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Pancreatic cancer is the ninth most common cancer death in women and the fourth in terms of both men and women.  Due to the fact that pancreatic cancer is so difficult to diagnose, we thought it would be important to provide the most common signs and symptoms of pancreatic cancer. Here are 30 signs and symptoms of pancreatic cancer.

30. Jaundice

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One of the telltale signs of pancreatic cancer is jaundice, which is a yellowing of the eyes and skin. According to the American Cancer Society, almost all cases of pancreatic cancer begin with jaundice. Jaundice is a result of bilirubin buildup ( a substance that is made in the liver). Usually, it’s excreted by the liver in bile, however when the bile duct becomes blocked it can build up in the body, usually do to cancers beginning in the head of the pancreas. As the cancer spreads, it usually moves to the liver which results in jaundice.

29. Dark Urine

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Another common symptom of pancreatic cancer is dark urine. This is once again a result of bilirubin buildup within the body. As the levels in the blood reach an all-time high, the urine turns brown in color. It’s recommended if you suffer from dark brown urine on a regular basis that you be examined by your primary healthcare physician.

28. Greasy Stool

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Not the most appetizing of subjects, but greasy stool is another symptom of pancreatic cancer. This is due to the cancer blocking the bile duct, which means a buildup of other toxins in the body and inability to digest fast.

27. Grey Stool

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Besides greasy stool, feces can turn grey as a result of pancreatic cancer as well. The grey color is contributed due to bile and pancreatic enzymes being unable to get to the intestines to help breakdown fat. This results in grey floating stools that are usually very soft in consistency.

26. Itchy Skin

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If you notice your skin begins to turn yellow and itchy, it’s time to see a doctor right away. Research has found that these symptoms are a clear indication of pancreatic cancer, and should be treated seriously. This is all a result of once again, bilirubin building up in the skin.

25. Stomach Pain

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Another common symptom of pancreatic cancer is abdomen pain. This is due to the fact that when cancers begins to grow larger within the body it can start to press on other organs, the stomach included. This can lead to what feels like a simple stomach ache, however if it remains constant, we suggest seeking out medical attention right away.

24. Back Pain

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When cancer starts in the tail of the pancreas, it can spread to the surrounding nerves, which often triggers intense lower back pain. As the cancer grows, this can lead to intense buildup of pressure on the spine, which can trigger other problems as well.

23. Weight loss and lack of appetite

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Due to the various ways the pancreas impacts our daily bodily functions, when cancer spreads it can reduce your appetite and even trigger weight loss. If you notice you’re losing weight without cause (like you’re still eating twinkies and steering clear of the gym) you may want to seek out medical attention sooner rather than later.

22. Nausea and vomiting

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As pancreatic cancer spreads, it can begin to press on the stomach and in extreme cases, block stomach access. This can make it harder for food to pass from the stomach into the intestines, which results in nausea and vomiting. These symptoms tend to appear after eating in most extreme cases.

21. Gallbladder Complications

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If pancreatic cancer begins to block the bile duct in the body, it can lead to a build up of bile in the gallbladder, which begins to make it larger. As the gallbladder expands, it becomes a hard mass underneath the right side of the rib cage, which can be felt easily during a routine physical exam.

20. Enlarged Liver

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Pancreatic cancer can also enlarge the liver, as bile and bilirubin back up in the body. Sometimes this is usually caused by the cancer spreading to the liver. Most doctors can feel the enlargement through a simple physical, which is why it is an easier symptom to detect.

19. Blood Clots

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Often, one of the first signs of pancreatic cancer is a visible blood clot in the leg. Technically called deep vein thrombosis (DVT), the symptoms for such an issue are leg pain, swelling, redness and often warmth in the leg with the clot. In worst case scenarios, the blood clot can break off and travel to the lungs which results in a pulmonary embolism, this can be fatal if not treated swiftly.

18. Fatty Tissue Abnormalities

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As pancreatic cancer spreads unchecked, layers of uneven fatty tissue can begin to accumulate underneath the skin. This results from the release of pancreatic enzymes that are used to digest fat. When this process is disrupted, the fat begins to collect in odd formations.

17. Diabetes

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While this is one of the more rare symptoms of pancreatic cancer, a select few people may develop diabetes when suffering from pancreatic cancer. Although this is highly unusual and most of the time its the cancer changing blood sugar levels that imitate diabetes.

16. Gastrinomas

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Pancreatic cancer can sometimes trigger the body to develop gastrinomas, which are tumors that make gastrin, a hormone that signals the stomach to make more acid. From these gastrinomas the stomach can make too much acid which leads to stomach ulcers and eventually internal bleeding.

15. Glucagonomas

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Due to the vast number of symptoms a patient can develop, it can be hard for doctors to determine whether it’s pancreatic cancer or another type of tumor. If you’re suffering from a glucagonoma tumor it will secrete glucagon, which can increase blood sugar levels and mimic diabetes. A distinguishing symptom of this type of tumor is irritation of the tongue and corners of the mouth, as well as a rash called necrolytic migratory erythema. According to the American Cancer Society, the rash is red and blistery and is the number one reason patients with glucagonoma tumors see a doctor. 

