Early Signs of Pancreatic Cancer

By Kathleen Doheny. Medically reviewed by Tom Iarocci, MD. May 7th 2016

Cancer of the pancreas, often dubbed the '“stealth cancer,”' has earned its unfortunate nickname.

“It’s really hard to detect,” says oncologist Yuman Fong, MD, chair of the department of surgery at the City of Hope Comprehensive Cancer Center in Duarte, California. “The tumor can be enormous before we find it.”

Early detection is elusive, Fong and other experts say, because there are often no initial signals that anything is wrong. Symptoms that do sometimes occur, such as back pain or abdominal discomfort, are often ignored or thought to be due to other conditions.

About 46,000 new cases of pancreatic cancer are diagnosed annually in the U.S., according to the National Cancer Institute, and 40,000 people per year die from it; the 5-year survival rate is less than 5 percent.

Earliest Signs of Pancreatic Cancer  

The pancreas produces enzymes that help the body absorb foods, especially fatty foods. It also produces the hormones insulin and glucagon, which help regulate blood sugar.

Experts still can’t pinpoint the cause of pancreatic cancer, but risk factors include aging, smoking, obesity and exposure to certain toxic chemicals. Recent research has focused on better tests to help find this devastating genetic mutations.

Meanwhile, Fong says, becoming mindful of certain symptoms – and what they might mean –helps in recognizing this cancer.

Part of the cancer detection problem has to do with the location of the pancreas. The 6-inch-long organ lies deep in the belly, behind the stomach and backbone.

As a tumor grows, it tends to block the bile ducts, causing jaundice, a yellowing of the skin and eyes, Fong says. Other times, the symptoms are vague belly or back pain that may occur once the cancer is spreading to nearby organs.

Other symptoms of pancreatic cancer may include:

  • Diarrhea,
  • Urine that is very dark,
  • Stools the color of clay,
  • Weakness and fatigue, and
  • Loss of appetite or weight loss.

Pay Attention to Family History

“The times we catch it early are usually the times when someone has vague abdominal pain,” Fong says. Sometimes a CT scan is part of the evaluation for abdominal pain caused by other illnesses. “The doctor orders a CT scan and sees a lump in the pancreas.” 

Here’s help identifying preliminary symptoms of pancreatic cancer:

  • If you have a family history of pancreatic cancer, be more aware of the possible symptoms. Don’t ignore them – get them examined, Fong says. Having a family member with pancreatic cancer increases your risk.
  • Any jaundice, with or without a family history, has to be evaluated, he says.
  • If you develop diabetes but have few risk factors for it (such as obesity), get checked out, too, he advises.

Next Steps

  • Avoid pancreatic cancer risk factors: Don’t smoke or drink to excess, eat healthier foods and maintain a lean body weight.
  • An existing blood test for pancreatic cancer looks for a substance called CA19-9, which is released by cancerous cells. However, by the time the test detects CA 19-9, cancer is already past the early stages, according to the American Cancer Society. (The test is not yet recommended for screening people).
  • Scientists are studying newer blood tests. One test looks for specific patterns in genetic material called microRNA that point to a possible cancer. The test is preliminary but the approach is promising for high-risk people.

For Caregivers

If you notice unusual symptoms in loved ones, such as jaundice, unexplained weight loss or lack of appetite, urge them to see a doctor pronto. If your loved one is at high risk (hereditary pancreatitis, for instance), ask about an endoscopic ultrasound. In this minimally invasive imaging test, a flexible tube is used to check the pancreas for suspicious lesions.  

  • If something looks iffy, doctors may remove some tissue during the test and biopsy it for the presence of cancer. Some universities, including the University of Chicago and the University of Virginia, have established special clinics for those at high risk, offering further testing and monitoring.

Sources

Fong Y., MD, physician and surgeon, chair of surgery at City of Hope Comprehensive Cancer Center in Duarte, California. http://cityofhope.org/people/fong-yuman. Interviewed April 2014.
The University of Chicago Medicine. “Early Detection of Pancreatic Cancer.” 2014. http://www.uchospitals.edu/specialties/cancer/pancreatic/screening.html Accessed April 2014.
The University of Virginia. “High-Risk Pancreatic Cancer Clinic.” 2014. http://uvahealth.com/directions-locations/clinics/pancreatic-cancer-clinic Accessed April 2014.
National Cancer Institute. “Pancreatic Cancer.” September 2013. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001283/ Accessed April 2014.
Schultz N., MD, PhD, Dehlendorff C., PhD, et al. “MicroRNA Biomarkers in Whole Blood for Detection of Pancreatic Cancer.” Journal of the American Medical Association. 2014; 311 (4); pages 392-404. http://www.ncbi.nlm.nih.gov/pubmed/24449318 Accessed April 2014.
American Cancer Society. “Can Pancreatic Cancer Be Found Early?” February 2014. http://www.cancer.org/cancer/pancreaticcancer/detailedguide/pancreatic-cancer-detection Accessed April 2014.
Hidalgo M., MD, “Pancreatic Cancer.” New England Journal of Medicine. 2010; 362 (17); pages 1605-1617. Accessed April 2014.

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