Your complete guide to understanding pancreatic cancer tests and diagnosis

The importance of early investigation

Early detection of pancreatic cancer is closely associated with the best treatment options and outcomes. Finding the cancer before it spreads from the pancreas to nearby blood vessels or other organs makes it possible for surgeons to consider removing the tumour. Patients diagnosed early have a much wider range of treatment options available to them.

When to see your GP

If you are experiencing persistent symptoms, such as a new pain in your tummy or back, unexplained weight loss, or yellowing of your skin and eyes, talk to your GP about an urgent referral for further tests. Your doctor will consider your symptoms alongside any risk factors, such as a family history of pancreatic cancer, chronic pancreatitis, or new-onset diabetes. Health professionals use these details to decide which investigations will give you the clearest answers.

Initial assessment

Awareness of your body

Keeping track of your general health and noticing what is normal for your digestion is the first step in early diagnosis. While your risk might be higher if you have certain lifestyle factors or a strong family history, staying vigilant about unexplained changes is vital. Remember, many digestive symptoms are caused by noncancerous conditions. Still, persistent changes should always be discussed with a doctor for a proper assessment.

Common pancreatic cancer symptoms

Pancreatic cancer symptoms can be quite vague at first, but some of the most common include:

• Yellowing of the skin and the whites of your eyes (jaundice), often accompanied by dark urine and pale bowel movements.
• A persistent pain in your tummy area or middle back that does not go away with standard pain relief.
• Unexplained weight loss and a noticeable loss of appetite.
• Changes in your bowel habits, such as large, floating bowel movements.
• Extreme tiredness or fatigue that does not improve with rest.

Early investigation of these symptoms means more choices. It allows your clinical team to explore whether the tumour can be removed surgically or managed with targeted therapies.

Comprehensive diagnostic testing

Visiting your GP

Initial tests typically start with a physical exam and a review of your general health. Your GP will feel your tummy for any tender areas or swelling. They will also arrange basic blood tests and ask for a urine sample to check how well your liver and kidneys are functioning.

Blood tests and general health

Blood tests are important early tools. They help doctors monitor your liver function, which can be affected if a pancreatic tumour blocks your bile duct. Your GP or specialist may also test your blood for specific tumour markers, such as CA19-9. While a tumour marker test cannot diagnose pancreatic cancer on its own, high levels can prompt health professionals to recommend an urgent referral to a specialist team for more detailed imaging.

Imaging tests: Seeing the full picture

Ultrasound scan: Sound waves for initial checks

An ultrasound scan is often the first imaging test used to look at your abdomen. It uses sound waves to create pictures of your internal organs. It is a painless way to check for blockages in your bile ducts or look for obvious abnormalities in the pancreas and liver.

CT scan: The gold standard for pancreatic imaging

A computed tomography (CT) scan is the most effective imaging test for diagnosing and staging pancreatic cancer. This scan takes detailed, three-dimensional pictures of your pancreas. It helps your doctors see the exact size of the tumour and whether cancer cells have grown into nearby large blood vessels or spread to other organs.

MRI scan: Magnetic resonance imaging for complex cases

An MRI scan offers another detailed way to view your digestive system. It uses magnetism and radio waves to create highly detailed images of your soft tissues. MRIs are especially useful for getting a clearer look at the bile ducts and pancreatic ducts, helping to plan the best treatment pathway.

Endoscopic ultrasound (EUS): A closer look

An endoscopic ultrasound is a highly specialised test. A doctor passes a thin, flexible tube with a tiny camera and an ultrasound probe down your throat and into your stomach. Because the stomach sits right next to the pancreas, this gives the clearest possible view of the tumour.

Tissue sampling: Confirming the diagnosis

Understanding pancreatic biopsy procedures

Diagnosing pancreatic cancer usually requires a biopsy. This involves taking a small sample of cells from the tumour so they can be examined under a microscope. Most often, doctors perform a biopsy during an endoscopic ultrasound (EUS) by passing a very fine needle through the tube and directly into the pancreas.

Confirming the exact type of abnormal cells, such as whether they started in the exocrine or endocrine cells, allows your medical team to tailor your cancer treatment plan precisely to your needs.

Advanced diagnostic testing

Staging: Understanding cancer spread

If you are diagnosed with pancreatic cancer, your medical team will use your scan results to stage the disease. Staging assesses whether the tumour is contained within the pancreas, if it involves major blood vessels (borderline resectable or locally advanced), or if it has spread to distant organs like the liver (metastatic).

Additional imaging for staging

• PET scan: This scan highlights areas where cells are highly active, which can help doctors find small areas of cancer spread that might not show up on a standard CT scan.
• Laparoscopy: In some cases, a surgeon will perform a minor keyhole procedure under general anaesthetic to look directly at the pancreas and surrounding organs before planning major surgery.

Specialised testing of cancer cells

A detailed analysis of your biopsy sample helps identify the specific grade and characteristics of the cancer. This analysis is essential for matching you with the most effective chemotherapy drugs or exploring whether you might benefit from newer, targeted treatments or clinical trials.

Supporting your health journey

Preparing for appointments

To help make the most of your hospital visits:

• Bring a notebook with all your questions and a current list of your medications.
• Take a family member or friend with you for extra emotional support and to help remember what was discussed.
• Keep all your appointment letters and test results in one folder so you can refer to them easily.

Managing anxiety and stress

A potential cancer diagnosis feels daunting, and hospital waiting rooms can increase that anxiety. We know how to provide clinical services outside the hospital. For nearly 30 years, we’ve pioneered access to clinical therapies outside of the hospital, in patients’ homes and communities. Every day, we’re helping patients live independently and take control of their lives. Finding comfort in your own home environment, supported by specialist cancer nurses, can make a profound difference to your mental wellbeing during this challenging time.