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Pancreatic Cancer Symptoms And Warning Signs
Your pancreas is a gland that makes enzymes to digest your food and hormones to regulate your blood sugar levels. Your pancreas is shaped like a comma and located deep in your belly, between your spine and your stomach. The head of your comma-shaped pancreas is on the right side of your belly, tucked into where your small intestine starts. The body and tail of your pancreas extend to the left, across your belly. Because it's so deep inside your belly, you may not have any symptoms or signs that anything is wrong until your condition is advanced.
Because your pancreas is deep in your belly, you may not have symptoms of pancreatic cancer until after it has grown large or spread to other organs. (Photo Credit: Science Photo Library/Getty Images)
The pancreas has a couple of types of cells: exocrine and endocrine cells. Exocrine cells make enzymes that help you digest food. About 90% of pancreatic cancer start as adenocarcinoma tumors in these exocrine cells. Usually, it starts in the cells that surround the pancreatic duct that feeds digestive juices into your small intestine.
Endocrine cells make hormones like insulin and glucagon that help regulate your blood sugar. Less than 10% of pancreatic cancers start in these endocrine cells. These cancers are called pancreatic neuroendocrine tumors (NETs), and they tend to grow slower than pancreatic adenocarcinoma tumors.
Read on to learn more about the symptoms of pancreatic cancer, whether it starts in the exocrine cells or endocrine cells.
One of the challenges with pancreatic cancer is that the symptoms are often vague and unexplained. This means that the symptoms can be caused by a lot of different conditions that are much more common than pancreatic cancer. You may not think to go to the doctor if you get diarrhea and indigestion a couple of days a week for a few months. This is because you're symptoms are much more likely to be from a viral infection or a condition like irritable bowel syndrome or colitis than pancreatic cancer.
You're more likely to have early symptoms from a pancreatic neuroendocrine tumor than from an adenocarcinoma. This is because a neuroendocrine tumor can make hormones that regulate your blood sugar levels. In this case, you may have digestive symptoms like diarrhea, indigestion, unexplained weight loss, and blood sugar changes.
If you have an adenocarcinoma that starts in the head of your pancreas, you may develop jaundice (yellowing of the whites of your eyes and skin) early on, before your cancer has grown large or spread outside your pancreas. This isn't specifically a sign of pancreatic cancer; there are many less serious conditions that can cause jaundice, such as gallstones. But if you develop jaundice, it's important to go see your doctor to get to the bottom of it.
Early on, pancreatic adenocarcinoma tends to be silent and painless as it grows. By the time you notice symptoms, pancreatic cancer from adenocarcinoma has generally spread outside of your pancreas. But you may have symptoms earlier from cancers that start in the head of your pancreas. Cancers that start in the body and tail of your pancreas may not cause symptoms until later on.
Another challenge with pancreatic cancer is that the symptoms can be caused by a number of conditions that are much more common than pancreatic cancer. Having any or all of these symptoms doesn't mean that you have pancreatic cancer. But if you do have several of these symptoms, it's time to see your doctor.
If you do notice symptoms, they may include:
Fatigue or physical weakness
You may feel very tired and physically weak even when you haven't done any physical activity. You may also have trouble sleeping and feel depressed. You may dismiss this symptom because it can be caused by a lot of things. But if you have fatigue, weakness, trouble sleeping, or depression for more than a few days, see your doctor.
Jaundice and related symptoms
The most obvious sign of jaundice is when the whites of your eyes and your skin turn yellow. This is caused by the buildup of a chemical called bilirubin in your tissues. Bilirubin is a dark yellow-brown chemical made by your liver. It's a waste product from when your liver breaks down old red blood cells.
Bilirubin is one part of a substance called bile. Your liver makes bile to help you digest your food, especially fats. As pancreatic cancer grows, it often blocks the duct that releases bile into your intestine. Since the bile can't pass through this blocked duct, bile can't get to your intestines and so bilirubin builds up and you get jaundice.
Adenocarcinoma tumors that start in the head of your pancreas start near this duct, so they can block it when they are still fairly small and contained within your pancreas. But if your tumor starts in the body or tail of your pancreas, which is farther away from this duct, you may not develop jaundice until the cancer has spread to your liver.
