Pancreatic cancer can be difficult to diagnose. It often develops without clear early symptoms and may require a series of tests to confirm. This uncertainty can feel overwhelming, but knowing what to expect, and when to seek help, can make all the difference.
If you notice ongoing or unusual changes in your body, it’s important to visit your GP as soon as possible. You might feel hesitant or worried about what your symptoms could mean, but delaying care can impact your options. Many symptoms are caused by other, less serious conditions, but if it is pancreatic cancer, finding it early gives you the best chance for effective treatment.
At your appointment, give your GP a full picture of how you’re feeling. Be sure to share all of your symptoms including:
- what makes them better or worse (e.g. eating, movement, rest)
- your emotional wellbeing
- any known family history of cancer
It may help to make a list of your concerns beforehand and bring it to your appointment. Having a trusted friend or family member come with you can also offer support and help you remember key information.
Your GP will ask about your general health, family history, and current symptoms. They may:
- examine your abdomen and other areas where you’re experiencing discomfort
- press on your abdomen to feel for any unusual lumps or swelling
check your skin and eyes for signs of jaundice (yellowing), which may indicate a blockage - listen to your chest if you’re feeling breathless, to check for fluid build-up
- ask about any symptoms you haven’t mentioned or might not have noticed
Based on this information, your GP may refer you to a specialist such as a:
- Gastroenterologist (digestive system specialist)
- Endocrinologist (hormone and gland specialist)
- Or directly to a surgeon or oncologist who specialises in pancreatic cancer
The path to a confirmed diagnosis
Because pancreatic cancer can be difficult to detect, even if initial tests raise concerns, your medical team may recommend further investigations. This is understandably a stressful time, and waiting for answers can be especially hard. But each test helps your doctors build a more accurate understanding of what’s going on, so they can determine the most appropriate treatment and care plan.
In rare cases, a cancer from a different part of the body may have spread to the pancreas, so your doctors will work to determine whether the cancer started in the pancreas or elsewhere.
My diagnosis was complicated, and it took a while to get a definite diagnosis – Aarathy
Tests for pancreatic cancer
If your doctor suspects pancreatic cancer, they may recommend a range of tests to better understand what’s happening. These tests help determine the type of cancer, where it’s located, and whether it has spread. This is called staging.
You may not need every test listed here, your doctor will tailor recommendations based on your individual situation.
Blood Tests
Blood tests are used to check your overall health, including how well your liver, kidneys and blood cells are functioning. Pancreatic cancer can affect these systems, so abnormal results may point to the need for further tests.
Some blood tests also look for tumour markers: proteins that may be raised in people with pancreatic cancer:
- CA19-9: The most commonly used and validated marker for detecting symptomatic pancreatic cancer. It can also help monitor treatment response, predict recurrence and guide prognosis.
- CEA (carcinoembryonic antigen): May be elevated in some cancers.
- CA125: A protein that can also be elevated in certain cancers.
These markers can’t confirm a diagnosis on their own. Some people with pancreatic cancer have normal levels, while others may have elevated markers due to unrelated conditions. Doctors use this information alongside other tests to form a clearer picture.
Understanding the CA19-9 Tumour Marker
CA19-9 is the most well-researched blood biomarker used in pancreatic cancer. While not diagnostic on its own, this marker can help assess treatment response, detect recurrence, and guide prognosis. Learn how it's used, what the results mean, and how it fits into the broader picture of pancreatic cancer care.
Imaging Tests
Often the first imaging test used. It uses sound waves to create images of the pancreas and nearby organs. While helpful, it’s not always definitive, especially if results are unclear, your doctor may order further scans.
A CT scan provides detailed cross-sectional images of your abdomen and surrounding organs. It can show the size, location and spread of any tumours. A contrast dye is often used during the scan to make images clearer. You may briefly feel warm or notice a metallic taste, these effects fade quickly.
MRI scans offer detailed views of soft tissues, while MRCP specifically looks at the bile ducts and pancreatic ducts. These tests may involve fasting beforehand and an injection of contrast dye. Not everyone will need an MRI or MRCP, your doctor will advise on what’s appropriate and discuss any associated costs.
A PET scan uses a small amount of radioactive glucose to detect areas of high activity, often caused by cancer cells. It’s especially useful for detecting spread that may not be visible on other scans. PET scans aren’t available at all hospitals and may not be covered by Medicare or private health insurance, your team will guide you on access and eligibility.
Biopsy
A biopsy confirms a diagnosis by examining a small tissue sample under a microscope. There are several ways to collect the sample, depending on where the suspected cancer is located. These include:
- Endoscopic ultrasound with fine needle aspiration
- During an ERCP
- Guided by CT or ultrasound
- Keyhole surgery (laparoscopy)
- Open surgery (laparotomy)
Biopsies are often recommended as they provide crucial information to help plan treatment. In rare cases, your doctor may recommend proceeding without one, based on other test results.
Endoscopic Tests
This procedure uses a thin, flexible tube (endoscope) with a camera and ultrasound probe. It’s passed through your mouth into the stomach to create detailed images of the pancreas and nearby areas. A biopsy can often be taken during the same procedure.
This is typically a day procedure done under sedation, so you’ll need someone to take you home afterwards.
Used especially when jaundice is present. A flexible tube guides a catheter into the bile duct. Dye highlights any blockages. A stent may be placed to relieve the blockage, and tissue may be collected. This is a day procedure performed under sedation, with a short recovery time.
Surgical Tests
A minor operation under general anaesthetic using a small telescope inserted into the abdomen. This allows doctors to check for cancer spread that may not appear on scans. Biopsies may be taken at the same time.
Other Possible Tests
You may need tests to check how well your heart and lungs are functioning. These help your team determine which treatments are safe for you.
What comes next
Once your doctors have gathered all the test results, they can explain your diagnosis, the cancer’s stage, and your treatment options. You may also hear about molecular profiling or genetic testing, which looks at the genetic makeup of the tumour to guide more personalised treatment decisions.
Pankind recommends discussing genomic testing with your medical team. It may offer important information that helps tailor your treatment plan.
Questions to ask your doctor
- What tests and scans will I need?
- What type of pancreatic cancer do I have?
- Has the cancer spread, and what stage is it?
- What are my treatment options?
- How much will the tests and treatment cost?
- Is there a chance of cure, or is treatment aimed at control?
- Are there clinical trials suitable for me?
- Should I consider genomic or molecular testing?
- Who do I contact if I feel unwell between appointments?
- Would a second opinion be helpful?