Pancreatic cancer is a serious disease that often presents with subtle symptoms in its early stages. Understanding disease progression is important for patients and caregivers. Recognizing changes or new symptoms helps in managing the disease and seeking timely medical evaluation.
Worsening Common Symptoms
Individuals with pancreatic cancer may experience an intensification of existing symptoms. Abdominal or back pain, a frequent initial complaint, can become more severe, persistent, or change in location as the tumor grows and presses on surrounding nerves or organs. This pain might radiate from the upper abdomen to the back, sometimes feeling like a band around the middle.
Significant and unintentional weight loss is another common symptom that can worsen. This often stems from poor appetite, difficulty digesting food due to reduced pancreatic enzyme production, and cachexia, a metabolic state where the body burns more calories and breaks down muscle. Digestive issues, such as nausea and vomiting, may also become more pronounced if the growing tumor obstructs the stomach or intestines. Changes in bowel habits, specifically steatorrhea (pale, greasy, foul-smelling stools difficult to flush), can worsen due to impaired fat digestion.
New Symptoms of Disease Progression
As pancreatic cancer advances, new symptoms may appear. Jaundice, a yellowing of the skin and whites of the eyes, is a new symptom that can develop. This occurs when a tumor in the head of the pancreas blocks the common bile duct, preventing bile from reaching the intestines. Related signs of bile duct obstruction include dark urine, pale or clay-colored stools, and itchy skin.
Diabetes can also emerge or worsen. Pancreatic cancer can affect the pancreas’s ability to produce insulin, leading to new-onset diabetes or making existing diabetes harder to control. Patients might experience increased thirst, frequent urination, or unexplained blood sugar fluctuations.
Severe fatigue and physical weakness, unrelated to activity, can also become prominent, sometimes accompanied by difficulty sleeping or a depressed mood. Blood clots, such as deep vein thrombosis (DVT) in the legs or pulmonary embolism (PE) in the lungs, are more common with advanced pancreatic cancer. DVT symptoms include pain, swelling, redness, and warmth in the affected leg, while PE can cause sudden shortness of breath or chest pain.
Signs of Metastasis
When pancreatic cancer spreads beyond the pancreas to other parts of the body (metastasis), distinct symptoms can arise depending on the organs affected. The liver is a common site for spread. Liver metastasis can cause new or worsening jaundice, abdominal swelling (ascites), and tenderness or pain in the upper right abdomen. A general feeling of fullness or reduced appetite may also be present.
If the cancer spreads to the lungs, individuals might experience a persistent cough, shortness of breath, or chest pain. Bone metastasis can lead to new or increased bone pain, often described as a gnawing ache that may worsen at night or with movement. Bones can also become weaker, increasing fracture risk, and sometimes high blood calcium (hypercalcemia) may occur. Swollen lymph nodes, particularly in the neck or groin, can also indicate spread to distant lymphatic sites.
When to Seek Medical Attention
Prompt medical evaluation is important if any new or worsening pancreatic cancer symptoms are observed. Changes in existing symptoms, such as increased pain intensity or frequency, or the development of new discomforts, warrant immediate attention. The emergence of jaundice, significant unexplained weight loss, or changes in diabetic control are particularly concerning and should be discussed with a healthcare professional without delay.
For individuals already diagnosed with pancreatic cancer, communicate any new or escalating symptoms to their oncology team. These changes provide important information about disease progression and guide treatment plan adjustments. For those without a prior diagnosis, these symptoms should prompt a doctor’s visit for comprehensive evaluation to determine the cause and receive appropriate care.