Pancreatic cancer is known as a "silent disease" because identifiable symptoms are not usually present in the early stages of the disease. Many symptoms of pancreatic cancer are mild at first, so patients may often be unaware of the potential seriousness of them. Due in large part to the position of the pancreas deep in the abdomen, a pancreatic tumor can grow for years before causing pressure, pain, or other signs of illness. This can make it difficult for a patient or doctor to recognize a problem.
There are several symptoms commonly associated with pancreatic cancer. However, other medical conditions can cause these, or similar symptoms. Having one or any combination of these symptoms does not always mean you have pancreatic cancer. If you are experiencing any of these symptoms, you should consult your doctor to discuss possible diagnoses.
Jaundice is identified primarily by your skin and the white of your eyes becoming yellow or greenish yellow. Dark urine and light or clay-colored stools can also be associated with jaundice.
Jaundice occurs when bilirubin, a component of bile, builds up in your blood. Bilirubin is created in the liver as a breakdown product of worn-out red blood cells and is typically eliminated from the body when bile is released from the gallbladder. Bile travels from the gallbladder through the common bile duct and passes through the pancreas just before emptying into the duodenum. However, when the bile duct becomes blocked - for any reason - jaundice can occur.
Deep-felt itching often accompanies obstructive jaundice. This is a condition known as pruritis.
In Pancreatic Cancer: Jaundice typically occurs in pancreatic cancer when a tumor in the head of the pancreas first narrows, then obstructs the common bile duct, blocking the flow of bile.
Other Causes: Gallstones, which are primarily made up of cholesterol, are a common cause of jaundice. Gallstones can also block the bile duct. Other causes of jaundice that are not obstructive include liver diseases like hepatitis and cirrhosis, and other conditions that cause red blood cells to break down too quickly.
Upper Abdominal Pain
In Pancreatic Cancer: Abdominal pain is a common symptom. It often radiates to the middle or upper back and worsens after eating or when lying down. Upper abdominal pain commonly occurs with advanced pancreatic cancer. Pain can occur when a tumor, typically originating in the body or the tail of the pancreas, grows to put pressure on surrounding abdominal organs or invades surrounding nerves.
Other Causes: Many other conditions can cause upper abdominal pain. If you are experiencing pain in your abdomen, discuss your symptoms carefully with your doctor.
In Pancreatic Cancer: Digestive difficulties including indigestion, nausea, weight loss, a poor appetite, and diarrhea, can arise as a result of pressure from a pancreatic cyst or tumor on the stomach or the small intestine that causes a block in the digestive tract. When a tumor grows, it can wrap around the far end of the stomach, causing a partial block. This can cause nausea, vomiting, and pain which may worsen after eating.
Diarrhea results when the nutrients in food are not absorbed properly. When this occurs, stool can become loose, watery, oily and foul-smelling. Pancreatic enzymes are responsible for digesting fatty foods. If a tumor blocks the pancreatic duct, insufficient pancreatic juices in the intestines can lead to poor absorption and diarrhea, as the undigested food passes quickly through the digestive tract. If this happens, stool may float due to the higher fat content, appear bulky, greasy, and unusually pale.
Other Causes: Stomach pain, nausea, vomiting, and diarrhea can be caused by a number of conditions. You should consult your physician if you are experiencing these symptoms. Oily stools can also be caused by autoimmune diseases such as celiac disease, where absorption in the intestines is affected.
Unexplained Weight Loss
This is a common symptom in many cancers. It is often accompanied by general loss of appetite and fatigue. The weight loss can be caused by cancerous cells that deprive healthy cells of required nutrients.
In Pancreatic Cancer: Weight loss due to pancreatic cancer can be caused by a lack of functional pancreatic enzymes, as discussed above under digestive difficulties. However, there are no distinguishing characteristics associated with pancreatic cancer when the weight loss is due to malignant cancer cells monopolizing the body's nutrients.
Other Causes: Unexplained weight loss can also be caused by some infections or parasites in the digestive tract.
Ascites is a condition in which excessive fluid builds up in the abdominal cavity causing swelling and distention of the belly. The abdominal cavity is created by the space between your organs and the abdominal wall and is surrounded by a lining called the peritoneum. In severe cases of ascites, it is possible to retain gallons of fluid in your abdominal cavity. Ascites may cause significant pain and difficulty breathing. If you suffer from ascites, your doctor may give you diuretics, or water pills, to slow down the fluid build up. In severe cases, the fluid can be drained during a procedure called paracentesis.
In Pancreatic Cancer: Ascites may occur at any stage of pancreatic cancer, but is typically associated with advanced metastatic pancreatic cancer. If the cancer spreads to the peritoneum, it can cause irritation and cause fluid to build up.
Other Causes: Pancreatic ascites can also occur if a cyst or a pseudocyst in the pancreas bursts, allowing the pancreatic juices to seep into the abdominal cavity. However, cirrhosis of the liver, and specifically alcoholic cirrhosis, is the most common cause for ascites. Cirrhosis causes a series of changes in the kidneys that prevents the body from getting rid of excess water-retaining sodium.
Sudden Onset Diabetes
Diabetes is a condition that is marked by high blood sugar and glucose intolerance. It occurs when the body does not produce enough insulin to properly metabolize, or break down, glucose in the system, or when the body cannot properly use existing insulin. Since insulin is a hormone produced in the pancreas, the development of diabetes is linked to problems in the pancreas.
In Pancreatic Cancer: Sudden onset of diabetes in people with normal body mass index is often a warning sign of pancreatic abnormalities and can be a symptom of pancreatic cancer. Additionally, when well-controlled diabetes suddenly becomes brittle or poorly controlled, this change can also be a warning sign for pancreatic cancer.
Other Causes: Individuals who are overweight and have a high body mass index often develop diabetes, especially when they get older. This is not uncommon and is linked to normal metabolic changes in the body.
If you're experiencing any of these symptoms, and you would like to contact us for a consultation, please Request an Appointment or call us at (212) 305-9467.
If you or someone you care for is dealing with a pancreatic condition, the Pancreas Center is here for you. Whether you need a diagnosis, treatment, or a second opinion, we have an entire team of experts ready to help.
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To keep learning about pancreatic cancer:
- Pancreatic Cysts
- Chemotherapy for Pancreatic Cancer
- Endoscopic Treatment for Pancreatic Disease
- Non-Invasive Tests for Pancreatic Cancer
- Palliative Procedures
- Surgery for Pancreatic Cancer
- Whipple Procedure (Pancreaticoduodenectomy)
- Total Pancreatectomy with Autologous Islet Cell Transplantation
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