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Pancreatic cancer is cancer that starts in the pancreas. The pancreas produces enzymes and hormones that are needed to facilitate digestion and regulate blood sugar levels.
Specific biomarkers, called tumor markers, can be found in the blood of patients with pancreatic cancer. These markers can not only help doctors diagnose pancreatic cancer, but also indicate if a treatment is working.
In this article, we review common pancreatic cancer tumor markers, their use, and accuracy. We also looked at other methods for diagnosing pancreatic cancer.
Tumor markers are produced by cancer cells or produced by your body in response to cancer. Tumor markers are usually proteins, but they can also be other substances or genetic changes.
These two proteins may be present at higher blood levels in pancreatic cancer. They can be used to diagnose pancreatic cancer and understand the effects of pancreatic cancer treatment.
Blood samples taken from a vein in the arm are used to measure CA19-9 and CEA levels. The table below shows typical and high ranges for both tumor markers.
For example, some patients with pancreatic cancer may not have elevated levels of CA19-9 or CEA. Several studies have shown that certain genetic variants affect levels of pancreatic cancer tumor markers.
A 2018 review compared the usefulness of measuring CA19-9 and CEA in diagnosing pancreatic cancer. Overall, CA19-9 was more sensitive than CEA for the detection of pancreatic cancer.
However, another review in 2017 found that CEA remains important in the diagnosis of pancreatic cancer when used in combination with CA19-9. Furthermore, in this study, elevated CEA levels were strongly associated with worse prognosis.
A 2019 review on the use of tumor markers to predict response to pancreatic cancer treatment concluded that current data are insufficient and more research is needed. A review of tumor markers used to detect pancreatic cancer recurrence in 2018 supports these ideas.
In addition to testing for tumor markers, doctors may use several other tests to diagnose pancreatic cancer. This includes:
Imaging tests help your doctor look inside your body to find areas that may be cancerous. They may use a variety of imaging tests to detect pancreatic cancer, including:
In addition to blood tests for tumor markers, doctors may order other blood tests if they suspect pancreatic cancer. This includes:
A biopsy involves removing a small sample of tissue from a tumor site. The sample is analyzed in a laboratory to determine if it contains cancer cells.
If cancer is found, other tests may also be performed on the biopsy sample to look for specific biomarkers or genetic changes. The presence or absence of these things can help determine what type of treatment is recommended.
The American Gastroenterological Association (AGA) recommends that people at increased risk due to a family history of pancreatic cancer or an inherited genetic syndrome consider screening for pancreatic cancer.
The age at which screening begins depends on individual circumstances, as recommended by the AGA. For example, it may begin at age 35 in people with Peutz-Jeghers syndrome, or at age 50 in people with a family history of pancreatic cancer.
Pancreatic cancer screening includes the use of MRI and endoscopic ultrasound. Genetic testing may also be recommended.
Screening is usually done every 12 months. However, if doctors find suspicious areas on or around the pancreas, they may shorten this interval, making screening more frequent.
Early stage pancreatic cancer usually causes no symptoms. This is why many types of pancreatic cancer are not detected until late. If present, symptoms of pancreatic cancer may include:
While other tests are very helpful in the diagnostic process, the only reliable way to diagnose pancreatic cancer is by analyzing a biopsy tissue sample. This is because samples from the affected area can be tested directly for cancer cells.
According to the American Cancer Society, pancreatic cancer accounts for about 3 percent of all cancers in the United States. The average lifetime risk of developing pancreatic cancer in a person is about 1 in 64.
Pancreatic cancer is difficult to detect at an early stage. Many people do not experience symptoms until the cancer has progressed. Also, because the pancreas is located deep in the body, smaller tumors are difficult to detect with imaging.
The prospects for early detection of pancreatic cancer have indeed improved. According to the National Cancer Institute, the 5-year survival rate for pancreatic cancer alone is 43.9%. This compares with 14.7% and 3.1% for regional and distant distribution, respectively.
Tumor markers are biomarkers produced by cancer cells or the body in response to cancer. Commonly used tumor markers for pancreatic cancer are CA19-9 and CEA.
While blood test results for these biomarkers can provide useful information to doctors, further testing is always required. These may include imaging tests, additional blood tests, and a biopsy.
Screening for pancreatic cancer may be done in people with a family history of pancreatic cancer or some inherited genetic syndromes. If any of the above apply to you, talk to your doctor about how and when to start screening for pancreatic cancer.
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