Pancreatic Cancer

Tests

Unfortunately, there are no laboratory tests available for the early detection or diagnosis of pancreatic cancer. The diagnosis is made using imaging tests and biopsy, but not usually until after the cancer has already spread.

Laboratory tests that may be abnormal but are diagnostic of pancreatic cancer include:

• Amylase: this may be raised if the tumour obstructs the ducts through which pancreatic juice flows to the intestine
• Liver function tests: a raised bilirubin indicates the tumour itself or glands it has spread to are blocking the bile duct. A raised ALT suggests that the tumour has spread to the liver
• Calcium: this is sometimes raised in pancreatic cancer (as in other cancers), producing symptoms such as weakness, nausea, abdominal pain and thirst. A raised calcium caused by cancer can be treated and the symptoms relieved
• CA 19-9 (Cancer Antigen 19-9): a tumour marker for pancreatic cancer; it is not useful for detection or diagnosis because it is not raised in all cases and may be raised in other conditions. If it is raised on diagnosis it may be used to assess the efficiency of treatment and to monitor for recurrence
• CEA (Carcinoembryonic antigen): a tumour marker that may also be used as a monitoring tool, if the concentration is raised at diagnosis.
• Other tests such as stool chymotrypsin or elastase, blood immunoreactive trypsin (IRT), amylase, and lipase may be measured to help determine how well the pancreas is functioning and whether pancreatic enzyme supplementation is necessary

Non-laboratory tests that may be used:

• CT (computed tomography) scan: useful for detecting pancreatic masses and detecting metastasised cancer
• Biopsy: used to confirm diagnosis of cancer, often in conjunction with CT scan
• ERCP (endoscopic retrograde cholangiopancreatography): test that uses a flexible endoscope tube inserted through the nose, stomach and into the pancreas which may be used to introduce a dye for X-rays, to place a stent (a metal or plastic tube that can help keep a duct open and functioning) or to take a biopsy
• Transabdominal ultrasound
• MRI (magnetic resonance imaging)