When it comes to cancers that are difficult to diagnose, pancreatic cancer often tops the list. The pancreas is a gland located deep within the abdomen, behind the stomach. It plays a crucial role in both digestion and blood sugar regulation. It has two main functions: producing digestive enzymes (exocrine function) and producing hormones like insulin and glucagon (endocrine function).
Pancreatic cancer occurs when cells in the pancreas start to grow uncontrollably, leading to the formation of a tumour. Unfortunately, experts suggest that by the time the disease shows symptoms, it’s mostly in the advanced stages. Even with regular screenings, pancreatic cancer may get missed. However, it is still important to get regular tests. Some of the annual screenings that increase your chances of detecting pancreatic cancer early are listed below.
Also Read: Can Pancreatic Cancer Be Caught Early? A Doctor's Insights
Why Pancreatic Cancer Is Hard To Detect Early
Pancreatic cancer is known for its low survival rate, with only about 12–13% of patients living beyond five years after diagnosis, according to the American Cancer Society (ACS). But these numbers vary greatly depending on how early the cancer is caught.
If it’s detected while still confined to the pancreas, the chances of surviving for five years go up to around 44%. However, once the cancer spreads, either to nearby lymph nodes (16%) or to distant organs (just 3%), the outlook becomes far more challenging.
According to Dr Mandeep Singh, Chief Oncologist, Art of Healing Cancer, Delhi NCR, pancreatic cancer is one of the most difficult cancers to detect and treat. It is highly resistant to treatment, and survival rates remain limited despite the availability of effective therapies. The biggest challenge with pancreatic cancer lies in its vague, non-specific early symptoms.
"By the time more specific symptoms appear, such as severe abdominal pain radiating to the back, unexplained weight loss, cachexia (extreme body wasting), jaundice, pale stools, or melena (dark stools indicating bleeding), the disease is often already in an advanced stage. For instance, jaundice typically occurs when the bile duct is obstructed; severe pain indicates that the tumour may be pressing on or invading nearby nerves. Similarly, changes in stool colour suggest bile flow obstruction or internal bleeding. These symptoms imply a later stage of disease progression," he explains.
Surgical Treatments At Advanced Stages Become Challenging
When pancreatic cancer is in an advanced stage, meaning it has spread to other parts of the body or metastasised, surgical treatment becomes challenging, as pancreatic surgeries are complex and carry significant risks. Moreover, pancreatic cancer is known to be resistant to chemotherapy and difficult to manage with radiation, Dr Singh highlights.
Although newer targeted therapies and immunotherapy are being explored and show slightly better outcomes, the overall prognosis has not significantly improved.
Annual Tests That May Help Detect Pancreatic Cancer Early
Detecting pancreatic cancer early is tough, but not impossible, especially for those in high-risk groups. According to Dr Singh, individuals with a family history of cancer, significant alcohol use, or hereditary risk factors like BRCA2 mutations should consider annual screenings. These can include imaging such as ultrasounds or CT scans, alongside blood tests like CA 19-9.
Dr Singh explains that while CA 19-9 is a commonly used tumour marker for pancreatic and bile duct cancers, it has limitations. “The error rate can be as high as 20–30%, so it should never be relied upon in isolation,” he says. “It’s best used in combination with imaging and clinical evaluation.”
He also highlights emerging technologies like liquid biopsies that are changing the early detection landscape. A newer blood test, now available in India and originally developed in Germany, examines immune cells (T-cells) to detect early signs of cancer. "This test is reasonably priced and not limited to pancreatic cancer but applicable to all solid tumours. It serves as an initial indication of cancer, and if results are suspicious, further imaging like PET-CT scans is necessary to pinpoint the origin."
There are also advanced liquid biopsies that can detect circulating tumour cells at a very early stage. However, many of these are still expensive and require samples to be sent abroad, especially to labs in Europe.
Encouragingly, Dr Singh notes that a new version of this test is now available in Delhi NCR at a much more accessible price point, making early screening more feasible for high-risk individuals in India.
That said, he cautions that these screenings must be done under the supervision of an oncologist. “Pancreatic cancer screening is complex and highly individualised. It’s not something general practitioners should attempt on their own,” he emphasises.