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Screening tests check for a condition, like cancer, in people who don’t have any signs or symptoms. There aren’t any screening tests for people who are at average risk for pancreatic cancer. So, the best way to detect this disease as early as possible is to see your primary care provider if you have any signs or symptoms that concern you.
If you have a health condition, family history or inherited gene that puts you at higher risk for pancreatic cancer, you might have screening options. Talk with your primary care provider. They may recommend imaging tests to check for signs of cancer even if you feel fine.
Take Charge of Your Health
Talk to your primary care provider if you have symptoms that you think may be pancreatic cancer. UW Medicine Primary Care can help you get started. Learn about Fred Hutch's relationship with UW Medicine.
High-Risk Pancreatic Cancer Screening
Fred Hutch Cancer Center has a pancreatic cancer surveillance program to screen people who are at high risk. It’s part of our Gastrointestinal Cancer Prevention Program. We’re also studying multi-cancer early detection tests — blood tests to screen for many types of cancer at once, including pancreatic cancer — in people without signs or symptoms.
“These exciting new screening technologies have the potential to revolutionize cancer screening. But they’re at a very early stage,” said Scott Ramsey, MD, PhD, co-principal investigator for the Cancer Screening Research Network.
Our researchers are working to improve early detection and prevention of pancreatic ductal adenocarcinoma (PDAC) through projects like the Pancreatic Cancer Early Detection (PRECEDE) Consortium. This group of scientists is collecting DNA samples from volunteers who have a family history of PDAC or a gene that puts them at increased risk.
History and Exam for Pancreatic Cancer
If you have signs or symptoms that could be from pancreatic cancer, your provider will ask you about your symptoms, your health history and your family history. They may ask about factors that might put you at risk for cancer or other conditions that might cause the same symptoms. Then, they’ll examine you to check for clues about what’s been bothering you.
Based on your conversation and exam, your provider may order tests to get more information.
Imaging Tests for Pancreatic Cancer
Imaging tests offer a way for your physician to find and look at tumors in your pancreas. Often, physicians can tell enough from the images to make a diagnosis of pancreatic cancer. Imaging might include:
- Computed tomography (CT) scan — Used to look for an abnormal growth on your pancreas and cancer anywhere else in your body.
- Endoscopic ultrasound (EUS) — Involves threading a flexible tube (endoscope) with an ultrasound probe through your mouth into your stomach. Your care team can use this method to make pictures of your organs, decide if a tumor can be removed surgically and take cells for a biopsy (looking at them under a microscope to see if they are cancer).
- Magnetic resonance imaging (MRI) scan — Used to get a picture of your pancreatic ducts if your major blood vessels are compressed or invaded by cancer and to look at your liver for signs that cancer has spread there. You might have a special type of MRI called MR cholangiopancreatography (MRCP) to get a better look at your pancreatic and bile ducts.
- Endoscopic retrograde cholangiopancreatography (ERCP) — Involves threading an endoscope through your mouth into your small intestine. The end of the scope has a small video camera. Your care team can then inject dye that helps the area show up better on an X-ray, or they can use a fine needle or brush to take cells for a biopsy. ERCP can also be used to place a stent to open a duct and help relieve jaundice.
Blood Tests for Pancreatic Cancer
CA 19-9 is a tumor marker (also called biomarker). The level of this substance in your blood might be high if you have pancreatic cancer. But CA 19-9 isn’t always high in people with this disease, and it can be high for other reasons.
Even though your care team cannot diagnose pancreatic cancer based on a CA 19-9 blood test alone, it may be one more piece of information that helps them tell what is happening in your body.
Your team may recommend other blood tests too, like tests to check how well your liver is working if jaundice is one of your symptoms.
Biopsy for Pancreatic Cancer
In a biopsy, a physician removes a small sample of tissue from your pancreas. A pathologist looks at the sample under a microscope to check for cancer cells. For many cancers, physicians must do a biopsy to diagnose and suggest a treatment plan.
If imaging tests show that you may have pancreatic cancer and your care team thinks it can be completely removed with surgery, you might not need a biopsy first. Instead, your surgeon might operate to take out the tumor and then send samples to confirm the cells are cancer.
If you do need a biopsy before starting any treatment:
- Your physician might be able to take a sample of tumor cells by passing a needle through your skin into your tumor (fine-needle aspiration).
- Your physician might take a sample of cells during EUS or ERCP.
- You might need surgery so they can make small incisions and insert tools to get a tissue sample (laparoscopic surgery).
Why Choose Fred Hutch for Pancreatic Cancer Care
When you choose Fred Hutch for care, our experts confirm your pancreatic cancer diagnosis. Your care team will review any imaging and blood tests you’ve already had and your pathology slides (tissue samples) if you had a biopsy. Your physician may meet with other experts at our multidisciplinary Pancreatic Cancer Specialty Clinic to talk about your condition and the best ways to treat it.
Most newly diagnosed patients have not yet had tests to stage their disease (check the extent of the disease in their body). If you haven’t had these tests yet, we will talk with you about which tests you need and why, how to get them and when you can expect results. We offer all these tests at Fred Hutch. Usually, the tests happen within a few days after your appointment.
At Fred Hutch, we may also collect and analyze your cancer cells for biomarkers that can inform the types of treatments that might be most effective, so we can customize your care.
For a CT, MRI or ERCP, you might get a substance to help your organs or ducts show up on the scan (contrast). For organs in the belly, contrast may be given by mouth or through a needle into a vein in the arm or hand (intravenously, or by IV).
The process and amount of time for each type of scan is different. For all three, you will lie on your side or back on a table. For a CT or MRI, the table will move into the scanning machine. For EUS or ERCP, you will get medicine (sedative or anesthesia) by IV so you’re relaxed and comfortable. You might also get medicine to gargle with or spray in your throat to numb it (local anesthetic). Then the physician will pass the endoscope through your mouth and down your esophagus. Your care team will give you details about what to expect based on the type of imaging you need.
Blood tests for CA 19-9 tumor marker and liver function involve just a quick blood draw using a needle that goes into a vein in your arm.
CT scans use radiation, but the benefits of getting a diagnosis outweigh the risks.
The magnets used in MRI scans aren’t harmful, but they might affect metal medical devices in your body. Your care team will talk with you about this before your scan. Some people don’t like being in the small space inside an MRI machine. Talk with your care team about this beforehand. You may be able to get medicine to help you relax so the experience is easier for you.
Endoscopic procedures are usually safe. Your throat might feel sore for a few days. There are some risks from having the endoscope inside your body, like the risk of infection or bleeding.
If you are getting contrast (a substance to help your organs or ducts show up on a scan), there is a risk of having an allergic reaction or having some contrast leak from your IV line.
The main risks from blood tests are that you’ll have mild discomfort or bruising where the needle goes in your arm.
Your Fred Hutch care team will aim to avoid or reduce any risks and side effects.
The time it takes for results may depend on which tests you have. It may take from a few days to a week or more. After tests are done, the radiologist or lab will provide a report saying what they found. When you go in for your tests, ask your care team how long it will take to get results in your case.