Jaundice has other symptoms aside from yellowing the whites of your eyes and skin, including:
Itchy skin. When bilirubin builds up in your skin, it can irritate your nerves, which causes itching without any rash. The itching can be either mild or severe, and you may itch all over or more in your hands, feet, arms, or legs.
Dark yellow or brown pee. In some cases, dark pee may be your first sign that you're developing jaundice. Your body releases some bilirubin in your pee, so your pee may turn dark, even though you've drunk plenty of water.
Light-colored poop. Your body releases most of the bilirubin in your poop, which is what makes it brown. But when your bile duct is blocked, the bile containing bilirubin can't flow into your intestine for elimination. Your poop may be clay-colored, which is pale gray or beige instead of brown. Also, without bile, you can't digest fats very well, so your poop will have a lot of fat in it. Your poop may float in the bowl instead of sinking or stick to the sides of the bowl. Your poop may also be very smelly.
Digestive problems
Such problems may include:
Upper belly pain. Tumors that start in the body or tail of your pancreas can grow very large and press on the other organs in your belly, which may cause pain.
Middle back pain. The pain may also spread to your back because the tumor may press on the nerves around your pancreas.
Loss of appetite and weight loss. People with pancreatic cancer often have little or no appetite because of the buildup of bilirubin in their body and also because the tumor may be compressing their stomach. They will often lose weight without trying.
Nausea and vomiting. If the tumor is compressing your stomach, you may not be able to digest your food very well, so you may feel nauseated or vomit. You may feel especially bad right after you eat.
Gas or bloating. Some people with pancreatic cancer have a sense of early fullness with meals (satiety) or an uncomfortable swelling in the abdomen. This may make you feel bloated or gassy.
Symptoms you may have if your cancer has grown large or spread beyond your pancreas include:
Swelling of your gallbladder or liver. If your tumor blocks your bile duct, bile may build up in your gallbladder. This may cause your gallbladder to swell. If cancer has spread to your liver, your liver may also swell. Your doctor may be able to feel your swollen gallbladder or liver on a physical exam, or they may see it using imaging tests.
Pancreatitis. This is inflammation of your pancreas caused by the tumor or the backup of bile. The main symptom of pancreatitis is upper belly pain, which can be moderate or severe and may radiate to your back. Your pain may vary in intensity, but it may never completely go away. And you may notice it more after eating, when you lie flat, cough, exercise, or eat more than usual. You may be able to ease your pain a bit by sitting upright, leaning forward, curling into a ball, or eating less.
Because of the inflammation, you may also have:
Diabetes. Some people with pancreatic cancer develop high blood sugar (diabetes) as the tumor destroys the insulin-making cells in your pancreas. Your doctor may suspect pancreatic cancer if you develop new-onset, insulin-dependent diabetes, especially as an adult. Your doctor may see these blood sugar changes on a blood test. Or you may notice symptoms, such as increased thirst, hunger, and having to pee more often than usual.
Blood clots (deep vein thrombosis or DVT). Because the backup of bilirubin can cause inflammation throughout your body when you have pancreatic cancer, you may develop a blood clot in your large veins, often in one of your legs. Part of this may clot may break off and travel to your lungs, which causes a pulmonary embolism (PE). Your symptoms may include pain, swelling, redness, and warmth in the area where you have the clot, or chest pain and trouble breathing if you develop PE.
Pancreatic neuroendocrine tumors (NETs) (also called islet cell tumor s) are very rare. They account for less than 5% of all pancreas tumors. NETs start in the cells of your pancreas that make hormones, so they make extra hormones, such as insulin and glucagon. Having extra of these hormones can cause:
Depending on which specific cells are affected, your symptoms may include:
There are no symptoms that point definitively to pancreatic cancer. Part of the challenge with diagnosing pancreatic cancer is that most of the symptoms can be caused by other conditions that are much more common than pancreatic cancer. And you may not have any symptoms until the tumor has gotten big enough to interfere with your other digestive organs or spread outside of your pancreas.
However, you should see your doctor right away if you have any of the following:
Pancreatic cancer can be challenging to diagnose early because it usually doesn't have any symptoms until it has grown large enough to affect your other digestive organs or spread outside your pancreas. If you do have symptoms, they may include fatigue, jaundice, upper belly and mid-back pain, loss of appetite, unintentional weight loss, and nausea or vomiting. It's very important to see your doctor if you're losing weight without trying, have any signs of jaundice, or have symptoms of blood sugar changes.
