Pancreatic Cancer Symptoms

Pancreatic cancer often goes undetected until it's advanced and difficult to treat. In the vast majority of cases, symptoms only develop after pancreatic cancer has grown and begun to spread.

Because more than 95% of pancreatic cancer is the adenocarcinoma type, we'll describe those symptoms first, followed by symptoms of rare forms of pancreatic cancer.

Pancreatic Cancer Symptoms: Location Matters

Initially, pancreatic cancer tends to be silent and painless as it grows. 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:

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

Pancreatic Cancer and 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 tumor grows. Pancreatic cancer can cause a dull ache in the upper abdomen radiating to the back. 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
  • Diarrhea
  • Pale-colored stools. If the duct draining bile into the intestine is blocked by pancreatic cancer, the stools may lose their brown color and become pale or clay-colored. Urine may become darker.

Pancreatic Cancer: Whole-Body Symptoms

As it grows and spreads, pancreatic cancer affects the whole body. Such 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.)

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Pancreatic Cancer and 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. The same blockage causes dark urine and light-colored stools.

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

Symptoms of Rare Pancreatic Cancers

Islet cell tumors, also called neuroendocrine tumors, arise from the cells in the pancreas that make hormones. Islet cell tumors account for only 1.5% of all pancreas tumors.

Like pancreatic adenocarcinoma, islet cell tumors may cause abdominal pain, weight loss, nausea, and vomiting. Hormones released by an islet cell tumor can also cause symptoms:

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

Pancreatic Cancer's Sneaky Symptoms

In a very small number of people with pancreatic cancer, early symptoms might be present that could lead to an earlier diagnosis. Unfortunately, researchers have been unable to identify any predictable pattern. One study that surveyed 305 people with pancreatic cancer illustrated the challenge:

  • About 4% reported having a sudden disgust for preferred tastes (like coffee, smoking, or wine) that preceded other symptoms by more than six months.
  • 5% of people had loss of appetite, a feeling of early fullness with meals, or profound weakness, more than six months before more obvious symptoms developed.
  • 1% of people had attacks of acute pancreatitis more than six months before their diagnosis with pancreatic cancer.

The rarity and vagueness of these situations points out the difficulty of using early symptoms to catch pancreatic cancer at an earlier stage.

That said, symptoms like weight loss, persistent loss of appetite, yellowing of the eyes or skin, dark urine, or light-colored stools should always prompt concern. Consistent or worsening discomfort, nausea, vomiting, or diarrhea are also disconcerting. If you feel something's not right, see your doctor.

WebMD Medical Reference Reviewed by Sujana Movva, MD on March 27, 2014

Sources

SOURCES:

American Cancer Society web site, "Detailed Guide: Pancreatic Cancer."

National Cancer Institute web site: "Pancreatic Cancer."

Gullo L. Pancreas, 2002; vol 22: pp 210-213.

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