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Diagnosis today

First steps

Pancreatic cancer is very difficult to detect before it has progressed to a serious health concern. At the early stages there are usually no symptoms, and when symptoms finally do appear they tend to be vague and similar to several other illnesses.

If the phycisian does observe symptoms suggesting pancreatic cancer, the patient is sent for a quick examination, usually by CT scan. Other methods used include magnetic resonance imaging (MRI), endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP), laparoscopy and biopsy. Unfortunately, none of these tests have proven to be 100% effective at detecting early stage cancers such as small lesions, pre-cancers etc.

After initial investigation, the patient is referred to a specialist unit for further investigation. This unit usually consists of experts from x-ray, pathology and oncology (cancer), but may include other specialists too such as diabetologists etc. Together with the patient and his or her family, the specialist unit make a decision about the appropriate treatment.

 

Blood tests for detecting pancreatic cancer

There are no fully satisfying blood tests for diagnosing pancreatic cancer on the market today, but two tests find clinical use.

  1. A test for high levels of hormones may be applied to identify rare forms of pancreatic cancer such as insulinoma and gastrinoma.
  2. And a test for elevated levels of bilrubin and liver enzymes may be used to test if the cancer is blocking the bile duct.

 

Blood tests for monitoring treatment

In addition, two blood tests are used to to monitor if a patient with pancreatic cancer is responding to treatment or if the tumor is progressing: the CA19-9 test and the Carcinoembryonic Antigen test (CEA) test.

Both tests are antibody-based blood tests that measure elevated levels of biomarker proteins that may indicate the presence of pancreatic cancer. However, neither of these tests can be used for diagnostics purposes, because not every patient with the pancreatic cancer will display elevated levels of these biomarkers. Moreover, some non-cancerous conditions may cause high levels of them. Therefore they are only used to monitor treatment.


References:

www.pancan.orgwww.cancerresearchuk.org
Wingren C et al., ’Identification of Serum Biomarker Signatures Associated with pancreatic cancer, Cancer Res, 2012.

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