
Additionally, the pancreas is located so deep inside the body that it’s extremely difficult for doctors to palpate (feel) any tumors (and even the pancreas itself) during a physical examination.
However, it’s possible that pancreatic cancer may cause early symptoms, or that testing for other medical conditions may show signs of pancreatic cancer, causing your doctor to diagnose it early. Most often, symptoms aren’t apparent in early stages, and small lesions aren’t always detected by pancreatic cancer diagnostic tests, so cases tend to be diagnosed in more advanced stages.
Blood tests may provide clues that indicate the presence of the disease, but they don’t provide definitive early detection of pancreatic cancer. Blood tests help your doctor determine whether further testing is warranted. They include:
The first sign of pancreatic cancer is often jaundice, which causes yellowing of the whites of the eyes and the skin. When a patient has jaundice, the doctor will typically order liver function tests to find out what’s causing it to occur. These blood tests measure levels of bilirubin, a chemical produced by your liver, as well as of liver enzymes in your blood, in order to differentiate between jaundice caused by liver disease and other issues. High levels of bilirubin present in the blood may indicate pancreatic cancer.
Tumor markers are substances released into the body by a tumor. Identifying these substances, or biomarkers, can assist with the diagnosis of pancreatic cancer. Carbohydrate antigen 19-9 (CA19-9) and, to a lesser extent, carcinoembryonic antigen (CEA), are tumor markers linked to certain types of cancer. However, not all people with elevated levels of these tumor markers have pancreatic cancer, and not all people with pancreatic cancer will have elevated levels. If you have pancreatic cancer and your levels of these markers are high, repeating blood tests may help show whether treatment is working.
Imaging screenings provide a visual snapshot of the pancreas to expose potential abnormalities. The type of tests used may depend on your situation and symptoms.
Tests may include:
A biopsy tests suspicious tissue for signs of cancer and is an important part of the diagnostic process. A tissue sample is taken, either during one of the endoscopic imaging procedures or with a needle biopsy (in which a fine needle is inserted into the pancreas to retrieve cells), then sent to a pathologist who studies it under a microscope.
If other tests indicate a high likelihood that a tumor is cancerous, the patient may undergo surgery to have it removed. In this case, the tissue may be analyzed after surgery, instead of through a biopsy.
Molecular testing is a more sophisticated analysis of tissue and cell samples, looking for specific gene mutations or proteins that may help direct treatment. Ask your care team whether you are a candidate for this test and whether it can be performed on your tissue sample.
Reviewing your test results enables your care team to put together a more complete picture of your condition, including the stage of the cancer and treatment options.
Determining the stage of pancreatic cancer is based on three important factors: