From the Guidelines
Pancreatic cancer often presents with vague symptoms that may not appear until the disease is advanced, including jaundice, dark urine, light-colored stools, abdominal or back pain, unexplained weight loss, loss of appetite, and new-onset diabetes or worsening of existing diabetes. The symptoms of pancreatic cancer can vary depending on the location of the tumor within the pancreas. According to the most recent and highest quality study 1, the majority of patients with pancreatic cancer progress to either metastatic or locally advanced disease in the asymptomatic phase. Common symptoms include:
- Jaundice (yellowing of the skin and eyes)
- Dark urine
- Light-colored stools
- Abdominal or back pain
- Unexplained weight loss
- Loss of appetite
- New-onset diabetes or worsening of existing diabetes
- Fatigue
- Nausea
- Vomiting
- Digestive problems
The location of the tumor within the pancreas affects which symptoms appear first. Tumors in the head of the pancreas are more likely to cause jaundice early due to bile duct obstruction, while tumors in the body or tail may grow larger before causing noticeable symptoms, typically pain that radiates to the back. These symptoms occur because pancreatic cancer disrupts normal pancreatic function, which includes producing digestive enzymes and hormones like insulin. Since these symptoms can mimic other less serious conditions, pancreatic cancer is often diagnosed at an advanced stage. Anyone experiencing persistent symptoms, especially jaundice without pain, unexplained weight loss, or new-onset diabetes after age 50, should seek medical attention promptly for proper evaluation.
The diagnosis of pancreatic cancer is typically made using a combination of imaging tests, such as abdominal ultrasound, endoscopic ultrasound (EUS), contrast-enhanced multi-detector computed tomography (MD-CT), and magnetic resonance imaging (MRI) combined with magnetic resonance cholangiopancreatography (MRCP) 1. Tumor markers, such as CA19.9, may also be used to guide treatment and follow-up, but are not specific for pancreatic cancer and have limited diagnostic value 1.
It is essential to note that the prognosis of pancreatic cancer has not improved significantly over the past 20 years, and the overall 1-year survival rate in Europe ranges from ∼11% to 28.3% 1. Therefore, early detection and diagnosis are critical to improve treatment outcomes. However, currently, there are no efficient screening tools available that can be recommended outside a high-risk population, such as those suffering from hereditary conditions 1.
From the Research
Symptoms of Pancreatic Cancer
The symptoms of pancreatic cancer can vary, but common signs and symptoms include:
- Abdominal or back pain 2, 3, 4, 5, 6
- Jaundice 2, 3, 4, 6
- Weight loss 3, 4, 5, 6
- Pruritus 2, 3
- Dark urine and acholic stools 2
- Nausea and vomiting 3
- Anorexia and early satiety 5
- Sleep problems 5
Less Common Symptoms
Some patients may experience less common symptoms, such as:
- No pain at diagnosis, particularly those with pancreatic head tumors 5
- Recent onset of diabetes mellitus, particularly if the diabetes occurs during or beyond the sixth decade 5
- Upper abdominal disease up to 6 months prior to diagnosis 5
Presentation of Symptoms
The presentation of symptoms can vary, and some patients may have no symptoms at all. However, if symptoms are present, they can be attributed to various factors, including: