Pancreatic Cancer Screening & Diagnosis

Screening for Pancreatic Cancer

While there is no standardized screening test for everyone, if you have a family history of pancreatic cancer or you have known genetic mutations such as BRCA1/2 or Lynch Syndrome, screening may be available. Tests usually include:

Computed tomography (CT) scan – An imaging test that can reveal the presence of suspicious lesions
Endoscopic ultrasound – A minimally invasive test that looks inside the pancreas using a lighted tube and camera. This allows the doctor to evaluate the pancreas for signs of cancer. A tissue sample of anything out of the ordinary can be taken for testing.
MRI or MRCP – This type of magnetic resonance imaging test provides detailed images of the pancreas and bile duct

If you qualify, screening usually begins at age 50 or 10 years earlier than your earliest relative’s age at diagnosis.

Symptoms of Pancreatic Cancer

Pancreatic cancer doesn’t show signs right away. When symptoms appear, the cancer has usually grown extensively. Talk to your doctor if you notice any of the following:

Pain in the upper abdomen or back: This can feel like a dull ache that comes and goes. It may get worse after you eat.
Itchy skin with no obvious cause
Unplanned weight loss
Yellowing of the skin or eyes (jaundice)
Dark urine, even if you’re hydrated, or pale stools
Nausea, vomiting, diarrhea, or constipation that doesn’t clear up on its own or has another known cause.
New or worsening diabetes
Ongoing fatigue

Diagnosing Pancreatic Cancer

If you have symptoms that suggest pancreatic or bile duct cancer, your doctor will run tests to determine if there is a tumor and if it is cancerous.

Imaging

Imaging tests are used to identify the location of a tumor in the complex structure of the pancreas and bile ducts. Imaging tests commonly used include:

CT Scan
MRI or MRCP - An MRCP is an MRI that provides detailed images of the pancreas and bile ducts
Endoscopic ultrasound - Your doctor passes a thin, lighted tube (endoscope) down your throat, through your stomach, and into the first part of the small intestine. This internal view of the pancreas and bile ducts provides a more accurate picture than an external ultrasound can for this area of the body. Biopsy samples can also be taken during this procedure.

Biopsy

If a tumor is found, a sample will be tested to determine whether cancer cells are present and what type they are. This can be done through an endoscopic procedure, often used as part of diagnosing pancreatic cancer, or through a fine needle aspiration that removes some of the cells through a needle inserted from outside of the body.

If imaging tests show that the cancer is extensive, the oncologist may move directly to treatment without a biopsy first.

Biomarker Testing

When a tissue sample is taken, tests are run to determine if a genetic mutation is present and causing the cancer to grow. This could be an inherited mutation or one that develops over an individual's lifetime.

If a genetic change is identified, specific targeted therapy drugs may be available to slow the growth of cancer.

Blood Tests

Blood tests are also used to test the liver’s function. If jaundice is found, a blood test will tell the doctor whether it’s caused by disease in the liver itself or by a blockage of bile flow from a gallstone, a tumor, or other disease.