Symptoms of Pancreatic Cancer

Published October 2019

Why Is Pancreatic Cancer So Hard to Detect?

The incidence of pancreatic cancer is on the rise. Because it is very difficult to treat once symptoms occur, help protect yourself by understanding your risk, including genetic factors.

Risks and Early Detection of Pancreatic Cancer

Located deep in your abdomen, your pancreas is responsible for creating and supplying digestive enzymes, insulin and glucagon. Pancreatic cancer forms when cells in the pancreas change and multiply abnormally, forming tumors. Ninety percent of pancreatic cancers arise from the cells that line the pancreatic duct and are known as adenocarcinoma of the pancreas. Other, less common types of pancreatic cancer include adenosquamous carcinoma, squamous cell carcinoma and Islet cell carcinoma.

By looking at family history, we can get better at detecting risk for pancreatic cancer.

— Mary F. Mulcahy, MD

Though there are a number of risk factors, including advancing age, smoking, obesity and Type 2 diabetes, certain genetic mutations may also increase your risk. Recent research has shown a link to BRCA mutations, which are commonly associated with breast and ovarian cancers.

“Detecting pancreas cancer early is very difficult, but a thorough family medical history can identify family members at risk,” says Mary F. Mulcahy, MD, a medical oncologist and gastrointestinal cancer specialist at Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

Knowing the Signs of Pancreatic Cancer

Pancreatic cancer can be difficult to detect for a number of reasons. First, symptoms can be vague and are not necessarily associated with the pancreas.

Generalized symptoms include:

Weakness
Weight loss
Loss of appetite
Pain in the abdomen or back

Because of the location of the pancreas, some symptoms will not present until the cancer advances. “Symptoms can differ depending on the location of the tumor within the pancreas,” adds Dr. Mulcahy. The pancreas can be described with three major anatomical parts: the head, body and tail. Here are some possible symptoms of pancreatic cancer based on the location of the tumor:

Head. This location causes an obstruction in the bile duct. As a result, individuals may have yellowing of their eyes, skin or nails, and have dark urine.
Body. A tumor in this location of the pancreas sits deep within the body. This is the largest cavity, allowing plenty of room for the tumor to grow without symptoms. However, you may experience nausea or mid-back pain.
Tail. These tumors often sit adjacent to the stomach, so you may experience indigestion or discomfort eating, especially after fatty foods. If the tumor has infiltrated the stomach, you may have constant, or chronic, nausea.

In some cases, individuals who previously had no risk factors may suddenly develop Type 2 diabetes. “The link is not completely clear, but if you do not have any family history or other risk factors for diabetes, it warrants further evaluation,” says Dr. Mulcahy.

Treating Pancreatic Cancer

Complicating the issue, the pancreas sits at a major pathway near many other vital structures. The main artery feeds the blood vessels to the GI tract and liver. By the time symptoms occur, the cancer may have already infiltrated the nerves, making it highly unlikely it can be operated on, explains Dr. Mulcahy.

If you have symptoms, your physician will use imaging to evaluate the cause. If you are diagnosed with pancreatic cancer, several treatment options are available. “Surgical techniques have improved significantly. We are able to operate on tumors that we once couldn’t and offer better quality of life,” says Dr. Mulcahy.

Researchers continue to look for better ways to both detect and treat pancreatic cancer. “We’re learning more and more about cancer and how it evades therapy, and hopefully we will find that one trigger,” says Dr. Mulcahy.

Ultimately, though, early detection offers more treatment options. And because early symptoms can be vague and difficult to detect, it’s important to know your risks, including age, family history and genetic predisposition.