Signs and symptoms
Signs and symptoms help doctors to work out what is
wrong with someone and make a diagnosis.
- Symptoms are the problems you experience that may
indicate a disease or condition, e.g. pain or loss of appetite. You
will need to tell your doctor about these as they do not show up on
- Signs are what the doctor can see when they examine
someone or something that shows up in a test, e.g. someone wincing
when the doctor touches a painful area or high blood
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 why
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
illnesses such as pancreatitis, gastritis, gallstones or hepatitis.
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
common symptoms of pancreatic cancer
Most pancreatic cancers are
exocrine tumours (95%). Their symptoms can be very vague and
depend on whether the tumour is in the head, body or tail of the
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 signs
of jaundice are that the skin and the whites of the eyes turn
yellow. Other signs include dark urine, pale stools (poo)
and itchy skin.
Jaundice develops when there is a build-up in the blood of
a substance called bilirubin. The substance is a by-product of red
blood cells breaking down and 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, especially
high fat food. This means that the body can't digest food properly
or get the nutrients it needs, leading to weight loss.
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 sick.
New, unexplained and persistent dyspepsia
(indigestion/heartburn) can be a symptom of pancreatic cancer,
particularly in older people.
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 interferes with the
pancreas working 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 over 50 has developed type 2 diabetes
within the past two years, with no other explanation, their GP
should consider the possibility of pancreatic cancer.
Pain in the upper back (not the lower lumbar region)
can occur if the cancer spreads to the nerves around the
Other symptoms can include
- Extreme tiredness/fatigue
- Feeling unusually full after food
- Venous thromboembolism (VTE) (blood clots that form
in a vein)
- Unexplained acute pancreatitis (inflammation of the
Symptoms of endocrine pancreatic tumours
Less than 5% of all pancreatic cancers are
pancreatic neuroendocrine 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 peptides that cause a clinical
Most pancreatic neuroendocrine tumours do not produce a
clinical syndrome (non-functioning) so they do not cause specific
symptoms. The list of symptoms above for the most common symptoms of pancreatic
cancer are also applicable to non functioning neuroendocrine
Rarely, some pancreatic neuroendocrine tumours overproduce
certain hormones and peptides that cause a typical clinical
syndrome (functioning). These give rise to different symptoms
depending on the type of tumour and the
hormone or peptide it produces.
overproduce gastrin, which causes peptic ulcers in the
stomach or duodenum. Symptoms include severe pain, black tarry
stools and diarrhoea.
- Glucagonomas 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 June 2014
Review date June 2016