Tests for pancreatic cancer
You may need several tests to work out whether you have pancreatic cancer. If you are diagnosed with pancreatic cancer, your doctors will use the test results to help decide the best treatment for you.
Your hospital will give you detailed information about each test and where you need to go. Ask your doctor for this information if you haven’t been given it.
If you have any questions about the tests you are having and why you’re having them, speak to your doctor. You can also speak to our specialist nurses.
You may have to wait a few days – or as long as two weeks – for some scans or tests. Sometimes people have to wait longer than this. If you’ve been given an urgent referral for a test because of suspected cancer, it should be done within two weeks. If you haven’t heard anything within two weeks, speak to your doctor. It may also help to speak to the consultant’s secretary.
If your GP doesn’t suspect cancer and you haven’t been given an urgent referral, you may have to wait several weeks for tests.
People with pancreatic cancer can start to feel very unwell quite quickly. If your symptoms get worse while you are waiting for tests, speak to your GP or specialist nurse, as you may need to be seen sooner. They can also help you manage symptoms. If you have to go into hospital for any reason, ask if any of the tests you are waiting for can be done while you are there.
What tests are used to diagnose pancreatic cancer?
You may have different tests at different times. For example, you may have tests which diagnose pancreatic cancer, but then need more to find out exactly what type of pancreatic cancer you have and what stage it is. You probably won’t need all the tests described here, and you may not have them in this order.
You may find it helpful to look at our diagram of the pancreas and surrounding organs when reading about some of the tests.
Blood tests are used to check your blood cell levels (blood count), how well your liver and kidneys are working, and your general health. If you have jaundice the blood test will show how bad the jaundice is.
Blood tests can also check for tumour markers. These are chemical substances produced by cancers that show up in the bloodstream. CA19-9 is a marker that may help diagnose pancreatic cancer. But not all pancreatic cancers produce tumour markers, and other conditions that aren’t cancer can also produce them. This means blood tests are used together with other tests to make a diagnosis.
Most blood tests can be done straight away. It may take a few days or up to a week to get the results.
Ultrasound scans use sound waves to make a picture of the pancreas and surrounding organs. The images are displayed on a screen.
The scan is done while you are awake and lying on your back on a couch. Gel is spread on the skin of your tummy, then a probe is passed over the area. It can take from 5-30 minutes, depending on the extent of the scan, and you can go home as soon as it’s over.
It may take one to two weeks to get the results of an ultrasound scan.
A CT scan uses x-rays to create a 3D picture of the pancreas and the organs around it. It is also usual to scan your chest and pelvic area (below your tummy) to check for any signs of cancer outside the pancreas.
You may have a CT scan after an ultrasound scan. If you have jaundice, you may just have a CT scan. If you have a biopsy, you may have a CT scan to guide the needle.
Before the scan, you may be asked to swallow a liquid containing a dye. This helps the different organs show up on the scan. You may also be given an injection into a vein, to help to show the blood vessels.
You will be awake during the scan, and you won’t feel anything. You will lie on a couch which moves through the scanner, and a series of x-rays are taken.
The CT scan usually lasts about 30 minutes, depending on the exact area being scanned. You will probably be able to go home straight afterwards.
It may take one to two weeks to get the results of the CT scan.
MRI scans use magnets and radio waves to build up detailed pictures of the pancreas and surrounding areas.
The scanner is shaped like a tunnel, and you will lie on a couch that moves into it. The scanner is noisy so you may be given earplugs or headphones. You won’t feel anything during the scan. You will be able to hear and talk to the radiographer who operates the scanner from outside the room. The scan usually takes 20-30 minutes and you can go home afterwards.
It may take one to two weeks to get the results of the MRI scan.
This test is usually done at a specialist centre.
A thin, flexible tube (endoscope) with a light at the end and a small ultrasound probe is passed through your mouth and into your stomach. The ultrasound creates detailed pictures that help to show where the cancer is in the pancreas, how big it is and whether it has spread outside the pancreas.
A needle can also be passed through the tube to take tissue samples. This is a type of biopsy called fine-needle aspiration (FNA).
