Pancreatic cancer symptoms

When it comes to telltale signs, pancreatic cancer poses a special challenge. Often referred to as a silent disease, it typically doesn’t show any apparent signs and symptoms in its nascent stages. Doctors usually can’t feel or detect an early tumor during a routine physical.

Buried deep in the abdomen, the pancreas sits hidden behind many organs, including the stomach, small intestine, liver, spleen, gallbladder and bile ducts. So, if a cancerous tumor develops in the pancreas, you may not notice until it’s grown too large.

By the time symptoms begin, the cancer may have spread beyond your pancreas to other parts of your body.

With other cancers, such as breast or colon cancer, patients can undergo routine screenings, including mammograms and colonoscopies, regardless of whether they’re experiencing symptoms. But these types of tests are not available for pancreatic cancer.

Most often, doctors would not scan you for pancreatic cancer unless you were showing symptoms. When symptoms do appear, they may be easy to confuse with those of other illnesses.

Other, more common conditions such as ulcers or pancreatitis share similar symptoms. 

Below are some of the symptoms of pancreatic cancer. Having one or more of these symptoms doesn’t mean you have pancreatic cancer, but if you notice any of the following—and especially more than one—notify your doctor.

When symptoms of a pancreatic tumor first appear, they most commonly include jaundice, or a yellowing of the skin and the whites of the eyes, which is caused by an excess of bilirubin—a dark, yellow-brown substance made by the liver. Sudden weight loss is also a common early warning sign of pancreatic cancer. Other symptoms of cancer of the pancreas include:

• Dark-colored urine
• Itchy skin
• Digestive problems, including abnormal stools, nausea or vomiting
• Pain in the upper abdomen, which may extend to the back
• Appetite loss
• Swollen gallbladder (usually found by a doctor during a physical exam)
• Blood clots
• Diabetes

Jaundice

Jaundice is a yellowing of the skin and eyes, and it may also cause itchy skin, dark urine and light-colored or greasy stools. It’s more commonly the result of conditions such as hepatitis or gallstones.

So why does jaundice potentially indicate pancreatic cancer?

Because—while jaundice is not most commonly caused by pancreatic cancer— it’s usually one of the first symptoms of pancreatic cancer, and it’s almost always experienced by pancreatic cancer patients.

Typically, the liver releases bile, which contains bilirubin (a dark yellow-brown substance produced in the liver). During digestion, bile travels through the common bile duct into the intestines to ease the breakdown of fats, then it’s eventually excreted in the stool.

But if the common bile duct is blocked (from a tumor that starts in the head of the pancreas, for example), then bilirubin may build up, causing jaundice. In some cases, even small tumors may press on the duct, enabling doctors to find the cancer at an earlier stage. That said, cancers that begin in the body or tail of the pancreas don’t begin to press on the duct until they’ve spread through the pancreas and, in some cases, to other organs—typically the liver, which also worsens jaundice.

Upper or middle belly/back pain

Abdominal pain is a common symptom of pancreatic cancer, as tumors that have grown fairly large start pressing on adjacent organs, causing discomfort and pain.

It’s also common for these cancers to cause pain in the patient’s back, usually as a result of spreading to nerves surrounding the pancreas.

However, back and belly pain may also indicate other conditions besides pancreatic cancer, so it’s important to speak with your doctor if you’re experiencing pain.

Nausea and vomiting

Patients who have  tumors that have grown near the end of the stomach, which may partially block the normal path of food through the digestive system, may experience nausea, vomiting and increased pain after eating.

Gallbladder or liver swelling

When a tumor blocks the bile duct, the gallbladder may fill up with excess bile and grow. If this is the case, the doctor may be able to find the swelling (a large lump under the right rib cage) during a routine exam. Otherwise, these tumors may appear in imaging tests such as a computed tomography (CT) scan or magnetic resonance imaging (MRI).

The liver may also swell, particularly if the cancer has spread there. This may also be detected through imaging.

Other symptoms

Other symptoms of pancreatic cancer may include:

• Blood clots
• Unexplained weight loss
• Loss of appetite
• Fatigue
• Fever
• Chills and sweats

While less common, developing diabetes may be a sign of pancreatic cancer, especially in patients who are older and have diabetes come on suddenly.

Sometimes, pancreatic cancer may damage the cells in your pancreas that help produce insulin (the hormone that regulates your blood sugar, which is made in the pancreas), leading to high blood sugar and diabetes.

The cancer may not always alter blood sugar levels enough to show signs of diabetes, but if it does, symptoms may include increased thirst, hunger and urination.

Diabetes as a risk factor

Having diabetes also may increase your risk of developing pancreatic cancer.

If you have type 2 diabetes or have had diabetes for several years, you may be more at risk than those with type 1 diabetes, according to the American Cancer Society. Scientists don’t know exactly why pancreatic cancer is more common in diabetics in general. But it’s important to keep in mind that having diabetes is not a sure indication that you’ll develop pancreatic cancer.