How is Pancreatic Cancer Diagnosed?

PANCREATIC CANCER IS VERY AGGRESSIVE; THERE ARE NO EARLY DETECTION METHODS

 

Because the pancreas is located deep within the abdomen, where tumors are hard to detect, and because pancreatic cancer can progress very quickly from stage 1 (localized within the pancreas) to stage IV (metastatic disease) in an average of only 1.3 years, it is critical to develop early detection tools. 

 

At this time, there are no proven biomarkers, or clues detectable in the blood or other bodily fluids that could indicate the presence of a pancreatic tumor.

 

WAYS TO DIAGNOSIS PANCREATIC CANCER:

Computed tomography (CT) scan

Magnetic resonance imaging (MRI)

Ultrasound

Cholangiopancreatography

Somatostatin receptor scintigraphy (SRS)

Positron emission tomography (PET) scan

Angiography

Biopsy

Blood tests

Several types of blood tests can be used to help diagnose pancreatic cancer or to help determine treatment options if it is found.

Blood tests for exocrine pancreatic cancers

Liver function tests: Jaundice (yellowing of the skin and eyes) is often one of the first signs of pancreatic cancer, but it can have many causes other than cancer. Doctors often get blood tests to assess liver function in people with jaundice to help determine its cause. For example, blood tests that look at levels of different kinds of bilirubin (a chemical made by the liver) can help tell whether a patient’s jaundice is caused by disease in the liver itself or by a blockage of bile flow (from a gallstone, a tumor, or other disease).

Tumor markers: Tumor markers are substances that can sometimes be found in the blood when a person has cancer. Two tumor markers may be helpful in pancreatic cancer:

  • CA 19-9

  • Carcinoembryonic antigen (CEA), which is not used as often as CA 19-9

Neither of these tumor marker tests is accurate enough to tell for sure if someone has pancreatic cancer. Levels of these tumor markers are not high in all people with pancreatic cancer, and some people who don’t have pancreatic cancer might have high levels of these markers for other reasons. Still, these tests can sometimes be helpful, along with other tests, in figuring out if someone has cancer.

In people already known to have pancreatic cancer and who have high CA19-9 or CEA levels, these levels can be measured over time to help tell how well treatment is working. If all of the cancer has been removed, these tests can also be done to look for the cancer coming back.

Other blood tests: Other tests can help evaluate a person’s general health (such as kidney and bone marrow function). These tests can help determine if they’ll be able to withstand the stress of a major operation.

Blood tests for pancreatic neuroendocrine tumors

Blood tests looking at the levels of certain pancreatic hormones can often help diagnose pancreatic neuroendocrine tumors (NETs). Tests might be done to check blood levels of:

  • Hormones made by different types of NET cells, such as insulin, gastrin, glucagon, somatostatin, pancreatic polypeptide, and VIP (vasoactive intestinal peptide)

  • Chromogranin A (CgA)

  • Glucose and C-peptide (for insulinomas)

Carcinoid tumors: For carcinoids, a blood test may be done to look for serotonin, which is made by many of these tumors. The urine might also be tested for serotonin and for related chemicals such as 5-HIAA and 5-HTP.

Other common tests to look for carcinoids include blood tests for chromogranin A (CgA), neuron-specific enolase (NSE), substance P, and gastrin. Depending on where the tumor might be located and the patient’s symptoms, doctors might do other blood tests as well.