One reason for the often poor outlook for people with exocrine pancreatic cancer is that very few of these cancers are found early. The pancreas is located deep inside the body, so early tumors cannot be seen or felt by health care providers during routine physical exams. Patients usually have no symptoms until the cancer has spread to other organs. Right now, there are no blood tests to find early cancers of the pancreas. Doctors are looking to see if something called endoscopic ultrasound can be useful in screening people with a high risk of pancreatic cancer.
Blood tests
A substance called CA 19-9 is released into the blood by exocrine pancreatic cancer cells and can be detected by blood tests. But by the time blood levels are high enough to be consistently detected by available methods, the cancer is no longer in its early stages. This is why the test is not recommended for routine screening of people without symptoms or a known diagnosis of cancer. The CA 19-9 test is sometimes used during treatment to see if the therapy is working or after treatment to see if the cancer has recurred (come back).
Another substance, carcinoembryonic antigen (CEA), can help detect advanced pancreatic cancer in some people. But it isn't sensitive enough to find the cancer early and is not recommended as a screening test.
Genetic testing
Inherited DNA changes are thought to cause as many as 10% of pancreatic cancers. Because these inherited cases are sometimes linked with other cancers, determining whether a patient's relatives have an increased risk is not simple. Talking to someone with experience in hereditary cancer syndromes such as a genetic counselor, geneticist, or an oncologist (doctor who specializes in caring for people who have cancer) is often helpful.
The American Cancer Society strongly recommends that any person considering genetic testing talk with a genetic counselor, nurse, or doctor qualified to interpret and explain the test results before they proceed with testing. It is important for people to understand and carefully weigh the benefits and risks of genetic testing before these tests are done. For more information, see our document, Genetic Testing: What You Need to Know.
For people in families at high risk of pancreatic cancer, there are newer tests for detecting early pancreatic cancer that may help. One of these is called endoscopic ultrasound (see the section, “How is pancreatic cancer diagnosed?”). This test is not used to screen the general public but might be used for someone with a strong family history of pancreatic cancer. Using endoscopic ultrasound, doctors have been able to find early, treatable pancreatic cancers in some members of high-risk families. In addition, interested families may wish to participate in ongoing research studies aimed at investigating the genetic factors and possible role of screening methods in those with a family history of the disease.
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