Some types of cancer can be detected earlier because they are found near the skin and causes deformation or visible alterations to the normal shape of the body. However, other types of cancer, as in the case of pancreatic cancer, lay hidden in deep organs and will only be visible when some time has already passed, and cancer cells have taken over the normal function of the organ and its surrounding tissue.
Pancreatic cancer is a silent type of cancer that still have some signs and symptoms to look up. The pancreas is one of the deepest organs in the human body, and it makes pancreatic cancer difficult to detect and treat. In every case, the diagnosis will require imaging exams and a biopsy, which is why not even having a handful of symptoms would necessarily mean that you have this type of cancer.
In this article, you will get the most common signs and symptoms in pancreatic cancer. Every case will be different, and you will notice some of them may seem contradictory because there are different types of cells in the pancreas, and depending on which one is taken you will have one or another. In any case, if you have experienced one of the symptoms listed in this article, the best thing to do would be asking your doctor and following his advice to rule out common diseases before starting to think about pancreatic cancer.
» The warning signs and symptoms of pancreatic cancer are as follows:
1. Abdominal and back pain
The pancreas is a deep abdominal organ located in the upper middle region of the abdomen. Thus, an alteration to the pancreas typically causes abdominal pain. In pancreatic cancer, we can have either colic pain or a rather dull, unspecific and continuous type of pain. Since pancreatic cancer causes a series of gastrointestinal alterations, doctors usually think abdominal pain is caused by an infection or a similar condition. This often delays the diagnosis and may lead to a progressive aggravation of the symptoms.
According to each case, patients with pancreatic cancer may feel intermittent colic pain or continuous dull pain. Intermittent colic pain arises when pancreatic cancer grows near the intestinal loops and pushed them aside, causing a mechanical obstruction. In this case, colic pain is the result of the continuous struggle of the smooth muscle in the intestines to overcome the obstacle, and in severe cases may be accompanied by severe vomiting and other signs of intestinal obstruction.
Continuous dull pain is caused by increased pressure in the abdominal cavity and the inflammation associated with the malignant tumor. Cancer cells do not have restraint and grow uncontrollably regardless of the anatomical disposition of blood vessels and nerves. Pressure on nerve terminals in the abdominal cavity may cause discomfort or dull pain that is poorly localized. On the other hand, inflammatory cytokines and other substances create irritation in the surrounding area of the tumor and activate pain nerve terminals.
2. Nausea and vomiting
The pancreas has a vital role in digestion. The pancreatic juice travels through the pancreatic duct, and it is released along with bile from the gallbladder into the intestines, where it aids digestion and fights the acidity of the stomach acid in the duodenum. An alteration to this vital organ would also cause digestive symptoms, including nausea and vomiting. The mucosal lining of the duodenum is not the same as the protective layer in the stomach, and not having enough pancreatic juice after an alteration to the normal function of the pancreas would cause increased acidity in the first portion of the small intestine, and extensive damage with vomiting, acid reflux, and other problems. Additionally, a reduction in the digestive enzymes would lead to indigestion and bloating, even after a light meal.
3. Diabetes-like symptoms
The pancreas is the most important organ in the metabolism of carbohydrates. It synthesizes insulin, a hormone that is released shortly after eating or whenever sugar levels in the blood reach a higher level. The function of insulin is opening the gate to sugar into the muscle fibres and other cells of the body, thus reducing the circulatory levels of glucose. Pancreatic cancer often results in progressive destruction of healthy tissue and may compromise the normal function of insulin, which gives out diabetes-like symptoms such as frequent urination, hunger and thirst, slow healing, among others.
Recent developments have shown that in some cases type 2 diabetes can be described as a risk factor to get pancreatic cancer. It has become clear that these two clinical entities are closely linked to one another, and they commonly appear in the same patient. This does not mean that if you have diabetes, you will also have pancreatic cancer. Instead, it is a warning sign to be attentive at your signs and symptoms and perform the routine check-ups required to keep your disease in check and avoid the complications of diabetes.
4. Hypoglycemia
We have already talked about diabetes-like symptoms, which arise from an increase in the levels of glucose in the blood. In some patients, we will rather find the opposite, and they suffer from hypoglycemia instead of high sugar levels. There’s a type of pancreatic cancer that is made of pancreatic beta cells, the ones that synthesize and secrete insulin. In this specific type of pancreatic cancer, the uncontrolled growth of the pancreatic tissue creates more and more cells capable of synthesizing insulin, and they would do so without any restraint, and independent from the levels of glucose in the blood. As a result, patients would have excessive levels of insulin in the body, which forces glucose inside the muscle fibers, and decreases the levels of sugar in the blood.
This unusual type of cancer is named insulinoma, and in most cases, it is a benign condition, but not always. Patients with an insulinoma would feel lightheadedness, dizziness, a sensation of fainting, sweating, muscle weakness, and related symptoms. They may also have low blood pressure along with hypoglycemia, which may lead them to an emergency room continuously to recover from their symptoms.