The EUS takes 30-60 minutes. You will be given a throat spray to numb your throat and help stop you coughing during the procedure. Then you will be given a sedative by an injection. It won’t put you to sleep but it will make you feel drowsy and relaxed. This makes it easier for the doctor to pass the endoscope into your stomach.
You will probably be able to go home a couple of hours afterwards.
An ERCP is sometimes used to diagnose problems with the pancreas. It is more usually used if your bile duct is blocked, to insert a small tube (called a stent) into the bile duct to unblock it. Read more about a blocked bile duct and inserting a stent.
Like the EUS, an ERCP uses an endoscope but it also takes x-rays. Dye is injected through the endoscope into the ampulla of Vater, which is where the pancreatic duct opens into the duodenum. Any blockages will show up on x-rays. While the endoscope is in place the doctor may take cells from the bile duct to check under a microscope. They may also take tissue samples for biopsy.
If your ERCP is done to get x-rays and tissue samples, you will be able to eat within a couple hours, and will probably be able to go home after a few hours. If your ERCP is to insert a stent, you will usually need to stay in hospital for a couple of days.
A biopsy involves taking small tissue samples to be examined under a microscope. A biopsy can be taken during a CT scan, EUS, ERCP or laparoscopy. A biopsy taken during EUS is called a fine-needle aspiration (FNA).
If the biopsy is taken during a CT scan the doctor will put a needle directly through your skin into the area where they think there may be cancer, and remove a small sample of tissue. This is done under a local anaesthetic, so you will be awake but won’t feel anything.
A biopsy is the only way of being absolutely certain that you have pancreatic cancer. However, it can sometimes be difficult to get enough tissue to make a definite diagnosis, and a second biopsy may be needed.
The results can also show exactly what type of pancreatic cancer you have, which may help the doctors decide on the most suitable treatment. You will need a biopsy to confirm your diagnosis before having chemotherapy, chemoradiotherapy (chemotherapy combined with radiotherapy) or starting a clinical trial. If you don’t think you have had a biopsy, ask your doctor or nurse about this.
If you are having surgery, you may not have a biopsy. The tissue removed during surgery will be examined under a microscope to confirm that it is cancer.
MRCP (magnetic resonance cholangio-pancreatography)
It can give clearer pictures of the bile duct and pancreatic duct, and any blockages in them. It gives similar pictures to an ERCP but it’s less invasive if you don’t need another procedure, such as a stent inserted. You may have an injection of a dye to help make the pictures clearer.
A PET-CT scan helps to build up a clearer picture of the cancer and how it is behaving. It may be used after you have been diagnosed if there is a chance of the cancer spreading, or to check how well treatment is working.
A small amount of a radioactive substance is injected into a vein in your arm. This dye shows up on the scan. You will wait for about an hour after the injection to have the scan. The scan takes 30-90 minutes, and you can usually go home straight afterwards.
This is a small operation that can help to check that the cancer can be removed by surgery, before you have the actual surgery. It may also be used to confirm a diagnosis of pancreatic cancer, or to work out how far the cancer has spread. A biopsy may also be taken. A laparoscopy is only done occasionally.
It is done under general anaesthetic (so you are asleep). A long tube with a camera at one end is inserted through a small cut in the skin of your tummy area. Other small cuts may be made so instruments can be inserted to help with the examination.
Sometimes an ultrasound probe is also used (laparoscopic ultrasound) to take pictures to help identify areas where there might be cancer.
You will need to recover from the anaesthetic before you go home, but you may be able to go home on the same day. You may need to take painkillers for a few days if the small cuts are uncomfortable.
If you have any questions about your tests, speak to your your doctor, nurse or medical team. You can also speak to our specialist nurses.
It may take a few days to a couple of weeks to get the test results. Ask how long it will be, and who to contact if you don’t hear anything, when you go for the test.
You will see your consultant or GP to get the results and discuss what happens next.
Your test results will also be sent to your GP, and you may be sent a copy of the letter. If there’s anything that’s not clear, your GP, nurse, medical team or our specialist nurses can help explain what it means.
Questions to ask
- Have you done a biopsy as part of my tests?
- When will I get my test results?
- How will I get my test results?
Published July 2016
Review date July 2018