There are multiple tests that can be used to help doctors find and diagnose cancer of the pancreas. Each test has different strengths, so usually more than one test is used in order to provide accurate information. There is some discussion within the medical field on how these tests should best be used to diagnose pancreatic cancer and determine the stage of the cancer.

Signs and Symptoms

As discussed earlier, before a patient gets tested for pancreatic cancer, they typically show signs or have symptoms that are associated with cancer of the pancreas. Usually, these symptoms are vague and tend to start in the later stages of pancreatic cancer, which is why it is hard to diagnose cancer of the pancreas in its early stages. The most common sign of pancreatic cancer is jaundice. Other common signs and symptoms like loss of appetite, weight loss, and problems with stomach pain and digestion are associated with other illnesses as well. For this reason, other illnesses that can be causing your symptoms may have been ruled out before checking for pancreatic cancer. 

Imaging tests

CT Scans

CT scans take detailed radiographic pictures of your internal organs so that all layers of the tissues can be seen. A CT scan can take pictures of your pancreas, as well as your chest and pelvis. It can see up to 90-95% of cancers of the pancreas. The images produced by CT scans can be used to decide if a tumor can be safely removed with surgery. They can also be used to see if cancer has spread to other parts of the body. However, the images are not always able to show small tumors in the liver and lymph nodes, which are two places to which pancreatic cancer commonly spreads.

There are special types of CT scans that show structures in an organ and blood vessels more clearly. These tests involve contrast dye. This dye helps doctors see structures that they wouldn’t be able to see with a normal CT scan, like the details of arteries. This information is important because it helps doctors decide if a tumor is safe to remove through surgery. If a tumor is too connected to an important blood vessel, it may be too dangerous to remove. This type of CT scans also gives information about the stage of the pancreatic cancer. It can be hard to tell the difference between certain types of pancreatic cancer using only CT scans, so other tests may be used along with CT scans to diagnose pancreatic cancer and determine the stage.

MRI

An MRI is a test that uses magnetic fields to create detailed pictures of different parts of the body. MRIs can find tumors in the liver that are associated with pancreatic cancer and identify the types of cancers that might be hard to see with a CT scan.

MRIs can look at the pancreatic duct and the bile duct to see if a tumor is blocking those areas. Certain types of MRIs can also give information on the blood vessels with which the tumor may be involved. 

PET Scan

During this type of imaging test, a form of sugar is introduced into the body that can be detected by the PET scan. The sugar (glucose) tends to collect in tumors since the tumors need energy to survive and use sugar as their energy source. This information can help determine a tumor’s characteristics.

Other tests

Ultrasound

Ultrasound tests use sound waves to create pictures of different parts of the body. Abdominal ultrasounds can be used to find pancreatic cancer tumors. This type of test tends to be used by experienced medical professionals outside of the US. One of the drawbacks of this test is that it is hard to get a clear picture if a patient has more fat on their body.

Ultrasounds are useful because they are sometimes able to find tumors that are too small for a CT scan to find.

Another type of ultrasound used for pancreatic cancer is an endoscopic ultrasound. During this test, a tube with an ultrasound device is put down the throat and into the stomach. This allows for a more direct and clearer image of the pancreas and tumors in this area.

Still, another type of ultrasound uses a small tube that is put in the abdomen, around the area of the pancreas. This is called a laparoscopic ultrasound. This allows doctors to see, for example, if the cancer has spread to the liver or the peritoneum.

Biopsy

A biopsy involves removing a small piece of tissue from the body, which can be looked at through a microscope. Sometimes, the tissue is taken from the body with a needle. After the piece of tissue is removed, it is examined under a microscope in order to find out what type of pancreatic cancer someone has. With the information that they get from a biopsy, doctors may be able to make a personalized cancer treatment plan.

Blood tests

There are some proteins and other elements associated with tumors, which can be detected and quantified.  People with pancreatic cancer may have these markers in their blood.  Examples are CEA, CA 19-9, cell-free DNA and circulating tumor cells. While CA 19-9 levels are usually elevated in patients with pancreatic re used less for diagnosis and often monitored to track the possible response to treatment.