Early symptoms of the commonest type of pancreatic caner
Other symptoms of the commonest type of pancreatic cancer
Symptoms from rare endocrine pancreatic tumours
The commonest type of cancer of the pancreas are exocrine tumours. The symptoms can be quite vague. And they vary depending on where the cancer is in your pancreas - in the head, body or tail. Early symptoms can include
Loss of appetite
General discomfort or pain around the stomach area
About 5 out of 10 people have jaundice when they first go to their doctors.
You may have recently lost a lot of weight for no apparent reason. At least 10% of your total body weight. This symptom is more common in cancers of the head of the pancreas.
About 7 out of 10 people with pancreatic cancer first go to their doctors because they have pain. Pain is more common in cancers of the body and tail of the pancreas. People describe it as a dull pain that feels as if it is boring into you. It can begin in the stomach area and spread around to the back. The pain is worse when you lie down and is better if you sit forward. It can be worse after meals. Your abdomen may also be generally tender or painful if your liver, pancreas or gall bladder are inflamed or enlarged.
About 5 out of 10 people have jaundice when they first go to their doctors. Jaundice is yellowing of the skin and whites of the eyes. The urine is darker than normal and bowel motions may be lighter in colour. Jaundice is more common with cancer of the head of the pancreas because the tumour blocks the bile duct. This tube carries bile into the duodenum. If it is blocked the bile ends up in your bloodstream instead. Bile contains a lot of yellow pigments so it turns the skin yellow. Jaundice is a common symptom of many liver and gall bladder diseases. It is often easier to spot in the whites of the eyes rather than the skin.
Jaundice without pain is the commonest reason for first going to the doctor in patients who have pancreatic cancer that can be removed with surgery (is 'operable').
There are other symptoms that you can have with cancer of the pancreas. You may have any of these symptoms from before you are diagnosed. Or you may develop them later. Of course, you may not have all of them. Not everyone has every symptom. But these non specific symptoms are common in pancreatic cancer. You may have
Change in bowel movements
Fever and shivering
Some people diagnosed with cancer of the pancreas are found to be newly diabetic. Some have been diagnosed with diabetes within the previous year. If you have diabetes you are not producing enough insulin. So there is too much sugar in your blood. The sugar is passed out of the body in the urine and takes a great deal of water with it. This causes
Passing a lot of urine
Weight loss and hunger because the sugars and starches you eat are being wasted in the urine
You may have itching if you have bad jaundice. The bile salts in the bloodstream cause itching in the skin.
You may feel or be sick because you have jaundice or an inflamed pancreas. Both these conditions upset the delicate chemical balance of the body, which can make you sick. You may also be sick if the cancer, or inflammation around it, is beginning to block the duodenum. This will stop digested food from passing through to the small bowel.
Again, if you have jaundice you may develop a symptom called steatorrhoea. This means fatty stools. You may pass frequent, large bowel motions that are pale coloured and smelly. These bowel disturbances can mean that you are not absorbing your food properly. So this may be a cause of weight loss.
Fever and shivering
You may have a temperature from time to time because you have jaundice or an inflamed pancreas. When your temperature is high you may feel cold and shivery.
There are rarer types of pancreatic cancer that produce hormones. These are the endocrine pancreatic tumours. The symptoms are different for each type, depending on the hormone the tumour produces. They are
Insulinomas produce too much insulin, causing weakness, loss of energy, dizziness and drowsiness.
Gastrinomas produce too much gastrin, causing peptic ulcers in the stomach or duodenum. This leads to severe pain, bleeding causing black tarry stools (faeces), and diarrhoea.
Somatostatinomas produce too much of a hormone called somatostatin. This causes gall stones, diabetes and diarrhoea with bulky fatty and smelly stools (steatorrhoea).
VIPomas produce too much of a hormone called VIP. This causes a great deal of watery diarrhoea, flushing of the face, and high blood pressure.
Glucagonomas produce too much of a hormone called glucagon. This causes a very specific type of skin rash (redness, ulceration and scabbing), anaemia, mouth ulcers and diarrhoea.
My mother was diagnosed with pancreatic cancer. I am so angry. She had a CA 19-9 blood test run late last year. Normal range for this test is below 100. Her first test was 2546. Five doctors said "nothing to worry about. We took out your gallbladder, you probably just have pancreatic cancer". WRONG. I went to the website of the company that makes this test. The chances of a benign result with those number is less than .1%. I found this out with 20 minutes of research on the internet in December. It took 2 MRI's, 2 CT scans, 2 EUS's, 1 more CA 19-9 test, a biopsy and 2 more months for a doctor to figure out that she had cancer. This test CAN give a false negative. But if the numbers are high, a false positive isn't likely. Pancreatitis will only elevate these numbers slightly. If they had run this test April of 2008 when she first started having symptoms, she would have a higher chance of survival. If they had known what the results MEANT, she would have had a jump on chemo and radiation to improve her survival odds. She finally went to UAB. They looked at a CT scan that was run before her gallbladder was ever taken out. His exact words..."I've seen all I need to, you have pancreatic cancer" This test cost less than $125 dollars. Insurance doesn't like to pay for it because it is "speculative". Pay for it yourself if you have symptoms such as loose floating stools, back pain, yellowing of the skin, abdominal pain, excessive flatulance and extreme fatigue. It may give you a fighting chance. My mom just started chemo. It will be followed by radiation. She is Stage 3 because her main artery is already choked with cancer. Even with chemo and radiation, they have told her she will only live 6-12 months. There is a 20% chance it will shrink enough to attempt resection. But, she is weak and in pain. She just wants it all to stop. She is too weak to fight now.
I have one more observation. Isn't a X-ray to look for pneumonia "speculative"? Isn't any diagnostic test "speculative"?