Diagnosis of Pancreatic Cancer

Your physician may select one or more of the following tests to help diagnose pancreatic cancer. The following is an overview of blood tests, diagnostic imaging tests, and biopsy, which can be ordered to assist in the diagnosis of pancreatic cancer.

Blood Tests

Research is advancing methods for diagnosing pancreatic cancer. Tumors release certain “markers” into a patient’s system, and biomarkers are being identified to help diagnose pancreatic cancer. The development of accurate blood tests is a major focus of medical research, but these tests are still being created and studied.

There are multiple blood tests that can be helpful for diagnosing pancreatic cancer, and may be monitored on an ongoing basis to track disease progression and therapy progress:

  • Liver function test: Measures liver enzymes and levels of bilirubin (pancreatic cancer causes elevated bilirubin in the blood)
  • CA19-9: Measures a type of protein in the blood that is often associated with pancreatic cancer (this protein can be present in non-cancerous conditions as well)
  • Carcinogenic Antigen (CEA): Measures a type of protein in the blood (different from CA19-9) that is often associated with pancreatic cancer (this protein can be present in non-cancerous conditions as well)

Diagnostic Imaging Tests

Diagnostic imaging tests can see the location of a tumor and indicate whether cancer cells have spread, or metastasized, to other parts of your body.

Computed tomography (CT): Provides the physician with computer-generated, cross-sectional images of the body by taking multiple x-rays from different angles.

Magnetic resonance imaging (MRI): Provides the physician with computer-generated, detailed images of the body by using magnetic/radiofrequency technology.

Magnetic resonance cholangiopancreatography (MRCP): Type of imaging test used in the evaluation of patients with known or suspected pancreatic cancer. An MRCP is a type of MRI programmed to look at the pancreatic and biliary tree.

Endoscopic ultrasound (EUS): An ultrasound performed while patient is under anesthesia – the ultrasound probe is inserted through the mouth and advanced to a position in the stomach that is right next to the pancreas. Because of this anatomical positioning, the EUS can provide a detailed image of the pancreas using ultrasound technology. For additional information on EUS, please click here.

Endoscopic retrograde cholangiopancreatography (ERCP): Type of endoscopic procedure used in the evaluation of patients with known or suspected pancreatic cancer. The Mayo Clinic defines ERCP as follows:

“Endoscopic retrograde cholangiopancreatography (ERCP) uses a dye to highlight the bile ducts. During ERCP, a thin, flexible tube (endoscope) with a camera on the end is gently passed down your throat, through your stomach and into the upper part of your small intestine. Air is used to inflate your intestinal tract so that your doctor can more easily see the openings of your pancreatic and bile ducts. A dye is then injected into the ducts through a small hollow tube (catheter) that’s passed through the endoscope. Finally, x-rays are taken of the ducts.” For additional information on ERCP, please click here.

Biopsy

Although there are multiple diagnostic approaches to detecting pancreatic cancer, the most accurate way is by taking a sample of tissue (biopsy), which can be evaluated under a microscope. A biopsy can be performed during EUS or ERCP, or by a radiologist inserting a needle to withdraw tissue while under anesthesia.