Signs and Symptoms of Pancreatic Cancer

Some people get cancer of the pancreas, the organ in your abdomen that makes digestive enzymes and hormones such as insulin. The cancerous mass can interfere with the pancreas’ function and lead to symptoms such as stomach or back pain, jaundice (yellowed skin), diarrhea, nausea, weight loss, and diabetes. 

Early in the disease, pancreatic cancer is typically asymptomatic (doesn’t cause any symptoms). Symptoms from pancreatic cancer often start gradually and intermittently, so people may dismiss them. Often by the time symptoms are more significant, the cancer is already large, or it has already spread. This makes it more difficult to treat.

But not everyone with pancreatic cancer will have all these symptoms. Most people who have one of these symptoms have a different medical condition and not pancreatic cancer. 

Symptoms Related to Jaundice

For most people with pancreatic cancer, jaundice is one of the first symptoms. Jaundice refers to a yellowing of the skin and/or the whites of the eyes. It occurs when there is some sort of build-up of bile, a substance made in the liver that helps break down fats.

Normally bile travels from the liver to the gallbladder and out through the intestines and the feces. But since the pancreas is located nearby, a pancreatic mass may block the flow of bile, leading to jaundice. It can also cause the skin to become itchy and the urine to turn dark brown.

If the mass is located in a specific spot, this might happen before the pancreatic cancer is advanced. Sometimes pancreatic cancer can also cause jaundice because the cancer has already spread to the liver. 

In people over 40, new jaundice carries a cancer risk of over 20%. This figure includes not just pancreatic cancer but other kinds of cancer as well. However, many other different medical conditions can also cause jaundice and related symptoms. 

Stomach or Back Pain

Upper stomach pain is another common symptom of pancreatic cancer. Because of the anatomy of the pancreas, which is found on the backside of the abdomen, back pain is also relatively common. The pain may tend to be worse after meals. However, most people who have stomach pain and/or back pain have it from other causes.

Nausea, Vomiting, and Weight Loss

Nausea and vomiting are very common symptoms of pancreatic cancer. The cancer may press up against the stomach, which can make vomiting worse. Unintended weight loss from poor appetite and decreased food intake is also common. 

Changes in Bowel Habits

Pancreatic cancer sometimes causes diarrhea, which may be due to decreased pancreatic digestive enzymes. However, other people with pancreatic cancer may notice constipation instead.

Stools that appear greasy are particularly concerning, as they might be a sign that bile and digestive enzymes aren’t making it to the intestines to break down fat. The stool may also be lighter in color instead of dark brown.

Diabetes

Although most people with diabetes do not get pancreatic cancer, it sometimes is the first sign of the disease. Damage to the pancreas can impair its ability to make insulin. In some people, this leads to diabetes, which is characterized by consistently elevated glucose levels in the blood (high blood sugar). Diabetes from damage to the pancreas is sometimes called pancreatogenic (type 3c) diabetes.

Diabetes might be picked up on a blood test without any initial symptoms. You may also notice symptoms of diabetes, like excess thirst, hunger, and urination.

Diabetes isn’t as common as some other symptoms of pancreatic cancer. Of people eventually diagnosed with pancreatic cancer, about 1 in 4 first receive a diagnosis of diabetes.

Blood Clots 

People with some kinds of cancer, including pancreatic cancer, are at risk of blood clots. For some people, such blood clots are the first sign that they have pancreatic cancer.

Often this occurs in one of the deep veins of the leg, called deep vein thrombosis. This can cause symptoms like leg pain, swelling, and warmth. 

Sometimes such clots travel to the lungs, termed a “pulmonary embolism.” This can cause symptoms like chest pain and severe shortness of breath. If severe, it can be life-threatening.

Symptoms in Less Common Pancreatic Cancer Types

At least 90% of pancreatic cancers are classified as adenocarcinomas, and the symptoms described apply to them. However, a small subset of people have other types of pancreatic cancer. These rare types may have some of the same symptoms, or they might not cause symptoms at all.

However, they may also have additional specific symptoms. For example, an insulinoma is an example of a pancreatic neuroendocrine tumor, which can cause symptoms based on excess hormones produced. An insulinoma might cause symptoms like irritability or headache from too much insulin and resulting low blood sugar. 

When to See a Healthcare Provider

If you are concerned you might have pancreatic cancer, make an appointment to see a healthcare provider right away, especially if you have a family history. It’s particularly important to do so if you are 60 or older and you have weight loss in addition to stomach or back pain, nausea or vomiting, diarrhea or constipation, or new diabetes.

It’s also important that you be seen by a health professional quickly if you have jaundice. Tell them you have jaundice when you call, as you need to be evaluated promptly. If you can’t schedule it in a relatively short period, you may need an urgent care appointment. 

A Quick Review

Pancreatic cancer can cause symptoms like stomach pain or back pain, nausea and vomiting, and weight loss. It can also cause symptoms related to jaundice, including yellowed skin or whites of the eyes. Some people with pancreatic cancer experience other symptoms, like those related to diabetes or to blood clots. 

Unfortunately, pancreatic cancer is often advanced by the time symptoms become significant, making it more challenging to treat.