Pancreatic Cancer: Gastrointestinal Symptoms,Location Matters, constitutional and Skin Symptoms

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:

• 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 withoutabdominal pain.
• Pancreatic cancer in the body or tail of the pancreas usually causes belly 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.

Pancreatic Cancer: 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 belly 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
• Diarrhea
• Fat in the stool (steatorrhea). 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-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: 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.)

  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 tumors, also called neuroendocrine tumors, arise from the cells in the pancreas that make hormones. These may be malignant (cancer) or benign (not cancer). Islet cell tumors 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 tumors can produce excess amounts of hormones. 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): 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 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 of these situations points out the difficulty of using early symptoms to catch pancreatic cancer at a curable stage.
    That said, symptoms like weight loss, persistent loss of appetite, or light-colored stools should always prompt concern. Consistent or worsening discomfort, nausea, vomiting, or diarrhea are also worrisome. If you feel something's not right, see your doctor.