If you experience hypoglycemia continuously, there are plenty of other diseases to rule out, and they are more common than pancreatic cancer. For example, certain metabolic imbalances cause hypoglycemia, and you should look through your diet and physical activity to check the appropriate balance between energy intake and expenditure. All of this assessment should be performed by a professional, and even an expert on the field would require a series of lab tests, imaging tests, and even a biopsy to diagnose cancer.
5. Diarrhea and greasy stools
The pancreatic juice has an important role in digesting protein, carbohydrates and fat. Thus, an impaired function of the pancreatic juice would cause various digestive problems, including problems to absorb fatty acids. This problem becomes even worse when the pancreatic tumor causes an alteration to the secretion of bile as well. In either case, it is possible to experience greasy stools as a sign of pancreatic cancer, and certain types of cancer would also cause persistent and profuse diarrhea.
There are specialized cells in the pancreas that synthesize and secrete a substance called vasoactive intestinal peptide. When pancreatic cancer takes these cells, they start secreting this substance without any control, similar to what happens in insulinoma. Vasoactive intestinal peptide reaches the intestines and regulates the calibre of the blood vessels. An increase in this substance will dilate the blood vessels in the intestines and make them more permeable, allowing water to leak out into the intestinal lumen. More water in the intestines would overcome the reabsorbing capacity of the colon, and lead to watery stools and chronic diarrhea.
6. Skin rash
We have covered different types of pancreatic cancers and their symptoms according to the cells involved in the tumor. There is still another type of pancreatic cancer that is composed of glucagon-producing cells. Glucagon has the opposite function than insulin, and it is typically released when blood sugar levels drop. In this type of pancreatic cancer, there’s a characteristic skin rash called necrolytic migratory erythema.
This type of rash is composed of red patches with a blister in the center. The blister breaks and forms a crust, heals, forms another blister to break in a continuous cycle that changes the color of the skin and causes an itching sensation. It typically appears in the buttocks, legs, and in the low portion of the abdomen. Since this is not a common disease, doctors usually confuse this skin rash with other skin diseases, and the diagnosis is delayed for a long time, allowing the tumor to keep growing in the meantime.
7. Jaundice
It is a yellowish coloration of the skin that typically results from liver disease. In this case, pancreatic cancer may spread to the liver or cause an obstruction to the bile duct. Jaundice is commonly seen when cancer is located on the head of the pancreas because this portion of the organ is closer to the gallbladder and the bile duct. Still, jaundice is difficult to make out and usually misleads health professionals and patients, delaying the diagnosis of pancreatic cancer.
The reason why pancreatic cancer causes jaundice is simple and easy to understand. After growing or spreading to the liver, pancreatic cancer starts pushing aside the gallbladder and the bile duct, it causes a blockade of the normal flow of bile, and this substance starts to build up in the blood instead of draining to the intestines. Bilirubin in the bile is then deposited in the skin and mucosa, causing this yellowish coloration.
8. Liver enlargement
Another liver manifestation of pancreatic cancer is liver enlargement, and it usually happens when pancreatic cancer spread to this organ. Cancer spreads to the liver in a late stage of the disease, and still then, it is mistaken with hepatitis and other liver problems.
Liver enlargement is detected in a physical exam, and it is not always obvious. The clinical name is hepatomegaly, and it results from many diseases, even viral infections not directly affecting the liver. Only a skilled physician would take the appropriate steps to detect liver enlargement and understand where it comes from.
9. Liquid retention
As it happens with many other types of cancer, pancreatic cancer sometimes causes liquid retention when it grows to block the venous or lymphatic return of a given area of the body. It is more common in the late stage of the disease, especially when cancer has spread to the liver. Metastasis to this organ would ultimately lead to a dysfunction of the liver, a reduction in the concentration of proteins in the blood, and liquid retention as more liquid starts leaking out of the blood vessels.
Additionally, pancreatic cancer patients usually have blood clotting problems and may experience deep vein thrombosis when blood clots travel to smaller arteries and block the normal blood flow. This is another cause of swelling and fluid retention in the lower extremities and other parts of the body. Deep vein thrombosis can be a life-threatening health problem, and if you see swelling and changes of color in your skin, it is a good idea to ask your doctor right away.
10. Weight loss
Similar to most types of cancer, an advanced stage is associated with unplanned and sometimes aggressive weight loss that is often very difficult to reverse. Pancreatic cancer has various factors adding up to increase the likelihood of weight loss. It leads to gastrointestinal problems, including nutrient absorption problems, loss of appetite, and diarrhea. As it happens with other types of cancer, pancreatic cancer changes the metabolism and increases the energy expenditure because cancer cells are always robbing nutrients from the blood, leading to nutrient deficiencies in patients with a balanced diet.
Weight loss is an important part of cachexia, a wasting syndrome associated with almost all types of cancer. Along with low energy levels, low appetite, muscle loss, weakness and fatigue, there’s a progressive decay in patients with advanced pancreatic cancer, and sometimes the disease is diagnosed in this later stage when patients finally realize that something is wrong. Thus, keep an eye on the warning signs and symptoms, ask your doctor and do not delay your diagnosis.
References
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