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NCCN Guidelines for Patients



Pancreatic Cancer, Version 1.2017


Treatment planning

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

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.

Tissue tests

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.