What are the specific symptoms of pancreatic cancer

Pancreatic cancer is a common disease with no specific early symptoms or signs. It brings a lot of trouble to patients. So what are the main symptoms of pancreatic cancer?

1. Yellow abdominal pain Pain is the main symptom of pancreatic cancer, and it occurs regardless of whether the tumor is located in the head or tail of the pancreas. 60% to 80% of patients experience upper abdominal pain, and 85% of these patients with pain are no longer able to undergo surgery or are already in the advanced stage. The pain is generally unrelated to diet. Most of them are mild at first, and the pain gradually worsens as they persist. Due to the different locations of the tumors and the mechanisms that cause pain, abdominal pain can present in a variety of ways. The degree ranges from fullness and discomfort, dull pain to severe pain. There is radiating pain, and pancreatic head cancer mostly radiates to the right, while most of the body and tail cancer radiates to the left. Pain in the lower back indicates a more advanced stage and a poor prognosis. Pancreatic cancer patients may enlarge the pancreas due to the tumor, compress the pancreatic duct, and cause the pancreatic duct to be obstructed, dilated, twisted, and the pressure to increase, causing persistent or intermittent distending pain in the upper abdomen, and sometimes combined with pancreatitis, causing visceral neuralgia. Nerve impulses are transmitted to the left and right T6-T11 sympathetic ganglia through the visceral nerves and then transmitted upward. Therefore, in the early stage of the disease, it often presents as a wide range of fullness, discomfort, dull pain or dull pain in the upper and middle abdomen, which is difficult to locate and has a vague nature. It often worsens 1-2 hours after eating, so people are afraid of eating to reduce the pain aggravated by eating. Less common is paroxysmal severe upper abdominal pain, which progressively worsens and may even be unbearable. This is more common in early pancreatic head cancer with pancreaticobiliary duct obstruction, because drinking or eating greasy food induces increased bile and pancreatic juice secretion, which causes a sudden increase in pressure in the bile duct and pancreatic duct. In addition to pain in the middle abdomen or left upper abdomen or right upper abdomen, a few cases complain of pain in the left or right lower abdomen, around the umbilicus or the entire abdomen, and even testicular pain, which can be easily confused with other diseases. When the tumor involves the visceral capsule, peritoneum or retroperitoneal tissue, tenderness may be present in the corresponding area.

2. Jaundice is an important symptom of pancreatic cancer, especially pancreatic head cancer. Jaundice is obstructive, accompanied by dark yellow urine and clay-like stools, which is caused by the invasion or compression of the lower end of the common bile duct. Jaundice is progressive, and although there may be slight fluctuations, it is impossible to completely disappear. The temporary relief of jaundice is related to the disappearance of inflammation around the ampulla in the early stage, and the jaundice caused by the ampulla tumor is more likely to fluctuate in the late stage due to the ulceration and sloughing of the tumor invading the lower end of the common bile duct. Jaundice only occurs in pancreatic body and tail cancer when it affects the pancreatic head. Jaundice in some pancreatic cancer patients in the late stage is caused by liver metastasis. About 1/4 of patients have persistent skin itching, which is often progressive. Although it is currently believed that the occurrence of itching in obstructive jaundice may be related to the accumulation of bile acid in the skin, a small number of patients without jaundice or mild jaundice may also have symptoms of skin itching.

3. The most common digestive tract symptoms are loss of appetite, followed by nausea and vomiting. There may be diarrhea or constipation or even black stools. Diarrhea is often steatorrhea. Loss of appetite is related to the blockage of the lower end of the common bile duct and the pancreatic duct by tumors, which prevents bile and pancreatic juice from entering the duodenum. Obstructive chronic pancreatitis of the pancreas leads to poor pancreatic exocrine function, which will inevitably affect appetite. Obstructive vomiting occurs in a small number of patients because the tumor invades or compresses the duodenum and stomach. Due to frequent insufficient food intake, about 10% of patients have severe constipation. In addition, about 15% of patients have diarrhea due to poor pancreatic exocrine function; steatorrhea is a late manifestation and is a unique symptom of poor pancreatic exocrine function, but it is rare. Pancreatic cancer can also cause upper gastrointestinal bleeding, manifested as vomiting blood, black stools or only positive fecal occult blood test, with an incidence of about 10%. The cause of gastrointestinal bleeding is the invasion and rupture of adjacent hollow organs such as the duodenum or stomach, and the ampullary cancer itself is more prone to bleeding due to rotting. Occasionally, the splenic vein or portal vein may be thrombotic due to tumor invasion, leading to secondary portal hypertension and massive bleeding due to rupture of esophageal varicose veins.

