Pancreatic cancer affects the pancreas, a gland that helps the body digest food and control blood glucose levels. It is one of the deadliest cancers, with the majority of people dying of the cancer within five years of diagnosis, according to the National Cancer Institute (NCI). One reason for the high mortality rate associated with pancreatic cancer is that the disease is often diagnosed late, when treatment options are limited and not likely to be successful. The lack of noticeable signs and symptoms during its early stages — especially symptoms that are distinguishable from those of other illnesses — makes pancreatic cancer difficult to detect early.
Signs and Symptoms
Most people with pancreatic cancer develop jaundice — a yellowing of the skin and eyes — as one of their first symptoms, according to the American Cancer Society (ACS). The liver normally produces a dark yellow-brown substance called bilirubin and excretes it as part of bile, which travels through the common bile duct into the intestines and then out of the body in stool. However, pancreatic cancer can block the common bile duct, causing bilirubin to build up and producing jaundice. Dark urine, light-colored stools, and itchy skin may also accompany jaundice. Although jaundice is common in people with pancreatic cancer, the symptom is more commonly associated with liver illnesses such as gallstones or hepatitis, according to the ACS. Other signs and symptoms of pancreatic cancer include:
Pain in the upper or middle abdomen or backUnexplained weight lossLoss of appetiteDigestive problems, including nausea and vomiting or pale, greasy stoolFatigueEnlargement of the gallbladderAbnormalities in the fatty tissue beneath the skin
In rare cases, pancreatic cancer may destroy the insulin-producing islet cells of the pancreas, leading to diabetes.
Pancreatic Cancer Complications
As the disease worsens over time, pancreatic cancer can lead to a number of serious complications, including:
Deep vein thrombosis, or DVT, a blood clot in the large vein of the legGastric outlet obstruction, in which the normal emptying of the stomach is disruptedPancreatic exocrine insufficiency, in which the pancreas doesn’t produce enough digestive enzymes, affecting digestion and absorptionCancer-associated anorexia-cachexia syndrome, which causes weight loss and muscle wastingDepression
Pancreatic Cancer Diagnosis
Diagnosing pancreatic cancer begins with your doctor getting your medical history — including the pattern and severity of the symptoms you may be experiencing — and conducting a physical exam. Because the pancreas is hidden behind various organs, your doctor will most likely be unable to feel a pancreatic tumor unless it has already advanced to the later stages of the disease, when the tumor is large. If cancer is suspected, your doctor may order blood tests. These tests typically measure the amounts of certain substances, particularly bilirubin, circulating in your body. Blood tests may also look for tumor markers, or certain proteins — especially CA 19-9 and carcinoembryonic antigen (CEA) — that typically increase if you have pancreatic cancer. (They may also spike if you don’t have pancreatic cancer, which is why these markers aren’t used for cancer screening.) Imaging tests are necessary to confirm that you have pancreatic cancer, and to determine how far the disease has spread. These tests may include:
Abdominal computed tomography scans (CT scans), which may be done at the same time as a positron emission tomography (PET) scanMagnetic resonance imaging (MRI) scans of the abdomenExternal abdominal ultrasound or endoscopic ultrasound, which uses a long, tube-like instrument that’s inserted into the body (esophagus and stomach)Endoscopic retrograde cholangiopancreatography (ERCP), a procedure to X-ray the bile ducts
In addition to imaging tests, your doctor may take a biopsy (small tissue sample) of the pancreas.
