
Diagnostic tests for pancreatic cancer
Pancreatic cancer is hard to diagnose - the symptoms may be vague and other conditions can cause them. Doctors may order various tests, including blood tests, ultrasound scans of the abdomen, computer tomography (CT), magnetic resonance imaging (MRI), (Magnetic Resonance Cholangio-Pancreatography (MRCP – a type of MRI that can give clearer pictures) and other slightly more invasive procedures (such as endoscopy (ERCP), endoscopic ultrasound (EUS) or biopsies see ‘Endoscopies and biopsies’ for more information). If initial signs and symptoms include change in bowel habit, e.g. loose stools, the GP or gastro-enterologist may also want to test the stools (faeces) for abnormal enzymes or for blood, and they may suggest a colonoscopy or sigmoidoscopy to check for bowel abnormalities.
- Age at interview:
- 62
- Sex:
- Female
- Age at diagnosis:
- 62
- Background:
- Ann is married with 3 children. She was a GP for over 35 years til her retirement when she developed pancreatic cancer, co-founder of the charity that runs healthtalk.org inspired by her own experience of breast cancer, and Medical Director of the Oxford University Health Experiences Research Group. Ethnic background/Nationality: White British.
- Age at interview:
- 76
- Sex:
- Male
- Age at diagnosis:
- 72
- Background:
- Hamish had a lighting consultancy until he retired. He is married with three children. Ethnic background/Nationality: White British.
- Sex:
- Background:
- Mr Ross Carter is a consultant surgeon in upper gastrointestinal (GI) and pancreatico-biliary surgery at Glasgow Royal Infirmary.
An ultrasound scan is usually one of the first investigations to be done but is not the best way to diagnose pancreatic cancer. If ultrasound shows an abnormality the doctor usually orders a CT scan or other scans. The ultrasound scan is painless; it uses sound waves, not radiation, to create images of organs and structures inside the body. The scans are similar to those that pregnant women have. Some people had to wait for a few weeks to have scans in NHS hospitals or clinics. In some areas facilities have been privatised. One man was told that he had to wait three weeks to have a scan locally. However, he could drive 30 miles and have the scan done the next week in a private clinic paid for by the NHS.
- Age at interview:
- 63
- Sex:
- Male
- Age at diagnosis:
- 60
- Background:
- Richard is single. He is a teacher (now retired). Ethnic background/Nationality: White British.
Some people had suspected from the radiographer’s behaviour or demeanour that something was wrong. For instance, Anthony’s wife had told him that the radiographers had been chatty at first, but then suddenly went silent.
- Age at interview:
- 62
- Sex:
- Female
- Age at diagnosis:
- 62
- Background:
- Ann is married with 3 children. She was a GP for over 35 years til her retirement when she developed pancreatic cancer, co-founder of the charity that runs healthtalk.org inspired by her own experience of breast cancer, and Medical Director of the Oxford University Health Experiences Research Group. Ethnic background/Nationality: White British.
And he [the gastro-enterologist] said, “And then you’ve got an ultrasound in two days’ time.” So I went for the ultrasound and that’s when I really realised what was going on. Because I went for the ultrasound expecting it to be pretty normal. And they did the ultrasound, and the, the radiographer who was doing it kept going backwards and forwards, backward and forwards over the top part of my abdomen. And so eventually I said, “Is there a problem?” And she said, “Actually, the bile duct and the pancreatic duct are dilated. And I don’t know why.” And I just knew then that I must have pancreatic cancer. Which I didn’t want to think about it really, because I know it’s a horrible cancer to have. And so I was pretty shaken by that really.
Alison was told she would have to wait four weeks to have an NHS scan so she chose a private referral to a consultant surgeon. She saw him within a few days and had a scan the next morning. Her husband’s private medical insurance paid for the scan.
