Signs and symptoms
Signs and symptoms are diagnostic tools that help doctors
to work out what is wrong with someone and make a
- Symptoms are the things that you are experiencing, e.g.
pain or loss of appetite that you will tell your doctor
- Signs are what the doctor can see when they examine
someone, e.g. someone wincing when they touch a painful
Signs and symptoms of pancreatic cancer
Pancreatic cancer doesn't usually give rise to any symptoms or
signs in the early stages. This is the main reason it can be so
difficult to detect and diagnose. As the cancer grows the symptoms
it causes will depend on the type of pancreatic cancer
and where it is in the pancreas.
Any symptoms people do have can be quite vague and may
come and go at first. An example is abdominal pain, which may start
off as occasional discomfort before becoming more painful and more
frequent. The symptoms can also be a sign of other more common,
less serious illnesses. This means that people may end up seeing
their GP several times or being sent for a number of different tests
before pancreatic cancer is even considered.
It is important to remember that any of the symptoms described
here are common for lots of illnesses and may not be a sign of
pancreatic cancer. But if you have persistent unexplained
symptoms it's important for your GP to refer you for tests to
explore what is
causing them. It can help to note down the frequency of your
symptoms and mention anything unusual you are experiencing, even if
it seems unrelated. If your symptoms get worse or you develop any
new symptoms suddenly you should always get in touch with your
Most common symptoms of pancreatic cancer
Most pancreatic cancers are exocrine tumours (90%).
Their symptoms can be very vague and depend on whether the tumour
is in the head, body or tail of the pancreas.
Pain is a symptom in about 70% of pancreatic cancer cases.
It often starts as general discomfort or pain in the abdomen
(tummy) which can spread to the back. It can be worse after eating
or when you are lying down. Sitting forward can sometimes relieve
the pain. At first the pain may come and go, but over time it may
become more constant. If any of the organs (pancreas, liver or gall
bladder) in your abdomen are inflamed or enlarged the area may also
be tender to touch.
Pain is caused by the cancer affecting nerves or organs
near the pancreas. It can also be a result of a tumour causing a
blockage in the stomach or duodenum (top part of the small
Jaundice occurs in about 50% of pancreatic cancer cases.
The most common symptoms
of jaundice are that the skin and the whites of the eyes turn
yellow. Other signs of jaundice include dark urine, pale
stools and itchy skin.
Jaundice develops when there is a build-up in the blood of
a chemical called bilirubin. This chemical is always present in the
blood. It usually gets removed from the body in the bile fluid
produced by the liver which empties into the small intestines
through the bile duct. Cancer growing in the pancreas can block the
bile duct so that bile and bilirubin keep building up in the body.
This is known as obstructive jaundice.
Jaundice can be caused by other non-cancerous conditions,
such as a gallstone blocking the bile duct, so it's important for
all the obvious causes to be explored.
Losing a lot of weight for no particular reason can be a
sign that something is wrong. People may also notice a loss of
appetite or changes in what they feel like eating.
Pancreatic cancer can affect the ability of the pancreas
to produce digestive enzymes that help to digest food. This means
that the body can't digest food properly or get the nutrients it
needs, leading to weight loss. Weight loss is more common with
cancers in the head of the pancreas.
Other common symptoms of pancreatic cancer
These symptoms are also common, though not everyone will
have every symptom. People may have these symptoms before a
diagnosis, develop them later on, or perhaps not get them at
A condition called steatorrhoea (stools that are large, pale,
oily, floating and smelly) is a common symptom of diseases of the
pancreas. It happens because the cancer affects the production of
the enzymes needed to digest food, particularly high fat food.
Undigested food passing quickly through the body can also cause
diarrhoea and subsequent weight loss.
Nausea and vomiting
Nausea (feeling sick) and sickness can occur for several
different reasons. A tumour can block the bile duct or press on the
duodenum, which obstructs digestion. It may also cause inflammation
around it in the pancreas, or jaundice. Both of these can lead to a
chemical imbalance in the body which can make people feel
Fever and shivering
If the pancreas is inflamed or the ducts are blocked because
of the tumour, this can cause a high temperature and
Diabetes can develop if a tumour stops the pancreas from
functioning properly. This is because the pancreas produces the
hormone insulin which the body needs to regulate the amount of
sugar in the blood. People with diabetes often feel extremely
thirsty, pass more urine than normal, lose weight and feel weak and
lacking in energy.
Diabetes is particularly associated with pancreatic cancer
in older people. If someone develops late onset diabetes with no
other explanation their GP should consider the possibility of
Symptoms of endocrine pancreatic tumours
Less than 5% of all pancreatic cancers are endocrine tumours, which
develop in the hormone producing cells of the pancreas. They are
divided into functioning and non-functioning tumours, depending on
whether or not they overproduce hormones and cause a chemical
Most endocrine tumours do not produce a clinical syndrome
(non-functioning) so they do not cause specific symptoms. As they
grow or spread they may cause pain, jaundice or a lump that can be
felt in the abdomen.
Some endocrine tumours overproduce hormones and
cause a clinical syndrome (functioning). These give rise to
different symptoms depending on the type of tumour and the
hormone it produces.
- Gastrinomas overproduce
gastrin, which causes peptic ulcers in the stomach or duodenum.
Symptoms include severe pain, black tarry stools and
- Glucagonomas overproduce
glucagon. Symptoms include a specific type of skin rash (redness,
ulceration and scabbing), anaemia (lack of red blood cells), weight
loss and inflammation inside the cheeks and lips.
- Insulinomas overproduce
insulin, leading to hypoglycaemia (low blood sugar levels).
Symptoms may include weakness, drowsiness, dizziness or lack of
- VIPomas overproduce a
hormone called vasoactive intestinal peptide (VIP). Symptoms
include watery diarrhoea, high blood pressure and flushing of the
Published March 2012
Review date March 2014