pancreatic cancer symptoms

pancreatic cancer symptoms

What Are The Symptoms Of Pancreatic Cancer?

Cancer symptoms are quite varied and depend on where the cancer is located, where it has spread, and how big the tumor is. Pancreatic cancer is often called a "silent" disease because it rarely shows early symptoms and presents non-specific later symptoms. Tumors of the pancreas cancers are usually too small to cause symptoms. However, when the cancer grows, symptoms include:

man holding his stomach

•     Pain in the upper abdomen from the tumor pushing against nerves
•     A painless yellowing of the skin and eyes and darkening of the urine called jaundice, created when the cancer interferes with the bile duct and the liver.
•     Loss of appetite, nausea, and vomiting
•     Significant weight loss and weakness
•     Acholic stool (pale or grey stool) and steatorrhea (excess fat in stool)

These symptoms of pancreatic cancer have numerous other causes, making it difficult to diagnose the disease before it is in an advanced stage.

Cancers of the pancreas are also associated with Trousseau's sign - spontaneous blood clots formed in the portal blood vessels, deep veins of the arms and legs, or other superficial veins. Clinical depression is another symptom that is sometimes reported before the cancer is diagnosed.

If the cancer spreads, or metastasizes, additional symptoms can present themselves in the newly affected area. Symptoms of metastasis ultimately depend on the location to which the cancer has spread.

Islet cell or neuroendocrine cancers of the pancreas may cause the organ to produce too much insulin or hormones. This may lead to weak or dizzy feelings, chills, muscle spasms, or diarrhea.

How Is Pancreatic Cancer Diagnosed?

In order to diagnose pancreatic cancer, physicians will request a complete physical exam as well as personal and family medical histories. The way in which the cancer presents itself will differ depending on whether the tumor is in the head or the tail of the pancreas. Tail tumors present with pain and weight loss while head tumors present with steatorrhea, weight loss, and jaundice. Doctors also look for recent onset of atypical diabetes mellitus, Trousseau's sign, and recent pancreatitis.

In general, when making a pancreatic cancer diagnosis, physicians pay special attention to common symptoms such as abdominal or back pain, weight loss, poor appetite, tiredness, irritability, digestive problems, gallbladder enlargement, blood clots (deep venous thrombosis (DVT) or pulmonary embolism), fatty tissue abnormalities, diabetes, swelling of lymph nodes, diarrhea, steatorrhea, and jaundice.

It is also common for doctors to administer blood, urine, and stool tests. Blood tests can detect a chemical called carcinoembryonic antigen (CEA) as well as CA 19-9 - a chemical released into the blood by pancreatic cancer cells. Liver function tests check for bile duct blockage.

Several imaging techniques are employed in order to see if cancer exists and to find out how far it has spread. Common imaging tests include:

patient abdomen being scanned

•     Ultrasound - to visualize tumor
•     Endoscopic ultrasound (EUS) - thin tube with a camera and light on one end
•     Abdominal computerized tomography (CT) scans - to visualize tumor
•     Endoscopic retrograde cholangiopancreatography (ERCP) - to x-ray the common bile duct
•     Angiogram - to x-ray blood vessels
•     Barium swallows to x-ray the upper gastrointestinal tract
•     Magnetic resonance imaging (MRI) - to visualize tumor
•     Positron emission tomography (PET) scans - useful to detect if disease has spread

The only absolute way to make a cancer diagnosis is to remove a small sample of the tumor and look at it under the microscope in a procedure called a biopsy. A fine needle aspiration (FNA) biopsy is the most commonly used method. A thin needle is inserted into the pancreas through the skin, and the pathologist uses CT scan or ultrasound images as a guide. Another type is the brush biopsy performed during ERCP to gather cells. A laparotomy is sometimes ordered to determine the stage, or extent, of the disease because it provides access to a large part of the abdominal cavity.