NICE – National Institute for Health and Care Excellence has issued new guidelines (NG12 June 2015) which state that doctors should:
“Consider an urgent direct access CT scan (to be performed within 2 weeks), or an urgent ultrasound scan if CT is not available, to assess for pancreatic cancer in people aged 60 and over with weight loss and any of the following:
• diarrhoea
• back pain
• abdominal pain
• nausea
• vomiting
• constipation
• new onset diabetes.”
After the ultrasound scan the people we interviewed had at least one CT scan. CT scans are far more detailed than ordinary X-rays. The scanner looks like a large doughnut. During the scan the patient lies on a bed. The bed then moves slowly backwards and forwards to allow the scanner to take pictures of the body.
- Age at interview:
- 49
- Sex:
- Female
- Age at diagnosis:
- 47
- Background:
- Helen is married and has 2 children. She is a clerical officer. Ethnic background/Nationality: White British.
I don’t know what else to say about a CT scan really. It’s, from a patient’s perspective it’s just, it’s just the dye that they inject you with, which helps all your insides to stand out clearly on the scan. That’s not a problem. You don’t really feel it, apart from it can give you a sensation of warmth flooding your body. And it can also make you feel as though you’re passing urine. It’s, it’s a very strange feeling. But it’s fine. It doesn’t hurt. It doesn’t affect you. You don’t feel it afterwards. It’s literally a few seconds of warmth and then it’s gone. And it’s just like a big doughnut, the CT scanner, that you pass through on a table. It’s, you know, it’s not frightening. Well, I don’t think it’s frightening. Very simple.
- Age at interview:
- 66
- Sex:
- Male
- Age at diagnosis:
- 65
- Background:
- Tony is a recycling operative. He is not working at the moment due to illness. He is married and has two children. Ethnic background/Nationality: White British.
Vicky had dreaded having the needle inserted into a vein, and one day the dye leaked out of a vein into the surrounding tissue, which was ‘excruciatingly painful’. A few people we interviewed also had Magnetic Resonance Imaging (MRI). These scans use strong magnetic fields and radio waves to produce a detailed image of the inside of the body. The scanner consists of a large tube that contains a series of powerful magnets. The patient lies inside the tube during the scan. Donna had had MRI scans before and knew there was nothing to worry about and May said the staff had put her at ease, but some people found MRI noisy and rather frightening.
- Age at interview:
- 59
- Sex:
- Male
- Age at diagnosis:
- 58
- Background:
- Richard was a finance director for a multi-national company. He is now retired. He is divorced and has three children. Nationality/ethnic background: White British.
- Age at interview:
- 64
- Sex:
- Male
- Age at diagnosis:
- 63
- Background:
- Fred was a college lecturer until he retired in 2009 due to ill health. He is married and has 4 adult children. Ethnic background/Nationality: White Scottish.
Two people had had Positron Emission Tomography (PET) scans as part of a clinical trial (see ‘Clinical Trials’). This type of scan can show how body tissues are working, as well as what they look like and also scans the whole body. These scans may help to identify tumours at an early stage, but in the UK are not done routinely to test for pancreatic cancer. One man needed a PET scan before starting Cyberknife treatment, to make sure his cancer had not spread to other organs (see ‘CyberKnife treatment and side effects’). Others had a PET scan when they developed symptoms which might have been due to a recurrence (see ‘Signs or symptoms of a recurrence’).
A few people said that before they'd had major surgery, such as a Whipple’s operation (see ‘Potentially curative surgery’), they'd had a laparoscopy (keyhole surgery) so that their surgeon could make sure that the cancer hadn't spread to other organs. Laparoscopy is an operation performed with the aid of a camera under general anaesthetic through one or more small incisions. Most people said that this simple operation went smoothly, though Audrey recalled that when she awoke from the anaesthetic she was in a lot of pain. She thought this might have been due to the gas that the surgeon had put into her abdomen to help see all the organs clearly.
- Age at interview:
- 47
- Sex:
- Female
- Age at diagnosis:
- 45
- Background:
- Lesley is a housewife. She is married and has 3 children. Ethnic background/Nationality: White British.

Last reviewed June 2015.
Last updated June 2015.