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.
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.
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.
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