Pancreatic cancer centre

Pancreatic cancer symptoms

A person with pancreatic cancer may not notice any symptoms for some time until the cancer has grown bigger and has started to spread.

Pancreatic cancer symptoms: Location matters

By the time it's large enough to cause symptoms, pancreatic cancer has generally grown outside the pancreas. At this point, symptoms depend on the cancer's location within the pancreas:

• Pancreatic cancer in the head of the pancreas tends to cause symptoms such as weight loss, jaundice (yellow skin), and fat in the stool, with or without abdominal pain.
• Pancreatic cancer in the body or tail of the pancreas usually causes stomach pain and weight loss.

In general, symptoms appear earlier from pancreatic cancers in the head of the pancreas, compared to those in the body and tail.

Gastrointestinal symptoms

Because pancreatic cancer grows around important areas of the digestive system, gastrointestinal symptoms often predominate:

• Abdominal pain. More than 80% of people with pancreatic cancer eventually experience some abdominal pain as the tumour grows. Pancreatic cancer can cause a dull ache in the upper abdomen and back pain. The pain may come and go.
• Bloating. Some people with pancreatic cancer have a sense of early fullness with meals ( satiety) or an uncomfortable swelling in the abdomen.
• Nausea
• Diarrhoea
• Fat in the stool (steatorrhoea). As pancreatic cancer reduces the pancreas' ability to secrete fat-digesting enzymes, more fat ends up in the stool. These fatty stools can be strange smelling, and float more than normal.
• Pale-coloured stools. If the duct draining bile into the intestine is blocked by pancreatic cancer, the stools may lose their brown colour and become pale or clay-coloured. Urine may become darker.

Constitutional (whole-body) symptoms

As it grows and spreads, pancreatic cancer affects the whole body. Constitutional symptoms can include:

• Weight loss
• Malaise
• Loss of appetite
• Elevated blood sugars. Some people with pancreatic cancer develop diabetes as the cancer impairs the pancreas' ability to produce insulin. However, the vast majority of people with a new diagnosis of diabetes do not have pancreatic cancer.

Skin symptoms

Jaundice: As pancreatic cancer blocks the duct that releases bile into the intestine (common bile duct), the ingredients of bile build up in the blood. This turns the skin and the eyes yellow, a condition called jaundice.

Itching: People with pancreatic cancer sometimes report itching all over. Blockage of the bile ducts is often responsible.

Symptoms from rare pancreatic cancers

Islet cell tumours, also called neuroendocrine tumours, arise from the cells in the pancreas that make hormones. These may be malignant (cancer) or benign (not cancer). Islet cell tumours are quite rare.

Like pancreatic adenocarcinoma, islet cell pancreatic cancer can cause abdominal pain, weight loss, nausea, and vomiting. Either benign or malignant islet cell tumours can produce excess amounts of hormones. Hormones released by an islet cell tumour can also cause symptoms:

• Insulinomas (excess insulin): sweating, anxiety, lightheadedness, and fainting from low blood sugar.
  
• Glucagonomas (excess glucagon): diarrhoea, excessive thirst or urination, weight loss.
  
• Gastrinomas (excess gastrin): abdominal pain, non-healing stomach ulcers, reflux, weight loss.
  
• Somatostatinomas (excess somatostatin): weight loss, abdominal pain, foul-smelling fatty stools.
  
• VIPomas (excess vasoactive intestinal peptide): abdominal cramping, watery diarrhoea, facial flushing.