Are liver and pancreatic enzymes always elevated with liver and pancreatic cancer?

Short answer: No. Most often if a malignant mass presses on the ductal system of liver or panc. (see picture), it can cause abn. blood enzymes. If the mass is small and ducts drain, routine enzymes are usually normal. Gilbert Syndrome, a genetic abn. of up to 7% of folks, has the significance like your fingerprints, and is discussed nicely in: http://ghr.nlm.nih.gov/condition/gilbert-syndrome.