Because of the lack of early-stages symptoms and gland’s placement deep within the abdomen, pancreatic cancer is difficult to detect and diagnose before it has progressed to a serious health concern. Furthermore, symptoms tend to be similar to other illnesses, rather than pointing specifically toward pancreatic cancer. Patients with symptoms suggesting pancreatic cancer need quick examination, usually by a CT scan, and early referral to a specialist unit for other investigations. Physicians from X-ray, pathology and oncology (cancer) departments will pool their expert knowledge to make a decision about diagnosis and treatment. Following this, they will meet with the patient and family, and together decide on the most appropriate form of treatment.
Currently, no simple blood test exists for detecting or diagnosing pancreatic cancer. However, a person with pancreatic cancer may have elevated levels of bilirubin and liver enzymes in the blood if the cancer is blocking the bile duct. High levels of certain hormones in the blood may also be a sign of a rare pancreatic neuroendocrine tumor, such as an insulinoma or gastrinoma.
After diagnosis, two types of blood tests can monitor the progress of a pancreatic tumor:
The normal range of CA 19-9 in the blood of a healthy individual is 0-37 U/ml (Units per milliliter). CA 19-9-associated antigen levels are elevated in many patients with pancreatic cancer, but not every patient with the disease will display elevated levels. In addition, some non-cancerous conditions can cause high CA 19-9 levels. For these reasons, the CA 19-9 test cannot be used as a diagnostic or screening test for pancreatic cancer.
Carcinoembryonic Antigen (CEA)
The carcinoembryonic antigen (CEA) test is a blood test that measures the level of CEA protein in the blood. This protein is present in the developing embryo but disappears from the blood by birth and normally remains at undetectable levels throughout adulthood. When CEA reappears in the blood of an adult, it may indicate presence of a cancer, including pancreatic cancer.
However, the test is not used to diagnose pancreatic cancer because the CEA protein is not produced by all pancreatic tumors. Other tumors, such as colon cancer, may also cause an increase in CEA. In addition, other factors, e.g. smoking, can increase CEA concentration in the blood even when no cancer is present. Like CA 19-9 therefore, CEA cannot be used as a diagnostic or screening test for pancreatic cancer. Measuring blood CEA levels is the most effective way to monitor if an existing pancreatic tumor is responding to treatment. If a pancreatic tumor produces the CEA protein and surgery is performed to remove the tumor, CEA levels in the blood should return to normal.