Cancer is usually asymptomatic for a while, but some types of cancer are easy to detect at an early stage. Some others can be difficult, but standard screening methods would help patients make an accurate diagnosis before it gets out of hand. However, some cancers remain elusive for both patients and doctors, and they are only detected if the tumors are large enough to cause serious changes. Pancreatic cancer falls into this category.
The pancreas is a retroperitoneal organ, which means it is intense in the abdominal cavity. We cannot feel this organ through the skin, and it is impossible to diagnose pancreatic disease without the help of radiology and laboratory tests. In most cases, pancreatic cancer begins to show clear signs and symptoms when large enough to cause structural damage to the surrounding organs and when cancer cells show endocrine activity, creating a hormonal imbalance. In this article, we cover the most important signs and symptoms to consider in pancreatic cancer but do not wait for these symptoms to appear before performing your routine check-up.
1.Loss of appetite
It counts as one of the initial symptoms patients report in pancreatic cancer, but sometimes it is only in advanced stages. The tumor synthesizes several inflammatory cytokines made to change the way blood vessels behave around the affected tissue. It is meant to increase blood circulation and blood flow to feed the tumor and promote its growth, but it would also travel through the bloodstream and reach other organs, including the brain. In reaching the brain, these inflammatory molecules alter the centers of appetite and cause anorexia, the clinical name of loss of appetite.
An additional cause to consider is that, in advanced stages of cancer, the tumor grows disproportionately and pushes aside other organs, including the stomach. This creates an additional source of pressure that is perceived by the stomach as fullness and satiety. This effect is more common in pancreatic cancer located around the tail of the pancreas, closer to the stomach.
2. Nausea and vomiting
It counts as one of the first symptoms patients report in pancreatic cancer. It is usually due to a change in the digestive system because the pancreas has a primary function in counteracting gastric acid. Also, patients with pancreatic cancer have delayed gastric emptying, which means their stomach is very slow in passing food to the first part of the small intestine. As the tumor becomes more substantial, a mechanical force against the stomach would also develop, pushing the organ and increasing nausea and vomiting.
3. Abdominal pain
Pain is a common symptom of pancreatic cancer, and it counts as one of the most symptoms patients reports. Abdominal pain is known as either mid-epigastric pain (located in the middle of the upper abdomen) or back pain. It is also described as upper abdominal pain radiating to the lower back. Patients radiating the pain to the end may have an advanced stage of the disease, and this symptom may indicate an invasion of the nerve plexus Signs of which are located deep in the retroperitoneal space.
Pain in pancreatic cancer is more common at night or when the patient is lying in bed or on a flat surface, and many patients describe an exacerbation of the pain after eating. However, pancreatic cancer does not exhibit any abdominal pain, and each patient should be assessed based on their symptoms.
The pancreas has an important endocrine function, and it synthesizes insulin and glucagon, the essential hormones in energy balance. Insulin is released when there is too much glucose in the blood, and it would open channels in the muscle fibers and other cells of the body to incorporate insulin and reduce its concentration in the blood. Glucagon is released when there’s not enough insulin in the body –as in prolonged fasting- and stimulates the formation of glucose from other sources of energy.
Certain pancreatic tumors affect the cells that produce insulin, while others originate in glucagon-producing cells. In both cases, they create an alteration of the metabolism of energy, more commonly associated with diabetes symptoms. 1% of patients with new-onset type 2 diabetes may have pancreatic cancer, especially if they are over 70 years old. This might seem a minimal number, but a massive number of patients keep in mind the incidence of this disease.
Read Also: Early Signs And Symptoms Of Diabetes
For the reasons described above, pancreatic cancer patients have impaired absorption of fatty acids. These nutrients concentrate on the stools and may result in diarrhea with greasy stools. Diarrhea tends to have a foul odor, and it is not easily treated with over-the-counter medications.
It is a characteristic feature of this type of cancer, as it is in many others. It is associated with anorexia (loss of appetite), which usually appears a bit earlier in the course of the disease. There is also malabsorption of nutrients, which contributes to insufficient nutrients and energy to the cells. Additionally, cancer cells take up a lot of the energy required for the organism’s normal function, further reducing the availability of energy and contributing to weight loss.
Weight loss in cancer is a very delicate matter, and it is associated with the severity of cancer. In advanced cases, it is very difficult to control, even after using nutritional supplements and other medications, which contributes to worsening the quality of life and the prognosis of cancer patients.
This is often described as a sign of liver or gallbladder problems. Interestingly enough, it is the most characteristic sign of pancreas cancer located in the head of the pancreas. This structure is in contact with the gallbladder and the bile duct, and cancer growth in this area leads to an obstruction in the normal flow of bile, and something called obstructive jaundice, which is to be verified by lab tests.
These patients won’t usually have abdominal pain unless the tumor has grown large enough to cause additional symptoms. They may have other symptoms associated with jaundice, especially dark urine and pale stools, and these symptoms may even appear before a change of coloration in the skin.
In most cases, patients with jaundice experience continuous skin itching, and in most cases, it becomes the most distressing symptom. All of these symptoms appear because there’s an obstruction to the normal flow of bile to the intestines. The bile contains bilirubin, a substance with a very intense color that accumulates in the blood and passes to the skin, causing a yellow color and itching. Since bile is no longer changing the color of the stools, they look pale, and since the kidneys are left in charge of clearing the blood from bilirubin, it appears in the urine and changes its color.
It counts as one of the initial symptoms patients report in pancreatic cancer, but it may also be one of the symptoms in the final stage of cancer. As mentioned, these patients have a nutrient absorption problem, and their tumor is taking extra nutrients from the organism. By reducing the availability of energy, pancreatic cancer promotes chronic fatigue, muscle weakness, and a wasting syndrome called cachexia.
In a late stage of the disease, cachexia sets in, characterized by severe weight loss, chronic fatigue, loss of appetite, muscle wasting, and weakness. So, if you have lost weight unintentionally and often feel tired, even after having a good night’s rest, it would be a good idea to ask your doctor to examine your case more closely.
Patients with pancreatic cancer have a very high incidence of venous thrombosis and thrombophlebitis. Sometimes, the first problem these patients have is a clotting complication, and through a series of exams and a physical evaluation, doctors detect a tumor growing in the pancreas. In some cases, pancreas patients develop a condition called marantic endocarditis, also known as nonbacterial thrombotic endocarditis.
Pancreatic cancer is a silent type of cancer, and it is difficult to detect for patients and skilled physicians. In most cases, this cancer is not recognized by symptoms but by a routine check-up or by chance when performing imaging tests to evaluate other health problems. Thus, even if you don’t have these symptoms, perform a regular check-up, which will rule out the possibility of pancreatic cancer and other types of silent cancer and reduce your risk of cardiovascular and metabolic disease.
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