Early pancreatic cancers often do not cause any signs or symptoms. By the time they do cause symptoms, they have often already grown through the pancreas or spread beyond it.
Jaundice is yellowing of the eyes and skin. Most people with pancreatic cancer (and virtually all people with ampullary cancer) will have jaundice as one of their first symptoms.
Jaundice is caused by the buildup of bilirubin, a dark yellow-brown substance made in the liver. Normally, the liver excretes bilirubin as part of a liquid called bile. Bile goes through the common bile duct into the intestines, eventually leaving the body in the stool. When the common bile duct becomes blocked, bile can’t reach the intestines, and the level of bilirubin in the body builds up.
Cancers that start in the head of the pancreas are near the common bile duct. These cancers can press on the duct and cause jaundice while they are still fairly small, which may allow these tumors to be found at an early stage. But cancers that start in the body or tail of the pancreas don’t press on the duct until they have spread through the pancreas. By this time, the cancer has often spread beyond the pancreas as well.
When pancreatic cancer spreads, it often goes to the liver. This can also lead to jaundice.
Dark urine: Sometimes, the first sign of jaundice is darkening of the urine from bilirubin. As bilirubin levels in the blood increase, the urine becomes brown in color.
Light-colored stools: If the bile duct is blocked, bile (and bilirubin) can’t get through to the bowel. When this happens, a person might notice their stools becoming lighter in color.
Itchy skin: When bilirubin builds up in the skin, it can start to itch as well as turning yellow. Pancreatic cancer is not the most common cause of jaundice. Other causes, such as gallstones, hepatitis, and other liver diseases, are much more common.
Pain in the abdomen (belly) or back is common in pancreatic cancer. Cancers that start in the body or tail of the pancreas can grow fairly large and start to press on other nearby organs, causing pain. The cancer may also spread to the nerves surrounding the pancreas, which often causes back pain. Of course, pain in the abdomen or back is fairly common and is most often caused by something other than pancreatic cancer.
Unintended weight loss is very common in people with pancreatic cancer. These people often have little or no appetite.
Pale, greasy stools: If cancer blocks the release of the pancreatic juice into the intestine, a person might not be able to digest fatty foods. The undigested fat can cause stools to be unusually pale, bulky, greasy, and to float in the toilet.
Nausea and vomiting: If the cancer presses on the far end of the stomach it can partly block it, making it hard for food to get through. This can cause nausea, vomiting, and pain that tend to be worse after eating.
If the cancer blocks the bile duct, bile can build up in the gallbladder, which then becomes enlarged. This can sometimes be felt by a doctor (as a large lump under the right ribcage) during a physical exam. It can also be detected by imaging tests.
Sometimes, the first clue that someone has pancreatic cancer is the development of a blood clot in a large vein, often in the leg. This is called a deep venous thrombosis or DVT. Symptoms can include pain, swelling, redness, and warmth in the affected leg. Sometimes a piece of the clot can break off and travel to the lungs, which might make it hard to breathe or cause chest pain. A blood clot in the lungs is called a pulmonary embolism or PE.
Still, having a blood clot does not usually mean that you have cancer. Most blood clots are caused by other things.
Some people with pancreatic cancer develop an uneven texture of the fatty tissue underneath the skin. This is caused by the release of the pancreatic enzymes that digest fat.
Rarely, pancreatic cancers cause diabetes (high blood sugar) because they destroy the insulin-making cells. Symptoms can include feeling thirsty and hungry, and having to urinate often. More often, there are small changes in blood sugar levels that don’t cause symptoms of diabetes but can still be detected with blood tests.