Type of Tests Required and Recommended for Pancreatic Cancer

I am not a medical professional.

Many tests are needed to confirm, but if you go to the closest testing group and get a CA 19-9 test you can get some indication.

If you can get your PCP to schedule it, great - if not, go and pay for it - the cost is not significant. Time is of the essence.

I would go to pancan.org and read about which tests are commonly performed to diagnose the disease. In addition, the org's volunteers will speak with you.

The following is long (sorry), but you and I have some symptom overlap, so please slog through. My diagnosis (PDAC -- a tumor on the head of the pancreas), in Feb. 2023, was made on the basis of
-- blood tests
-- a CT scan, which showed a mass on my pancreas, and
-- a biopsy, which was done when a stent was inserted in my bile duct (it was blocked bc of the tumor, and the bile in my bloodstream was causing ferocious itching and jaundice).

Those decisions were made by the ER doctors who saw me. (I went to an ER bc I temporarily had no primary-care physician -- long story -- and bc the itching had persisted for several weeks; in addition, I was ***exhausted*** and had lost 14 lb in 6 weeks, which is a lot for me. I should have sought care sooner but I thought it was just ***non-alcoholic fatty-liver disease,*** based on something my then-PCP had said about 8 mos. earlier -- and, at some level I was scared. Don't delay, as I did!)

Anyway. The onc. you see will know which tests to administer -- in other words, you need not request Test A and Test B -- as long as s/he is paying attention to your symptoms. (Be sure to write them down, and write down your questions, and bring all that info to the appt. I use my laptop; some people prefer pen and notebook.) And be sure to ask the onc., "Which tests are you administering, and why? Are they definitive?" And if you're not satisfied with the onc.'s answers, advocate for yourself -- bc if you have pancan, you need to know ASAP, so you can start treatment ASAP.

More symptom overlap between us (not to freak you out but to give you info that could help): In Dec. 2020, I developed a weird pattern of constipation, after 59 years of healthy stools: Approx. every three weeks I'd have a day-long episode of fierce back pain (waist-level, right side) accompanied by tiny bits of stool that departed every few hours (vs. my typical early-morning formed, firm, long stool). This went on for about 6 months; it stopped after I became v. careful about drinking at least 48 oz of water daily (I was already eating a lot of fiber). I have not yet gotten a definitive answer about whether this was caused by the start of my pancan, or whether it was caused by something unrelated.

With regard to CA19-9: Keep in mind that it can be elevated for other reasons -- and that its absence doesn't mean that a person doesn't have pancan. Per a very knowledgeable member, stageivsurvivor, "Only the PDAC form of pancreatic cancer secretes CA19-9 except in approximately 10% of the Caucasian population who are non-secretors."
https://connect.mayoclinic.org/discussion/why-ca-19-9-test-not-included-in-annual-lab-tests/
.
Read the parts of this board, and the parts of the pancan.org site, that are relevant for someone like you (might or might not have it). Get as much info as you can before your 1st onc. appt. so you can ask relevant questions. Good luck.

Hello @dmac70 and welcome to Mayo Connect. On the American Cancer website there is a list of tests that are used to diagnose pancreatic cancer. Here is a link to the information.

If you are seeing an oncologist, he/she will probably determine the type of tests needed. Is your concern about pancreatic cancer due a previous cancer diagnosis? Have you lost weight?

Hi Hopeful,
Yes, I have loss weight over the 2 weeks my symptoms started due to loss of appetite.
Never weighed myself, so I only know because my clothes are looser fitting.
I did get a colonoscopy performed a week ago due to my symptoms and my family history ( father died from colon cancer) but it came back clear.
Because of my continuing symptoms ( which are listed in my original post) I am requesting to be tested for pancreatic cancer. Unfortunately, the oncologist can not see me before 14/12/23. However, in the meantime, I did manage to organize CA19 -9 blood test for tomorrow as everybody is saying to be proactive and not delay testing.
Hoping that I get positive results. Thank you for the additional helpful information and replying to my post.

just be careful re the CA 19-9 test. I have stage 4 pancreatic cancer and the CA19-9 doesn't show anything in my case. It is not definitive. It was only the CT scan followed by a liver biopsy that 100% confirmed it...even then because of the CA19-9 not being indicative, they also did a PET scan.