When pancreatic cancer first develops it often causes no symptoms, which means it can be hard for your GP to diagnose it, particularly in its early stages.

If your GP suspects you have pancreatic cancer, they will examine your eyes and skin for any signs of jaundice. They may also test your urine for bile or carry out a blood test. This is because in some cases jaundice can be a sign of pancreatic cancer. Learn more in symptoms of pancreatic cancer. 

Your GP may also physically examine your abdomen (tummy) to feel for any swelling or abnormality. The pancreas is relatively well-hidden within the body because it is covered by part of the bowel. This can make it difficult for your GP to feel for tumours during a physical examination.

Your GP may send you for further testing at a hospital. Some of the tests you may need are outlined below.

Ultrasound

An ultrasound scan uses high-frequency sound waves to produce an image of the inside of your body.

If your GP suspects you may have pancreatic cancer, you will be referred for an ultrasound scan of your abdomen.

During an ultrasound scan, your doctor will be able to look at your pancreas to see if there are any signs of abnormality.

An ultrasound is painless. However, it can often miss pancreatic cancer as ultrasound waves are not good at penetrating deep into body tissues. Therefore, a normal ultrasound scan does not necessarily mean you do not have pancreatic cancer.

If you are still concerned, you should insist on a CT scan or MRI scan (see below).

Computerised tomography (CT) scan

A computerised tomography (CT) scan is able to produce a detailed image of the inside of your body using a series of X-ray images. Your doctor can use the results of this scan to check for any abnormalities and assess the size of the tumour.

Magnetic resonance imaging (MRI) scan

A magnetic resonance imaging (MRI) scan also produces an image of the inside of your body, but uses strong magnetic and radio waves instead of X-ray images.

An MRI scan takes longer than other scans to perform. It takes place in a small, enclosed space and can be noisy. As with a CT scan, an MRI scan allows your doctor to check for signs of cancer in other parts of the body.

Endoluminal ultrasonography (EUS)

If a small shadow is seen on a CT or MRI scan but it is not obvious what this is, another test can be performed called endoluminal ultrasonography (EUS).

During an EUS, a thin flexible instrument called an endoscope is passed through your mouth and towards your stomach. An ultrasound probe attached to the tip of the endoscope is then able to take very accurate pictures of the pancreas, as it is very close to it.

You will usually be given a sedative to help you relax. EUS can also be used to take a biopsy (tissue sample).

Endoscopic retrograde cholangiopancreatography (ERCP)

Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure used to insert a plastic tube or stent into the bile duct if someone has jaundice.

During an ERCP, an endoscope is passed through your mouth and towards your stomach. The endoscope is then able to inject a special dye into your bile and pancreatic ducts.

After the dye has been injected, an X-ray will be taken. The dye will show up on the X-ray and should be able to outline any tumour that is blocking the bile and pancreatic ducts. An ERCP can take 30 to 60 minutes. You will usually be given a sedative to help you relax.

During the procedure, a small brush is pushed into the bile duct and the cells there are examined to see if they are cancerous.

Laparoscopy

A laparoscopy is a surgical procedure that allows the surgeon to access the inside of the abdomen (tummy) and the pelvis.

During a laparoscopy, a small cut is made in your abdomen and a laparoscope (a thin, bendy microscope) is passed through. This will allow your doctor to see the inside of your body and make sure that the tumour has not spread before recommending the removal of the cancer. This procedure is done under a general anaesthetic (where you are put to sleep).

Biopsy

A biopsy involves taking a small sample of cancerous cells from a suspected tumour. These cells can then be tested in a laboratory to see if they are cancerous (malignant) or non-cancerous (benign).

A biopsy can be taken during an EUS, ERCP or laparoscopy, where a small instrument attached to the endoscope collects a number of cells.

A biopsy may also be taken using a long, thin needle that is passed through your abdomen. The needle can be guided towards the tumour using an ultrasound scan or CT scan.