What are the symptoms of pancreatic cancer?

Pancreatic cancer is often difficult to detect in the early stages because distinct symptoms usually do not occur until the cancer is advanced. The early symptoms of pancreatic cancer can resemble those of other diseases. With the pancreas located behind other organs including the stomach, liver, small intestine, gallbladder, bile ducts and spleen, symptoms usually occur only when the cancer has grown large enough to impact these surrounding organs' function.

Initial symptoms may include pain in the upper abdomen moving into the back, and unexplained weight loss. As most pancreatic tumors start in the head of the pancreas where digestive juices are produced, these tumors frequently block a bile duct, producing jaundice, and itchiness of the skin. (However, these symptoms more commonly reflect viral hepatitis or gallstones). Other signs of pancreatic cancer may include loss of appetite, nausea, fatigue, fat malabsorption, and depression. Any of these symptoms should be examined by a physician.

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 often ignore 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
• Upper Abdominal Pain
• Digestive Difficulties
• Unexplained Weight Loss
• Ascites
• Sudden Onset Diabetes

Perhaps the most classic symptom of pancreatic cancer is upper abdominal pain radiating to the back. In general, however, pancreatic cancer symptoms depend upon whether the mass is located in the head, body, or tail of the organ. If a mass in the head of the pancreas (a common location for cancer) obstructs the biliary tree, then jaundice may result. Patients who develop jaundice may have yellow discoloration of the whites of their eyes or skin. They may also notice light-colored stools as well as dark "tea-colored" urine classically. Unexplained weight loss is very common. The amount of weight loss can be significant, sometimes more than 20 to 30 pounds, or a 10% to 20% decrease from baseline.

Is it pancreatic cancer -- or something much less serious? Find out why the symptoms of pancreatic cancer are sometimes mistaken for a more common ailment by watching this video featuring cancer specialist Deborah Axelrod, M.D.

Digestive problems: Cancer may prevent pancreatic enzymes from being released into the intestine making it difficult to digest foods, especially those high in fat. This may result in significant weight loss (as much as 25 pounds or more) and malnutrition.

Gallbladder enlargement: If the cancer blocks the bile duct, the gallbladder may become enlarged from bile build up. The bile ducts are thin tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. This enlargement may be felt by a doctor during a physical exam or it may be detected by imaging studies, such as computerized tomography (CT) or magnetic resonance imaging (MRI).

Jaundice: Jaundice, or yellowing of the skin and the whites of the eyes, occurs when bilirubin, a breakdown product of worn-out blood cells, accumulates in the blood. Normally, bilirubin is eliminated in bile, a fluid produced in the liver, which is then excreted with the feces. However, if a pancreatic tumor blocks the flow of bile, excess pigment from bilirubin may turn the skin and the whites of the eyes yellow. Urine may be dark brown and stools white or clay-colored. Jaundice is a common sign of pancreatic cancer and occurs in about half of individuals with pancreatic cancer.

Loss of appetite and unintentional weight loss: In addition to weight loss caused by the cancerous (malignant) cells depriving healthy cells of nutrients, weight loss may also result from loss of appetite associated with pancreatic cancer.

Nausea and vomiting: In advanced cases of pancreatic cancer, the tumor may block a portion of the digestive tract, usually the upper portion of the small intestine (duodenum), causing nausea and vomiting.

Upper abdominal pain: Pain is a common symptom of advanced pancreatic cancer. Upper abdominal pain, which is often caused by a tumor pressing on surrounding organs and nerves, may radiate to the middle or upper back. The pain may be constant or intermittent and is often worse after eating or when lying down.

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