Specific tests for Pancreatic Cancer

• Ultrasound scans of the abdomen
• Endoluminal ultrasound (EUS) – this is done during an endoscopy as a day case procedure.
• Biopsies of pancreatic cancer may be guided by endoluminal ultrasound or CT imaging, or taken during ERCP (Endoscopic retrograde cholongiopancreatography), laparoscopy or even laparotomy (surgical incision into the abdominal wall). A biopsy is not always necessary to diagnose pancreatic cancer for sure, because it is often very obvious what it is.
• MRI scan – staging
• CT scan - staging
• ERCP – ‘endoscopic retrograde cholangiopancreatography’ – this is an endoscopy test, contrast is injected into the bile ducts and x-rays taken to look at the structure of the pancreas and bile ducts. Biopsies can be taken at the same time. Palliative treatment can be given if jaundice caused by the tumour pressing on and blocking the bile duct is a problem. A plastic or self expanding metal stent can be placed in the duct to prop it open and allow bile to drain. Symptoms of jaundice resolve over a few days, itching and steatorrhoea especially can be much improved. Jaundice can re-occur if the stent slips or tumour grows and blocks the bile duct further up than the stent reaches.
• Blood tests – liver function tests (LFTs) show jaundice, full blood count may show anaemia
• Tumour markers – CEA and CA19-9 may be raised but they are not specific for pancreatic cancer.
• Laparoscopy – keyhole surgery may used to perform a detailed ultrasound scan of the pancreas or to take biopsies.
• PET scanning especially to look for lymph nodes affected by cancer

Amended November 2008