Jaundice
Jaundice is yellowing of the eyes and skin caused by the
buildup of bilirubin in the body. Bilirubin is a dark yellow-brown substance
that is made in the liver. Normally, the liver excretes bilirubin into bile.
Bile goes through the common bile duct into the intestines, eventually leaving
the body in the stool. When the common bile duct becomes blocked, bile cannot
reach the intestines, and the level of bilirubin builds up. At least half of
all people with pancreatic cancer and in all people with ampullary cancer have
jaundice.
Cancers that begin in the head of the pancreas are near
the common bile duct. These cancers can compress the duct while they are still
fairly small. This can lead to jaundice, which may allow these tumors to be
found in an early stage. However, cancers that begin in the body or tail of the
pancreas do not compress the duct until they have spread through the pancreas.
By this time, the cancer may have also spread beyond the pancreas.
When pancreatic cancer spreads, it often goes to the
liver. This can also lead to jaundice.
Sometimes, the first sign of jaundice is darkening of the
urine from bilirubin. As bilirubin levels in the blood increase, the urine
becomes brown in color.
If the bile duct is blocked, bile (and bilirubin) cannot
get through to the bowel. When this happens, a person may notice their stools
becoming lighter in color.
When bilirubin builds up in the skin, it turns yellow and
starts to itch.
Please keep in mind that cancer cannot be considered the
most common cause of jaundice. Other causes, such as gallstones, hepatitis, and
other liver diseases, are much more common.
Abdominal or back
pain
Pain in the abdomen or back is common in advanced pancreatic
cancer. Cancers that start in the body or tail of the pancreas may grow fairly
large and start to compress on other nearby organs, causing pain. The cancer
may also spread to the nerves surrounding the pancreas, which often causes back
pain. The pain may be constant or it may come and go.
Of course, pancreatic cancer is not only, and even is not
the most widespread cause of pain in the abdomen or in the back. Such pain is more
often caused by non-cancerous diseases, or may be even caused by another types
of cancer.
Weight loss and
poor appetite
Unintended or unexpected weight loss is very common in
patients with pancreatic cancer. These people also complain of being very tired
and having little or no appetite.
Digestive problems
If cancer blocks the release of the pancreatic juice into
the intestine, a person may not be able to digest fatty foods. The undigested
fat may cause stools to be unusually pale, bulky, greasy, and to float in the
toilet. The cancer may also wrap around the far end of the stomach and partly
block it. This can cause nausea, vomiting, and pain that tend to be worse after
eating.
Gallbladder
enlargement
If the cancer blocks the bile duct, bile can build up in
the gallbladder, which then becomes enlarged. Such internal enlargement may
sometimes be caught by an experienced doctor during a physical exam. It can also
be detected by imaging studies.
Blood clots or
fatty tissue abnormalities
Sometimes, the first clue that there is a pancreatic
cancer is the development of a blood clot in a large vein, often a vein in the
leg. This is called a deep venous thrombosis or DVT. Sometimes a clot breaks off
and travels to the lungs, making it hard to get enough air. A blood clot in the
lungs is called a pulmonary embolism or PE. Still, having a blood clot does not
usually mean that you have cancer. Remember that most blood clots are caused by
other things.
Another pancreatic cancer clue is the development of uneven
texture of the fatty tissue underneath the skin. This is caused by the release
of the pancreatic enzymes that digest fat.
Diabetes
Rarely, exocrine cancers of the pancreas cause diabetes
(high blood sugar) because they destroy the insulin-making cells. More often,
there are slight problems with sugar metabolism that do not cause symptoms of
diabetes but can still be recognized by certain blood tests.
Source: America Cancer Society http://www.cancer.org