What causes pancreatic cancer?
Ultimately, any cancer is caused by the accumulation of a number of mutations in a cell that causes it to grow out of control. This is why cancer mostly happens in older people. But how and why these mutations happen isn't entirely clear. It probably isn't one single factor, but a number of factors that build up over time.
Researchers do know that some of these factors can increase your chance of getting pancreatic cancer:
Beware Potential Signs Of Pancreatic Cancer
Nikki is having chemotherapy to help prevent the cancer from returning
One in three adults might ignore potential symptoms of pancreatic cancer, according to a charity.
Stomach ache, indigestion, unexplained weight loss and faeces that float rather than sink in the lavatory can be warning signs of the potentially deadly disease, says Pancreatic Cancer UK.
Early detection and treatment are vital to save lives.
Nikki Davies was diagnosed in March, aged 51. Her tumour was caught early, meaning a surgeon could remove it.
"I have been incredibly lucky that mine could be operated on and hadn't spread, as far as we can tell.
"My message to others would be that no-one knows your body like you do.
"Know what the symptoms are and talk to your GP if you notice anything that's unusual for you.
"Deep down, I think you know something is wrong.
"For me, it was the pain. It felt like an animal was eating me from the inside. It was in my back too, between my shoulder blades. And I'd lost a lot of weight very quickly.
"I didn't know anything about pancreatic cancer before my diagnosis, and I certainly wouldn't have known what the symptoms were."
Know the signs
Currently, about one in 10 people diagnosed with the condition survives beyond five years.
Hollywood actor Patrick Swayze died from advanced pancreatic cancer aged 57
This is in large part due to most patients being diagnosed at a late stage, when treatment options are very limited, says Pancreatic Cancer UK.
Its survey of 4,000 UK adults suggests awareness of the symptoms is still too low.
Alex Ford, chief executive at Pancreatic Cancer UK, said: "We do not want people to panic if they have some or all of these symptoms, because most people who have them will not have pancreatic cancer.
"But it is vital that people know more about this disease, and talk to their GP if they have any concerns.
"The earlier people are diagnosed, the more likely they are to be able to have surgery, which is the one treatment which can save lives."
Common symptoms of pancreatic cancer include:
Other symptoms include:
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Woman Shocked To Find Her Bloating And Exhaustion Were Signs Of 2 Kinds Of Cancer
Kristen Foreman was exhausted. The then 33-year-old would take a few steps and be out of breath. She believed she was too young to feel this tired. Then other symptoms — such as bloating and spotting between periods — began. Foreman wondered if these signs were related, and she followed up with her OB-GYN who eventually suggested Foreman have an ultrasound.
"I was told that there was a small mass near my left ovary," Foreman, 38, of Baltimore, tells TODAY.Com. "I was told it was a cyst, but I was told that they often dissolved and not to be too terribly concerned because it was common for women to have these cysts."
Foreman had "an inkling" that this mass was something more serious and unfortunately her instincts were right, and she was diagnosed with ovarian cancer. But after surgery to treat that, Foreman received some distressing news — she also had endometrial cancer.
"This is a lot of information to learn at one time," she says. "There are no words to describe how I felt. It was definitely crushing."
Fatigue, bloating, bleedingWhen the overwhelming tiredness began at the end of 2019, Foreman suspected something was wrong.
"I was like, 'I'm way too young to be this fatigued,'" she recalls. "There was this tension in my lower abdominal area, which was bloating as well."
As soon as Kristen Foreman started feeling exhausted and bloated, she visited her doctors to try to understand what caused her symptoms. Soon, she was diagnosed with two gynecological cancers.Courtesy Kristen ForemanForeman first visited her primary care physician who urged her to visit her OB-GYN. At first, the doctor encouraged her to track her symptoms, including the bloating, and ordered regular lab tests. She then recommended that Foreman have an ultrasound and that's when doctors noticed the mass. While doctors reassured her that cysts can disappear without treatment, Foremen was wary.
"The placement was so close to my ovary I had that unsettling feeling that it was more," she says. "My first thought was that it was fibroids because that is common in my family and it's also common among African American women."
Her doctor continued to monitor Foreman, but then she noticed a bulge in her stomach.
