Pancreatic cancer usually does not cause any signs or symptoms. By the time symptoms appear, they are usually very large or have spread outside the pancreas.

Having one or more of the symptoms below does not mean you have pancreatic cancer. In fact, many of these symptoms are caused by other conditions. However, if you have any of these symptoms, it’s important to see your doctor so the cause can be found and treated if necessary.

Jaundice and associated symptoms
Jaundice is yellowing of the eyes and skin. Most people with pancreatic cancer (and almost all people with ampullary cancer) have jaundice as one of the first symptoms.

Jaundice is caused by the accumulation of bilirubin, a dark yellow-brown substance produced in the liver. Normally, the liver secretes a fluid called bile that contains bilirubin. Bile enters the intestine through the common bile duct and helps break down fat. It eventually leaves the body in the feces. When the common bile duct is blocked, bile cannot reach the intestines and bilirubin accumulates in the body.

Cancers that start in the head of the pancreas are near the common bile duct. When these tumors are small, they press on the ducts and cause jaundice, which sometimes leads to the detection of these tumors at an early stage. But cancer that starts in the body or tail of the pancreas doesn’t press on the duct until it spreads through the pancreas. At this point, the tumor has often spread outside the pancreas.

When pancreatic cancer spreads, it often goes to the liver. It also causes jaundice.

In addition to yellowing of the eyes and skin, there are other symptoms of jaundice.

Dark urine: Sometimes the first symptom of jaundice is dark urine. As the amount of bilirubin in the blood increases, the urine becomes brown.
Light-colored or oily stools: Bilirubin helps make stools brown. If the bile duct is blocked, the stool may be pale or gray in color. Also, if bile and pancreatic enzymes do not enter the intestine to help break down fat, stool can become greasy and float down the toilet.
Itchy skin: When bilirubin accumulates in the skin, it becomes yellow in addition to itching.
Pancreatic cancer is not the most common cause of jaundice. Other causes are more common, including gallstones, hepatitis, and other diseases of the liver and biliary tract.

Abdominal or back pain
Abdominal (stomach) or back pain is common with pancreatic cancer. A cancer that originates from the body or tail of the pancreas can become quite large and press on other nearby organs, causing pain. Cancer spreads to the nerves surrounding the pancreas, which often causes back pain. Abdominal or back pain is quite common and is often caused by something other than pancreatic cancer.

Weight loss and loss of appetite
Unintentional weight loss is very common in people with pancreatic cancer. These people often have little or no appetite.

Nausea and vomiting
If the cancer presses on the end of the stomach, it partially blocks it, making it difficult for food to pass through. It causes nausea, vomiting, and pain that is worse after eating.

Enlargement of the gallbladder or liver
When cancer blocks the bile ducts, bile accumulates in the gallbladder and becomes enlarged. Sometimes a doctor can feel it (like a large lump on the right side of the rib cage) during a physical exam. This can also be seen in imaging experiments.

Pancreatic cancer can sometimes enlarge the liver, especially if the cancer has spread there. During the examination, the doctor can feel the edge of the liver at the bottom of the right rib or see a large liver on imaging.

Blood clots
Sometimes the first sign that someone has pancreatic cancer is a blood clot in a large vein, usually in the legs. This is called deep vein thrombosis or DVT. Symptoms may include pain, swelling, redness, and warmth in the legs. Sometimes the clot breaks off and travels to the lungs, causing difficulty breathing or chest pain. A blood clot in the lungs is called a pulmonary embolism, or PE.

However, blood clots do not usually mean cancer. Most blood clots are caused by other things.

In rare cases, pancreatic cancer destroys insulin-producing cells, causing diabetes (high blood sugar). Symptoms may include thirst, hunger, and frequent urination. Cancer often causes small changes in blood sugar levels that do not cause symptoms of diabetes, but can be detected by blood tests.

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