From the Guidelines
The most common presentation of pancreatic tumor is jaundice, abdominal pain, weight loss, steatorrhoea, and new onset or worsening of pre-existing diabetes, with the specific symptoms varying based on tumor location. According to the most recent study 1, approximately three quarters of pancreatic cancers arise in the head of the pancreas, and these tumors are more likely to present with jaundice due to obstruction of the common bile duct. Tumors located in the body and tail, on the other hand, are likely to be diagnosed at a more advanced stage and present with abdominal pain and weight loss rather than jaundice.
Key Presenting Symptoms
- Jaundice, particularly for tumors located in the head of the pancreas
- Abdominal pain
- Weight loss
- Steatorrhoea
- New onset or worsening of pre-existing diabetes These symptoms often develop insidiously, contributing to delayed diagnosis, and many pancreatic tumors remain asymptomatic until they reach an advanced stage, which partly explains why pancreatic cancer has such poor survival rates. The presentation varies somewhat based on tumor location, with tumors in the body or tail typically presenting later with pain and weight loss rather than jaundice, as they don't obstruct the bile duct until more advanced stages 1.
From the Research
Common Presentations of Pancreatic Tumors
- The most common presenting complaint in pancreatic and biliary tract carcinomas is abdominal pain, regardless of the tumor size 2
- Jaundice may also be an early sign, and pancreatic tumors that present as painless jaundice have been ascribed a relatively more favorable prognosis 2
- Weight loss is a common finding in most patients, usually associated with malabsorption 2
- Other possible presentations include:
- Diabetes
- Acute pancreatitis episode
- Venous thrombosis or malignant thrombophlebitis
- Gastrointestinal hemorrhage
- Mental disturbances
- Skin manifestations 2
Disease Stage at Presentation
- Most patients present with locally advanced (30%-35%) or metastatic (50%-55%) disease at diagnosis 3
- Only 10%-15% of patients have resectable disease at presentation 3
- The incidence of pancreatic ductal adenocarcinoma (PDAC) is increasing by 0.5% to 1.0% per year, and it is projected to become the second-leading cause of cancer-related mortality by 2030 3