Symptoms of pancreatic cancer often don’t show up until the disease has advanced. They can include pain that starts in the abdomen and moves to the back, loss of appetite, jaundice and weight loss.
If the tumor is resectable, a health care provider can remove it surgically. Medications, radiation and chemotherapy can help control symptoms, shrink the tumor and keep it from growing back.
Abdominal pain
Pain in the belly or abdomen is a common symptom of pancreatic cancer. It can range from mild to severe. The pain may be felt as a sharp, burning sensation or more of a dull, constant ache. The pain might be aggravated by eating or moving. It might be accompanied by other symptoms, such as a loss of appetite, unintentional weight loss, jaundice (yellowing of the skin and eyes) or itchy skin.
Your doctor will want to know if your pain is sudden, rapid or gradual. The onset of the pain is important because it can help identify the cause. Pain of gradual onset often occurs with inflammatory diseases of the gastrointestinal tract, and other intra-abdominal conditions. Unlike pain of sudden onset, patients who have pain of gradual onset cannot usually recall the exact moment when the pain started.
If you have abdominal pain, your doctor will arrange tests to check for pancreatic cancer. You might also be referred to a specialist, such as a gastroenterologist or hepato-pancreatobiliary surgeon. The specialist might discuss your treatment options with other health professionals who specialise in different aspects of your care, including a dietician and a radiologist. This is called a multidisciplinary team meeting.
Your doctor will explain the results of your tests and talk to you about your prognosis. Prognosis means the chances of recovery. It takes into account your age, fitness and medical history as well as the type, stage and location of the cancer. The prognosis will depend on many factors, and it is impossible to predict exactly what will happen to you. However, you and your doctor will work together to plan the best course of action for you.
Jaundice
When red blood cells break down, a substance called bilirubin is formed. This bilirubin moves through the liver and gallbladder to the small intestine, where it is eliminated from the body in stool or urine. If the liver and ducts aren’t working well, bilirubin can build up in the bloodstream, causing jaundice. Newborn babies have a natural level of bilirubin that usually goes away on its own or with treatment. In adults, high levels of bilirubin can be a sign of liver disease or viral hepatitis.
Pancreatic cancer can cause the bile ducts to become blocked, which may lead to jaundice. Other signs of blockage include a pain in the abdomen that radiates into the back, abdominal pain, loss of appetite, weight loss, itchy skin caused by excess bile salts, darkened urine and a swollen gallbladder.
If your GP suspects that you have pancreatic cancer, they will refer you to a specialist such as a gastroenterologist or surgeon. They will discuss your symptoms and arrange further tests, including a CT or MRI scan of the liver and the bile ducts. They will also order blood tests to look for a high level of unconjugated bilirubin, which indicates hemolytic jaundice.
You may also have a procedure called endoscopic retrograde cholangiopancreatography (ERCP), in which a lighted tube is passed through your mouth, esophagus and stomach into the first part of the small intestine. This test allows the doctor to x-ray the ducts that carry bile from the liver and gallbladder into the small intestine. If they are blocked, the doctor can insert a fine tube into the duct to unblock it. They may also take a sample of tissue from your abdomen to check for cancerous cells.
Weight loss
If you lose a lot of weight for no obvious reason, it might be a sign that cancer is growing near your pancreas. It may also be a sign of other health problems, so talk to your doctor about it.
Unexplained weight loss might be a problem for people with cancer because it can lead to malnutrition. It is important to try and eat as much as you can, even if it is only small amounts. Your doctor can help you to find ways to eat more, even if you can’t eat much because of pain or sickness. They might suggest trying a soft food diet or a liquid diet. They might also give you medicine that acts on nerves in the abdomen to help with the pain and discomfort.
The pancreas is an oblong organ that makes juices to aid digestion and makes hormones, such as insulin, to control blood sugar levels. It is about 6 inches (15 centimeters) long and looks like a pear lying on its side. It is behind the stomach, between the stomach and the spine.
Pancreatic cancer can sometimes cause symptoms such as jaundice (yellow skin and eyes). The cancer may grow to block the duct that takes bile from the liver to the duodenum, which is the first part of the small intestine. This can also cause other symptoms, such as pain, loss of appetite and tiredness.
Your GP will arrange the initial tests to check for pancreatic cancer. You will then be referred to a specialist, such as a gastroenterologist or surgeon. You might also see other health professionals, such as a radiologist and a dietician. This group of experts is called a multidisciplinary team.
Abdominal swelling
Pancreatic cancer can cause your abdomen to swell up (abdominal distension). This may be due to the tumour pushing on nerves in the area. It can also be caused by fluid build-up from pancreatic cancer cells that cannot break down. Other symptoms that might accompany this are abdominal pain, loss of appetite and jaundice.
If you have these symptoms, you should see your GP. They will take a detailed medical history and do a physical examination. They may suggest you have a series of tests including a CT scan or ultrasound and an MRI or PET scan. These will create pictures of your pancreas and other areas of your body. These will show whether there are any cysts or tumours, and if the cancer has spread to other parts of your body.
Your GP will also look at your general health and lifestyle to find out what might be causing your symptoms. They may ask you about your family history and past illnesses. They may also ask you to complete a cancer screening questionnaire.
You may be advised to have a blood test or a CT scan to rule out pancreatic cancer. These are often done together, and you will have to wait for results.
Blood clots in your veins can be a sign of pancreatic cancer. If you have a blood clot in your vein, you will need to visit your GP immediately. Your GP will want to know your symptoms and do a blood test. They will also refer you for a CT or MRI scan to check your pancreas and surrounding tissues.
The most common type of pancreatic cancer is adenocarcinoma, which starts in the ducts of the pancreas and makes up more than 90 percent of all diagnoses. It can spread to other parts of your body before it is diagnosed. Other types of pancreatic cancer include neuroendocrine tumors, which start in the clusters of cells that produce digestive enzymes. These make up the remaining five percent of pancreatic cancer cases.
Fatigue
Fatigue is a common pancreatic cancer symptom and can feel disabling. It may be due to the pancreatic cancer or side effects of treatment such as chemotherapy or pain relief. It is important to try to keep active and not become too tired. If you are unsure about how to manage fatigue, your local pancreatic cancer specialist team will include a dietitian. They can help you to find ways of eating enough food and drinking high calorie drinks to keep your weight up and boost your energy levels.
Tummy (abdominal) pain and a loss of appetite are also common pancreatic cancer symptoms. They can be caused by a tumour invading nerves or organs that lie near the pancreas, for example the stomach or the small intestine. Often the pain and a lack of appetite will be felt above the belly button and below the breast area (called the epigastric region).
A few people with pancreatic cancer develop jaundice. This is when your skin and the whites of your eyes turn yellow or greenish yellow. You may also have dark urine and light or clay-coloured stools. It is important to get jaundice checked because it can be a sign of pancreatic cancer.
Occasionally, pancreatic cancer can cause nerve pain that starts in the abdomen (belly) and travels to the middle or upper back. This pain is usually described as a burning or tingling sensation. This is most likely because the cancer is growing and pressing on large groups of nerves. Sometimes doctors can reduce this sort of pain by giving you drugs such as amitriptyline or gabapentin, which are antidepressants that can also help with nerve pain.
