Clinical features of pancreatic cancer

Pancreatic cancer is often diagnosed at an advanced stage. Common clinical features include weight loss, abdominal pain, and jaundice.

1. Weight loss

It is a nonspecific symptom that is usually gradual and begins months before pancreatic cancer is diagnosed.

(ii) Abdominal pain

65%-80% of patients have abdominal pain, which is often more severe at night. The pain is aggravated by lying down or sitting. The pain is often vague and difficult to describe, which often delays diagnosis.

3. Jaundice

It is the third most common symptom and many patients present late. Jaundice is usually progressive, but it can fluctuate naturally. Jaundice may be the only clinical manifestation in patients with small pancreatic cancers adjacent to the common bile duct. Therefore, this unexplained jaundice should be carefully evaluated. Such tumors are often easier to remove. Jaundice is often accompanied by annoying itching in the upper arms, calves, and abdomen, especially at night. Itching is related to bile salt retention in the skin. This is because the level of bile salts in the skin is more closely related to the severity of itching than the level of serum bilirubin.

4. Nonspecific signs and symptoms of pancreatic cancer

These include anorexia, ascending cholangitis, and changes in bowel habits (constipation, diarrhea, malabsorption, flatulence, intestinal bloating). Diabetes may accompany the attack. Therefore, it is difficult to distinguish pancreatic cancer from chronic pancreatitis.

Due to direct damage to the stomach, pylorus or duodenum, or due to gastric dysfunction, symptoms of gastric emptying disorder may occur. Metastatic thrombophlebitis (Trousseau sign), which is usually associated with lung cancer, may also be an early sign of pancreatic cancer. Depression, paranoia and hysteria may occur in middle-aged people, which are generally believed to be caused by pancreatic cancer. Mental symptoms, mainly depression symptoms, can occasionally be seen in patients with pancreatic cancer. More than half of these patients with mental symptoms have a proportion of mental symptoms that is 6 months earlier than the appearance of physiological signs and symptoms. It is precisely because there are many non-specific and vague signs and symptoms that early diagnosis of pancreatic cancer is very difficult, and doctors must remain highly vigilant. With the delay in diagnosis comes a low surgical resection rate for pancreatic cancer. More than 80% of pancreatic cancer patients can only undergo exploratory or palliative surgery when diagnosed, and recurrence and metastasis are early and the incidence is high after surgery. The treatment effect of single radiotherapy or chemotherapy is not ideal, and the prognosis is extremely poor.