10 Pancreatic Cancer Symptoms & Signs Not To Ignore

Cancer is usually asymptomatic for a while, but some types of cancer are readily detectable at an early stage. Some others might be tricky, but there are standard screening methods that would help patients get a clear diagnosis before things get out of hand. However, there are certain types of cancer that remain elusive for both patients and doctors, and they are only detected when tumors are large enough to cause severe alterations. Pancreatic cancer enters this category.

The pancreas is a retroperitoneal organ, which means it is very deep within the abdominal cavity. We can’t feel this organ through the skin, and it is impossible to diagnose pancreatic disease without the aid of radiology and lab tests. In most cases, pancreatic cancer starts displaying clear signs and symptoms when its large enough to cause structural damage to the surrounding organs and when cancer cells display endocrine activity causing a hormonal imbalance. In this article, we are going to cover the most important signs and symptoms to take into consideration in pancreatic cancer, but do not wait for these symptoms to show up before performing your routine check-up.

Abdominal pain

Pain is very common symptoms of pancreatic cancer, and it counts as one of the initial symptoms patients reports. Abdominal pain is either mid-epigastric pain (located in the middle of the upper abdomen) or back pain. It is also described as upper abdominal pain radiated to the lower back. Patients who describe pain that radiates to the back may have an advanced phase of the disease, and this symptom may signal an invasion of the nerve plexus Signs of that is located deep in the retroperitoneal space.

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Pain in pancreatic cancer is more common in the night or when patients are lying down in the bed, or any flat surface, and many patients describe an aggravation of pain after eating. However, pancreatic cancer does not display a single type of abdominal pain, and each patient should be assessed according to his symptoms.

Nausea and vomiting

It counts as one of the initial symptoms patients report in pancreatic cancer. It typically results from an alteration to the digestive system because the pancreas has a primary function to counter the acid from the stomach. Additionally, patients with pancreatic cancer have a delayed gastric emptying, which means their stomach is very slow in passing food to the first portion of the small intestines. When the tumor becomes larger, it would also create a mechanical force against the stomach, pushing the organ and increasing nausea and vomiting.

Loss of appetite

It counts as one of the initial symptoms patients report in pancreatic cancer, but sometimes it is present only in advanced stages. The tumor synthesizes several inflammatory cytokines made to change the way blood vessels behave around the affected tissue. It is meant to increase blood circulation and blood flow to feed the tumor and promote its growth, but they would also travel through the bloodstream and reach other organs, including the brain. In reaching the brain, these inflammatory molecules cause an alteration to the centers of appetite and causes anorexia, the clinical name of loss of appetite.

An additional cause to take into consideration is that, in advanced stages of cancer, the tumor grows disproportionately and pushes aside other organs, including the stomach. This creates an extra source of pressure that is perceived by the stomach as fullness and satiety. This effect is more common in pancreatic cancer located around the tail of the pancreas, which is closer to the stomach.

Diabetes symptoms

The pancreas has an important endocrine function, and it synthesizes insulin and glucagon, the most important hormones in energy balance. Insulin is released when there is too much glucose in the blood, and it would open channels in the muscle fibers and other cells of the body to incorporate insulin and reduce its concentration in the blood. Glucagon is released when there’s not enough insulin in the body –as in prolonged fasting- and stimulates the formation of glucose from other sources of energy.

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Certain pancreatic tumors affect the cells that produce insulin while others originate in glucagon-producing cells. In both cases, they create an alteration of the metabolism of energy, more commonly associated with diabetes symptoms. 1% of patients with new-onset type 2 diabetes may have pancreatic cancer, especially if they are over 70 years of age. This might seem a very small number, but it is a very large number of patients keeping in mind the incidence of this disease in our population.

Malabsorption of nutrients

The pancreas has a very important exocrine activity, which means it synthesizes and releases substances. These substances end up in the first portion of the small intestines and promote the absorption of fatty acids and other nutrients. Cancer typically destroys the exocrine cells, and it may also cause an obstruction of the pancreatic duct. Since there’s a reduction in digestive enzymes, the absorption of nutrients is compromised, and patients are more susceptible to weight loss and wasting syndrome.

Diarrhea

For the reasons described above, pancreatic cancer patients have impaired absorption of fatty acids. These nutrients concentrate on the stools and may result in diarrhea with greasy stools. Diarrhea tends to have a foul odor, and it is not easily treated with over-the-counter medications.

Jaundice

This is often described as a sign of liver or gallbladder problems, but interestingly enough, it is the most characteristic sign of pancreas cancer located in the head of the pancreas. This structure is in contact with the gallbladder and the bile duct, and cancer growth in this area leads to an obstruction in the normal flow of bile, and something called obstructive jaundice, which is to be verified by lab tests.

These patients won’t usually have abdominal pain unless the tumor has grown large enough to cause additional symptoms. They may have other symptoms associated with jaundice, especially dark urine and pale stools, and these symptoms may even appear before a change of coloration in the skin.

In most cases, patients with jaundice experience continuous skin itching, and in most cases it becomes the most distressing symptom. All of these symptoms appear because there’s an obstruction to the normal flow of bile to the intestines. The bile contains bilirubin, a substance with a very intense color that accumulates in the blood and passes to the skin, causing a yellow color and itching. Since bile is no longer changing the color of the stools, they look pale, and since the kidneys are left in charge of clearing the blood from bilirubin, it appears in the urine and changes its color.

Weight loss

It is a characteristic feature of this type of cancer, as it is in many others. It is associated with anorexia (loss of appetite), which usually appears a bit earlier in the course of the disease. There is also malabsorption of nutrients, which contributes to insufficient nutrients and energy to the cells. Additionally, cancer cells take up a lot of the energy required for the normal function of the organism, further reducing the availability of energy and contributing to weight loss.

Weight loss in cancer is a very delicate matter, and it is associated with the severity of cancer. In advanced cases, it is very difficult to control, even after using nutritional supplements and other medications, and it contributes to worsening the quality of life and the prognosis of cancer patients.

Chronic fatigue

It counts as one of the initial symptoms patients report in pancreatic cancer, but it may also be one of the symptoms in the final stage of cancer. As mentioned, these patients have a nutrient absorption problem, and their tumor is taking extra nutrients from the organism. By reducing the availability of energy, pancreatic cancer promotes chronic fatigue, muscle weakness and a wasting syndrome called cachexia.

In a late stage of the disease, cachexia sets in, characterized by severe weight loss, chronic fatigue, loss of appetite, muscle wasting, and weakness. So, if you have lost weight unintentionally and often feel tired, even after having a good night’s rest, it would be a good idea to ask your doctor to examine your case more closely.

Clotting problems

Patients with pancreatic cancer have a very high incidence of venous thrombosis and thrombophlebitis. Sometimes, the first problem these patients have is a clotting complication, and through a series of exams and a physical evaluation, doctors detect a tumor growing in the pancreas. In some cases, pancreas patients develop a condition called marantic endocarditis, also known as nonbacterial thrombotic endocarditis.

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Pancreatic cancer is a silent type of cancer, and it is difficult to detect for patients and skilled physicians. In most cases, this cancer is not detected by symptoms but rather by a routine check-up or by chance when performing imaging tests to evaluate other health problems. Thus, even if you don’t have these symptoms, perform a routine check-up, which will not only rule out the possibility of pancreatic cancer and other types of silent cancer but also reduce your risk of cardiovascular and metabolic disease.