There is no way to screen for pancreatic cancer for early detection. Early detection is difficult because:

• Symptoms do not appear until the later stages.
  
• Symptoms mimic those of other diseases.
  
• The pancreas is hidden behind the stomach and intestines, making it difficult to view tumor formations or other abnormalities. It is also difficult to feel (palpate) during a physical examination.

To diagnose pancreatic cancer, the physician will conduct a number of tests, including:

• Medical history. A personal medical history including family history of disease.
  
  
• Physical examination. An examination of the patient’s body for signs of disease, with particular focus on the abdominal area. The physician will also closely examine the lymph nodes and surrounding organs for signs of swelling. The skin and eyes of the patient will be examined for jaundice, a common symptom of pancreatic cancer.
  
  
• Blood tests. A sample of blood is extracted and tested to determine if levels of certain substances in the body are normal. These may include:
  
  
• • Serum bilirubin (orange or yellowish pigment in bile). Abnormal levels of bilirubin in the blood may indicate the liver is diseased or weakened.
    
    
  • Liver function test. Abnormal levels of liver enzymes may indicate damage to the liver and may be a sign of metastasis.
    
    
  • Tumor marker test. Levels of certain tumor markers (CA 19-9 and CEA) may be higher in individuals with pancreatic cancer. However, the cancer is usually in the advanced stages by the time these markers are elevated.
    
    
• X-rays. The use of radiation to create images of organs in the body. A chest x-ray is taken to show if there are masses in the organs and bones in the chest cavity indicating metastasis to bones and organs.
  
  
• CAT scan (computed axial tomography). Images are taken of the body from different angles to locate tumors in the body using an injected or ingested dye and specialized x-ray equipment. Lumps in the pancreas appear in the images.

• MRI (magnetic resonance imaging). A test that uses radio waves and magnetic fields analyzed by a computer to create cross sectional images of the body.
  
  
• Ultrasound. A machine that uses sound waves to create images of organs and tissues in the body. This test can help determine the type of tumor present in the pancreas.
  
  
• PET scan  (positron emission tomography). A sugar substance containing a radioactive element is injected into the vein and collects in cancerous tissue. This test is beneficial for detecting cancer that has spread beyond the pancreas and cannot be removed by surgery.  
  
  
• Endoscopic ultrasound (EUS). An endoscope (thin lighted tube) is used with an ultrasound device. This device is passed down the throat into the stomach where sound waves are sent to the pancreas and images of the pancreatic tumors are produced. This ultrasound is effective in imaging small tumors that are difficult to see.
  
  
• Endoscopic retrograde cholangiopancreatography (ERCP).  An endoscope is passed through the esophagus, the stomach and to the small intestine. Air is pumped through to inflate the intestines and make the pancreatic and bile ducts more visible. A dye is passed through the ducts then x-rays are taken to show any obstructions.
  
  
• Percutaneous transhepatic cholangiography (PTC). A dye is injected into the ducts of the liver and an x-ray is taken from several different angles. The x-ray will show any obstructions in the ducts, indicating metastasis. A stent (flexible tube) may be placed in the duct to drain bile. This procedure is performed only in place of ERCP.
  
  
• Laparoscopy. A thin, lighted viewing instrument is inserted through a small incision in the abdomen in a procedure using general anesthesia. Laparoscopy can show the pancreatic tumors and extent of metastasis to the surrounding tissue as well. Tissue sample may be taken.
  
  
• Biopsy. Tissue is removed from the pancreas and examined under a microscope for the presence of cancer cells. Fine needle biopsy is performed with a thin needle inserted through the skin and into the tumor where a sample is taken using local anesthesia. Brush biopsy is performed during an ERCP. A small brush is passed through the endoscope to collect cells from the tumor. This procedure may also be performed during a laparoscopy, endoscopy or through surgery. A biopsy is the definitive way to diagnose cancer.