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One reason for the often poor outlook for people with exocrine
pancreatic cancer is that very few of these cancers are found early.
Because the pancreas is located deep inside the body, 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 to screen 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. Because of this, 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 are at
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 would not be
used to screen the general public but might be used in 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.
Last Medical Review: 10/13/2009 Last Revised: 10/13/2009
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