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What are the Signs and Symptoms?
A SILENT DISEASE | General Symptoms | When to See a Doctor
Pancreatic cancer can be called a silent disease because many times no signs or symptoms are noticed until the cancer is in an advanced stage. Even when there are early signs and symptoms, they may be vague and
easily attributed to another disease. The signs and symptoms also may be confusing to patients and healthcare providers because
they vary, depending on where the tumor is located in the pancreas (the head, body, or tail). 1 It is important to see your doctor if you have any of the signs or symptoms of pancreatic cancer ( Box 3-1 ).
JAUNDICE AND ITS SIGNS AND SYMPTOMS
Jaundice is a yellowing of the skin and the whites of the eyes. Signs and symptoms that may occur with jaundice are itching, dark
urine, and clay-colored stool. The itching may be severe. 2,3
Jaundice occurs when bilirubin stains the skin. Bilirubin is a dark-green substance made in the liver. 3 Starting in the liver, bilirubin travels down the bile duct and into the small intestine. When the bile duct is blocked by
a tumor or when a tumor is located in the head of the pancreas near the bile duct, the bile is prevented from reaching the
intestines. The bile then accumulates in tissues, blood, and the skin, leading to jaundice. 3
There are other, more common causes of jaundice, such as hepatitis (inflammation of the liver) or obstruction of the bile duct by a gallstone. 3
GENERAL SYMPTOMS
| Back Pain |
This common sign of advanced pancreatic cancer occurs when the tumor presses on organs and nerves around the pancreas. The
pain may be constant or intermittent and can be worse after eating or when lying down. Many conditions other than pancreatic
cancer can cause back pain. 2,3 |
| Fatigue or Weakness |
People with pancreatic cancer may feel very tired. 3 |
OTHER ILLNESSES
| Pancreatitis |
An inflammation of the pancreas called pancreatitis can be a sign of pancreatic cancer when it is chronic or when it appears
for the first time and is not related to either drinking alcohol or gallstones. 4,5 |
| Diabetes |
Developing diabetes mellitus (sugar diabetes), especially after the age of 50, can be a sign of pancreatic cancer. 6 |
DIGESTIVE PROBLEMS OR PAIN
Unexplained Weight Loss,
Loss of Appetite,
or Malnutrition |
People with pancreatic cancer may lose weight, may have little or no appetite, or may suffer from malnutrition. 2,3 When pancreatic enzymes cannot be released into the intestine, digesting food, especially high-fat foods, may be difficult.
Over time, significant weight loss and malnutrition may result. 2 |
| Nausea or Vomiting |
If the tumor blocks the upper part of the small intestine (the duodenum), nausea and vomiting may result. 2 |
| Abdominal Pain |
Just as in back pain, abdominal pain is a common sign of advanced pancreatic cancer. It occurs when the tumor presses on organs
and nerves around the pancreas. 2,3 |
WHEN TO SEE A DOCTOR
Many other illnesses can cause these signs and symptoms, but it is important to take them seriously and see your doctor. If
you have a first-degree relative with pancreatic cancer, tell your doctor and consider joining a pancreatic registry. See Services & Resources for more information and a list of registries
| IMPORTANT INDICATOR FOR PANCREATIC CANCER: CLUES IN THE BLOOD 7 |
In a study of more than 2,000 people with diabetes over 50 years of age, researchers at the Mayo Clinic in Rochester, Minnesota,
found an association between newly developed sugar diabetes and pancreatic cancer. Within 3 years of diagnosis, people with
diabetes had a risk of pancreatic cancer that was eight times that of same-age, average persons. It is thought that new-onset
diabetes may be an indicator that would allow for earlier detection and treatment of pancreatic cancer. It is too early to
tell if this indicator can be used to screen people over the age of 50 for pancreatic cancer.
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REFERENCES ! Click reference number to return to text.
1. OncoLink. Types of cancer. Pancreatic cancer: the basics. http://oncolink.com/ types/article.cfm?c=4&s+7&ss=49&id= 1739.
Accessed April 11, 2007.
2. Mayo Clinic. Pancreatic cancer. April 12, 2006. www.mayoclinic.com/health/ pancreatic-cancer/DS00357/DSECTION=8. Accessed
April 14, 2007.
3. American Cancer Society. Detailed guide: pancreatic cancer. April 2006. www.cancer.org/docroot/CRI/CRI_2_3x. asp?dt=34. Accessed
April 14, 2007.
4. Lowenfels AB, Maisonneuve P, Cavallini G, et al. International Pancreatitis Study Group. Pancreatitis and the risk of pancreatic
cancer. N Engl J Med. 1993; 328:1433-7.
5. Abbruzzese J. The University of Texas MD Anderson Cancer Center, Houston, Texas. Personal communication; March 8, 2007.
6. Chari ST, Leibson CL, Rabe KG, et al. Probability of pancreatic cancer following diabetes: a population-based study, Gastroenterology.
2005;129:504-11.
7. Mayo Clinic. Older Americans with new-onset diabetes have high risk of pancreatic cancer. July 31, 2005. www.mayoclinic.org/news2005-rst/2984.html.
Accessed March 19, 2007.
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