NCCN Guidelines for Patients
Pancreatic Cancer, Version 1.2017
Blood tests | Tissue tests
This test is a type of surgery that allows your doctors
to see organs in your belly area (abdomen). It uses
a tool like an endoscope called a laparoscope. For
this test, the laparoscope will be inserted through
a tiny cut in your abdomen. Laparoscopy is done
under general anesthesia. This is a controlled loss of
wakefulness from drugs. This surgery is done in an
operating room and takes about 30 minutes. After the
surgery, you may feel tired and may have some pain.
You may also have a small scar after the cut has
healed. It is usually done on an outpatient basis.
Blood tests check for signs of disease, how well
organs are working, and treatment results. One
common blood test is a CBC (
This test counts the number of blood cells in a blood
sample. Too few or too many cells may signal there’s
a problem. A blood chemistry test is another common
type of blood test. This test measures the levels of
different chemicals in the blood. Cancer or other
diseases can cause abnormal levels that are too low
or too high.
Other blood tests may be done to check for
pancreatic cancer. They may include:
Liver function tests measure the health of your
liver by measuring chemicals that are made
or processed by the liver. Levels that are too
high or low signal that the liver is not working
well or that some blockage of the bile ducts is
One of the liver function tests that is typically
measured is bilirubin, a chemical that gives
bile its color. There may be too much bilirubin
in the blood if a tumor is blocking a bile duct
and preventing the free flow of bile from the
liver into the intestines. Too much bilirubin
causes a yellowing of the eyes and skin
CA 19-9 is a substance found in blood that is
often high in people with pancreatic cancer.
This test is not used by itself to diagnose
pancreatic cancer. A CA 19-9 blood test is also
often measured routinely during treatment to
see if the treatment is working. It may also be
measured before and after surgery.
Other health problems besides pancreatic
cancer can cause high levels of CA 19-9.
This includes pancreatitis or a benign
blockage in the biliary system (for example,
due to gallstones).
Your doctor may change your treatment plan based
on the results of blood tests. How often you have
blood tests depends on the cancer treatments you
receive and other factors. Common side effects of
blood tests are bruising and dizziness.
In order to confirm a tumor in the pancreas, your
doctor may want you to have a biopsy. A biopsy is the
removal of a small sample of tissue from the body
for testing. The biopsy sample will be sent to a lab so
a pathologist can examine it with a microscope for
cancer cells. A pathologist is a doctor who’s an expert
in testing cells and tissues for disease.
Lab tests, conducted by the pathologist, often find
cancer cells if any are present in the tissue sample.
If no cancer cells are found, a biopsy sample may
be taken from a different spot of the pancreas if your
doctors still think there’s cancer. More than one type
of biopsy may be used. The types of biopsies used
for pancreatic cancer are described next.