What is Pancreatic Cancer?

The pancreas is an organ located horizontally in the lower abdomen. It is responsible for distributing enzymes that help digestion and hormones that help manage blood sugar. Surgical interventions, chemotherapy and radiation therapy are used for this type of cancer. Symptoms of pancreatic cancer usually do not appear until the disease is advanced. Most cases are detected at stages when the cancer is growing and has the ability to spread rapidly to other organs. Early diagnosis is difficult, but some screenings for pancreatic cysts and people with a family history of pancreatic cancer can help detect the problem early.

What are the symptoms of pancreatic cancer?

Symptoms of the disease include the following at first glance:

• Severe pain radiating from the upper abdomen to your back
• Loss of appetite, unwanted and unexplained weight loss
• Depression
• High blood sugar
• Abdominal bloating
• Blood clotting
• Fatigue
• Yellowing of the whites of the eyes and skin (jaundice)

Early pancreatic cancer often has no symptoms. By the time it causes symptoms, it is usually very large or has already spread outside the pancreas. Having one or more of the following symptoms does not necessarily mean that a person has pancreatic cancer, but if you have any of these symptoms, you may want to consider seeing a doctor to find out the underlying cause.

Jaundice and related symptoms

Jaundice means yellowing of the eyes and skin. Most people with pancreatic cancer (almost all people with ampulla cancer) have jaundice as one of their first symptoms.

Jaundice is caused by the formation of bilirubin, a dark yellow-brown substance, in the liver. Normally, the liver contains a fluid called bile, which contains bilirubin. Bile enters the intestines through the bile duct and helps break down fats there. When the common bile duct becomes blocked, bile cannot reach the intestines and so the amount of bilirubin in the body increases.

Cancerous tissues that start to grow in the head of the pancreas are close to the common bile duct. These cancers can put pressure on the duct and, although small, can cause jaundice, so sometimes tumors can be detected at an early stage. However, cancers that start in the body or tail of the pancreas do not affect the duct until they start to spread from the pancreas into the body. When pancreatic cancer starts to spread, it often tends to spread to the liver first, which can also cause jaundice.

In addition to the whites of the eyes and yellowing of the skin, there are other signs of jaundice:

Dark urine: One of the first signs of jaundice is dark urine. As bilirubin levels in the blood increase, the urine turns brown.

Light and oily stools: Bilirubin normally gives stools their brown color. In some cases, bile duct blockage can cause light or gray stools. Also, because pancreatic enzymes cannot reach the intestines to help break down fats, the stool becomes greasy and may float in the toilet.

Itchy skin: When bilirubin accumulates in the skin, the skin turns yellow and starts to itch.

Abdominal and back pain

Pain in the abdomen (belly) and back is common with pancreatic cancer. Cancers that start in the body or tail of the pancreas can press on other nearby organs as they grow, causing pain. Cancer can also spread to the nerves around the pancreas, which often causes back pain.

Weight loss and loss of appetite

Unwanted weight loss is common among people with pancreatic cancer. They experience loss of appetite and tend to lose weight uncontrollably and rapidly.

Nausea and Vomiting

If the cancer forms close to the stomach, it presses on the stomach and can partially block the passageway, making it difficult for food to pass through. This can cause nausea and vomiting after eating.

Gallbladder or liver enlargement

When cancer blocks the bile duct, bile can build up in the gallbladder and it can become larger than normal. In some cases, a doctor may notice this lump during a physical examination. It is usually found as a lump on the right side of the chest. Imaging tests are also ideal for detecting an enlarged sac.

Pancreatic cancer can also affect the liver and cause it to enlarge, especially if it has started to grow and spread near the liver. During the examination, the doctor can feel the enlarged part of the liver under the right rib cage.

Blood clot

In some cases, the first clue as to whether a person has pancreatic cancer is often a blood clot in the large veins in the legs. This is called deep vein thrombosis or DVT. Symptoms include pain, swelling, redness and warmth in the leg where the clot is located. However, blood clots do not always indicate cancer.

Diabetes

Rarely, pancreatic cancer destroys the cells that make insulin, causing diabetes (high blood sugar). Symptoms include excessive thirst, feeling hungry all the time and frequent trips to the toilet. There are cases where pancreatic cancer does not affect the body’s blood sugar levels very much, but can still cause small changes that can be detected by blood tests.

What are the rare symptoms of pancreatic cancer?

Islet cell tumors, also called neuroendocrine tumors, are made up of cells that produce hormones in the pancreas. Islet cell tumors account for less than 5% of all pancreatic tumors. Islet cell tumors, such as pancreatic adenocarcinoma, can cause abdominal pain, weight loss, nausea and vomiting. Hormones released by an islet cell tumor can also cause rare pancreatic cancer symptoms, including

• Excess insulin Sweating, anxiety, dizziness and fainting from low blood sugar
• Excess glucagon: Diarrhea, excessive thirst and urination, weight loss
• Excess gastrin: Abdominal pain, bleeding stomach ulcers, reflux, weight loss
• Excess somatostatin: Diarrhea, weight loss, abdominal pain, foul-smelling and oily stools
• Excess vasoactive intestinal peptide: Watery diarrhea, abdominal cramps, facial flushing.

What are the symptoms of insidious pancreatic cancer?

For a very small number of people with pancreatic cancer, symptoms that allow early diagnosis can be observed. Unfortunately, no predictable pattern has yet been identified for this disease. The rarity and ambiguity of the signs needed for early diagnosis point to the difficulty in their use. However, symptoms such as reluctant weight loss, loss of appetite, yellowing of the eyes or skin, dark urine or light-colored stools should be cause for concern. Nausea, vomiting and diarrhea are also disturbing. If you think something is wrong with your body, be sure to see a specialist…

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