4. Weight loss and fatigue. Pancreatic cancer is different from other cancers. Weight loss and fatigue often occur in the early stages. This symptom has nothing to do with the location of the tumor. Among digestive tract tumors, pancreatic cancer causes the most prominent weight loss. Obvious weight loss occurs within a short period of time after the onset of the disease. The weight loss can reach more than 30 kilograms, accompanied by symptoms such as weakness and fatigue. Some patients first show progressive weight loss before other symptoms appear. The reason for weight loss is loss of appetite, reduced food intake, or although there is an appetite, the patient is unwilling to eat due to upper abdominal discomfort or abdominal pain after eating. In addition, poor pancreatic exocrine function or obstruction of pancreatic juice outflow through the pancreatic duct, which affects digestion and absorption functions, is also related to a certain extent.

5. Abdominal mass The pancreas is deep in the posterior abdomen and is difficult to feel. The abdominal mass is the result of the development of the cancer itself and is located where the lesion is. If a mass has been felt, it is mostly in the progressive or advanced stage. Chronic pancreatitis can also cause masses to be felt, which is difficult to distinguish from pancreatic cancer. Pancreatic cancer can cause dilatation of the intrahepatic and extrahepatic bile ducts and gallbladder and cholestatic enlargement of the liver, so an enlarged liver and gallbladder can be felt. The tumor is irregular in shape, of varying sizes, firm and stable, and may have obvious tenderness. Because lesions in the head of the pancreas often have other obvious symptoms before the appearance of the mass, the abdominal mass caused by this disease is relatively more common in pancreatic body and tail cancer. When the cancer compresses the abdominal aorta or splenic artery, a blowing-like vascular murmur can be heard around the umbilicus or in the left upper abdomen. Sometimes the abdominal mass is an enlarged liver and gallbladder, and there are also pancreatic cysts complicated by pancreatic cancer.

6. Symptomatic diabetes: A small number of patients initially present with symptoms of diabetes, that is, they first develop diabetes before the main symptoms of pancreatic cancer, such as abdominal pain and jaundice, appear, so that the accompanying weight loss and weight loss are mistakenly regarded as manifestations of diabetes, and pancreatic cancer is not considered; it can also be manifested as a patient with long-term diabetes who has recently become more seriously ill, or the treatment measures that were able to control the disease for a long time have become ineffective, indicating that pancreatic cancer may have occurred on the basis of the original diabetes. Therefore, if a diabetic patient has persistent abdominal pain, or an elderly person suddenly develops diabetes, or an original diabetic has suddenly worsened recently, they should be alert to the possibility of pancreatic cancer.

7. Thrombophlebitis Patients with advanced pancreatic cancer may experience migratory thrombophlebitis or arterial thrombosis. If there is deep vein thrombosis in the lower extremities, it may cause edema of the affected lower extremities. Autopsy data show that the incidence of arterial and venous thrombosis is about 25%, which seems to be more common in pancreatic body and tail cancer. Spain believes that the tumor may secrete some substance that promotes thrombosis. For example, portal vein thrombosis can cause esophageal varicose veins or ascites, and splenic vein thrombosis can cause splenomegaly. These patients are prone to acute upper gastrointestinal bleeding.

8. Psychiatric symptoms Some pancreatic cancer patients may show psychiatric symptoms such as anxiety, irritability, depression, personality changes, etc. The mechanism of occurrence is still unclear, but it may be because pancreatic cancer patients often have symptoms such as intractable abdominal pain, insomnia, and inability to eat, which can easily affect their spirit and emotions.

9. Others In addition, patients often complain of fever and obvious fatigue. There may be high fever and even chills, which are similar to symptoms of cholangitis, so it is easy to confuse it with cholelithiasis and cholangitis. Of course, when there is bile duct obstruction and infection, there may also be chills and high fever. Some patients may also have redness, swelling, pain, heat in small joints, subcutaneous fat necrosis around joints, and unexplained testicular pain. The supraclavicular, axillary or inguinal lymph nodes may also swell and harden due to pancreatic cancer metastasis.

The above content introduces the symptoms of pancreatic cancer. I hope it can be helpful to everyone. If you have any other needs, you can also consult our online consulting experts at Feihua Health Network. We are always here to answer your questions. I wish you good health!

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