What Are The First Signs Of Pancreatic Cancer?

Pancreatic cancer is so difficult to treat in large part because it often isn't discovered until the disease has spread to other parts of the body. That's because in many cases there are no signs or symptoms until the cancer has reached an advanced stage. Even when there are early signs and symptoms, they are often vague, so patients tend to ignore them or doctors attribute them to another disease. For these reasons, pancreatic cancer is often known as a silent killer.

"There is not a single (symptom) that lets you home in specifically on pancreatic cancer," says Dr. Brian Wolpin, director of the Lustgarten Foundation Pancreatic Cancer Research Laboratory at Dana-Farber Cancer Institute and an associate professor of medicine at Harvard Medical School. "They tend to occur later in the disease course, so for most people a small tumor will not be symptomatic. Symptoms develop later, when the tumor is larger or has spread."

Even when symptoms do develop, "they are not a very good way to find the disease," he says, because they may be confusing to patients and doctors. The symptoms also vary depending on where the tumor is located in the pancreas, which consists of a head, body and tail.

According to the Lustgarten Foundation, the signs and symptoms of pancreatic cancer that need to be taken seriously include:

  • Jaundice (with or without itching), dark urine or light-colored stool.
  • General symptoms such as back pain, fatigue or weakness.
  • Other illnesses, including pancreatitis and new-onset diabetes in an adult.
  • Digestive problems, such as unexplained weight loss, loss of appetite, malnutrition, nausea or vomiting and abdominal pain.
  • Blood clots, which may cause pain, swelling, redness and warmth in the leg, chest pain or trouble breathing.

Pancreatic Cancer Symptoms to Take Seriously

Jaundice causes a yellowing of the skin and the whites of the eyes. Jaundice may also cause signs and symptoms such as itching (which may be severe), dark urine and light or clay-colored stool. Pancreatic cancer can lead to jaundice when a tumor blocks the bile duct. Bile, produced in the liver to aid digestion, contains a dark yellow substance called bilirubin. If the bile is blocked, it accumulates in the blood, skin and other tissues, causing jaundice.

"The main symptom is abdominal discomfort," Wolpin says. "That sometimes radiates into the back because the pancreas is in the back of the abdomen." The pain may be constant or occasional and can worsen after eating or when lying down. Of course, many conditions other than pancreatic cancer can also cause abdominal or back pain, which makes this a challenging symptom to attribute to pancreatic cancer.

Pancreatic cancer may cause digestive problems and weight loss. When pancreatic enzymes cannot be released into the intestine, digesting food, especially high-fat foods, may be difficult. Over time, significant weight loss and malnutrition may result. If the tumor blocks the upper part of the small intestine, that can lead to nausea and vomiting.

Pancreatitis, which is an inflammation of the pancreas, can be a sign of pancreatic cancer if the condition is chronic or when it appears for the first time and is not related to either drinking alcohol or gallstones.

Developing diabetes mellitus (high blood sugar), especially after the age of 50, can be a sign of pancreatic cancer, Wolpin says. "The cancer seems to cause diabetes in some cases, so a new onset of diabetes, particularly later in life and with weight loss, is a sign. That being said, most people with diabetes do not get pancreatic cancer."

Pancreatic cancer can cause blood to clot more easily. The clots can block blood flow in the legs, lungs or other organs such as the pancreas itself or liver.

While many other illnesses can cause these signs and symptoms, it is important to take them seriously and see your doctor as soon as possible.

Knowledge of Pancreatic Cancer Is Key

With so few advanced warnings, how can people stay vigilant about the potential for pancreatic cancer?

"Knowledge of the disease is the key," says Dr. Victoria Manax, chief medical officer of the Pancreatic Cancer Action Network. She recommends knowing the risk factors associated with the disease, including smoking, obesity and a history of chronic pancreatitis. "There are also hereditary factors that may come into play. If you have a relative or relatives that have been diagnosed with the disease, you may be at an increased risk," Manax says. "Maintaining a healthy lifestyle and being aware of your own risk factors is important."

You should always see a doctor if you have any signs or symptoms that worry you or are persistent, Manax says. The doctor can perform tests and procedures to help investigate what may be the cause. "If you have certain risk factors, you may also want to see a pancreatic specialist early on," she says. "You are your own best advocate."

Video: Optimism over test to help detect pancreatic cancer in early stages (Courtesy: Fox News)

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