14. Insulinomas

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Insulinomas tumors make, you guessed it–insulin (You may have started to notice a theme with the name and the corresponding chemical corruption). The increase in insulin can cause the body to suffer from effects associated with low blood sugar such as weakness, confusion, rapid heartbeat, and sweating. Having low blood sugar can cause some serious complications and when your body is overproducing insulin, it can really take a toll on your health.

13. Somatostatinomas

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The chemical somatostatin, which is a chemical that helps naturally regulate hormones. When your hormones are out of whack you can have a multitude of symptoms associated with many other issues including nausea, diarrhea, stomach pain, and jaundice, but many of the symptoms don’t present themselves until advanced stages. Usually, when doctors diagnose this type of tumor it has already spread to surrounding areas such as the liver.

12. VIPomas

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Vasoactive intestinal peptide is created by VIPomas and can cause the body harm and discomfort with diarrhea. You may notice the symptoms to be mild at first but will increase in intensity and frequency as time progresses and by the time someone seeks medical attention the diarrhea is severe and watery, so if you’re suffering from any discomfort like described seek medical attention. People who are diagnosed with VIPomas also have problems with digestion due to the low acid levels in the stomach. 

11. PPomas

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PPomas get their name because they create pancreatic polypeptide which is what regulates the activity of the pancreas, as well as gastrointestinal secretions which aid in digestion. Pain can be felt in the lower belly as well as in the liver due to the overacting PP levels.

10. Carcinoid Tumors

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Carcinoid tumors cause problems because they create excess serotonin, which gets broken down by your liver before it can make its way through your blood and body. The liver does an amazing job at breaking down the excess chemical to prevent any harm from happening, so much so that there are virtually no signs or symptoms until it has spread beyond the pancreas.

9. Non-functioning Neuroendocrine Tumors

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These are probably the sneakiest of tumors found in the pancreas, as they don’t cause any hormone imbalances which in turn create no symptoms in the early stages. The lack of symptoms allows the tumors to grow to enormous sizes, as well as giving them time to metastasize.

8. Symptoms Of Metastasis

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When pancreatic tumors metastasize there can be a variety of symptoms, depending on the location where the cancer has spread to. Unfortunately, for this reason, pancreatic cancer often spreads, making it hard to treat. It commonly spreads to the liver, causing symptoms of liver failure like jaundice, but has also been known to spread to organs higher up such as the lungs and brain.

7. Testing

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If a patient exhibits signs and symptoms of pancreatic cancer, there are multiple tests that doctors will administer to try and narrow down the possibilities of causes. First, you will most likely have a physical exam and go over your medical history to communicate all your worries to your physician. Depending on what they find, they might choose imaging testing like an MRI, Ultrasound, or CAT scan to try and get a physical image of what’s going on inside. They also use tests like these to see if treatment is working and/or if the cancer has spread.

6. Somatostatin receptor scintigraphy (SRS)

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If your doctor does find that there is cancerous material, they may use a test called a somatostatin receptor scintigraphy (SRS) to determine where all the cancerous cells are in your body. This test doesn’t work for all the tumor types listed above, but can be helpful for some. The process begins with a chemical octreotide, which is bound with a radioactive material and injected into the blood stream. A couple hours later the doctors can use a special camera giving them a highlighted look at the problem areas, as well as help determine the best treatment plan.

5. Blood Tests

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Due to the connection with pancreatic cancer and liver issues, blood tests can be done to determine the seriousness of liver function as well as white blood cell counts. They can then use the results to determine the exact cause of the liver failure, as it can be a variety of things. Blood tests can also be helpful in determining tumor markers, which give specific information on the type of tumor they’re dealing with.

4. Biopsy

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Most likely a biopsy will be needed to be positive on what kind of tumor and what stage the cancer is at, which will involve a small procedure that takes a small sample of the tumor. The sample is then looked at under a microscope and classified. This is the only way to be 100% sure on the type., however in rare cases, enough evidence will be present that this step is not needed.

3. The stages

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Just like any other cancer, pancreatic cancer can be classified by different stages depending on its development. The American Joint Committee On Cancer stages cancer with three pieces of information: the size (T), if it has reached nearby lymph nodes (N), and how far/if its spread (M). The higher the number in each category, the more advanced the cancer is.

2. Location Matters

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Not all pancreatic cancers are the same, as we have noted many times above–but what many people don’t know is that there is actually a difference when it comes to the location of your cancer on your pancreas. If the cancer is in the head of the pancreas will cause symptoms including jaundice, nausea, vomiting, weight loss, and back pain. Cancer that is located in the body of the pancreas often causes belly pain.

1. Risk Factors

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Although the cause of pancreatic cancer is unknown, there are risk factors that have been determined to increase the chances of developing the disease, such as inherited gene mutations. Genetic testing may help determine if you’re at a higher risk for pancreatic cancer and can help determine both inherited and acquired mutations. Acquired mutations can come from chemical exposure, tobacco use, obesity, and alcohol abuse.