"It was a bit unusual because to the touch it felt different than the rest of my abdominal area, which was a bit unsettling," she says. "Every few weeks it increased (in size)."
Foreman returned to her PCP who took blood from her and then asked Foreman to return to the office. The bloodwork revealed her white blood cell count was elevated. During an exam, the doctor also noticed that her abdomen was "firm," and she recommended that Foreman go to the emergency room. Doctors performed a CT scan and lab tests.
"They found a mass, which was quite large," Foreman says. "It was a little larger than an apple — that's how much it had progressed."
Doctors determined that they would remove the mass and her left ovary to try to preserve Foreman's fertility while treating the growth. But pathology revealed that she had Stage 1 ovarian cancer and doctors believed it would be better for Foreman to have a hysterectomy. That meant that Foreman couldn't carry children.
"Trying to come to terms with this, it was almost impossible," she says.
The pathology after her hysterectomy revealed that Foreman had another cancer, Stage 2 endometrial cancer. Foreman underwent six rounds of chemotherapy followed by 12 rounds of radiation.
"Because I was so young I was jolted into menopause," she says. "In terms of side effects I experienced a lot of sweating, night sweats, but other than that I didn't really have too (many others)."
Ovarian and endometrial cancerOvarian cancer is often called "the silent killer" because it was thought to have few symptoms associated with it in early stages, but Dr. Sharyn Lewin notes that there are subtle symptoms people should know.
"We now know that it's not so silent that women often have these repetitive symptoms for many months before they're diagnosed," the director for the division of gynecological oncology at Holy Name in Teaneck, New Jersey tells TODAY.Com. "The problem is it's always a balance because we certainly don't want to scare women because a lot of those symptoms are symptoms of other things that are not cancer."
Thanks to her diligence, Kristen Foreman received early cancer diagnoses and she has been cancer free for 4 years.Courtesy Deonte CaryLewin says that's why people should be mindful of the consistency of the symptoms. Signs include:
"It's always important that women know if they have a change in their body, if they feel something different, they really need to please see their gynecologist right away and be evaluated," Lewin says. "It's the new and repetitive nature of these symptoms."
About 22,000 women annually are diagnosed with ovarian cancer.
"It's not as common as breast cancer, for example, but it has a really high death rate," Lewin says. "It's important … to really talk about the signs and symptoms and educate our community."
Endometrial cancer is a type of uterine cancer that impacts about 65,000 Americans every year.
"Many more women will definitely be diagnosed with uterine cancer every year than ovarian cancer," she says.
Symptoms of endometrial cancer include:
"Endometrial cancer means it starts within the lining of the uterus," Lewin says. "Most of these cases happen in women after menopause. Postmenopausal cases and the first symptom is bleeding after menopause or spotting or discharge. Bleeding after menopause is abnormal."
Cases of people having both ovarian and endometrial cancer are unusual.
"There are some cases where we find what are called synchronous ovarian and endometrial cancers, which basically means that a cancer started with the uterus and within the ovary, which is actually a pretty rare phenomenon," Lewin says. "Sometimes we find that to be a little bit higher in pre-menopausal women or young women."
Treatment for both cancers can include surgery, chemotherapy, radiation and hormone blockers, which are also used in hormone positive breast cancers. Recently the FDA approved a new immunotherapy medication, Jemperli, which "dramatically changed the landscape for women with endometrial cancer," Lewin says.
'Every day is a mile mark for me'It's been almost four years since Foreman was diagnosed with cancer and she has no evidence of disease in that time. But she takes things incrementally.
"I obviously feel like every year, every day is a mile mark for me," she says. "I have a different perspective of life in that way that every moment is truly precious, and I know that I'm fortunate and I don't take for granted that my outcome could have been completely different."
Grappling with 2 cancer diagnoses and the loss of her fertility in her early 30s felt tough, but Kristen Foreman hopes that by sharing her story she can raise awareness of the gynecological cancers.Courtesy Kristen ForemanThanks to her advocacy, Foreman received early stage diagnoses of her cancers. She hopes that others understand the symptoms of gynecological cancers and talk to their doctors if they observe changes.
"At the end of the day, every concern should and can be raised when it pertains to your health," she says. "When it comes to different symptoms you should not underestimate anything."
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