Answers
What are the warning signs of pancreatic cancer?
Short answer
Pancreatic cancer often causes vague symptoms until it is advanced, which is why warning signs should not be ignored: painless jaundice, upper belly pain spreading to the back, unexplained weight loss and diabetes appearing for the first time after 50. A CT scan and EUS with a needle biopsy are the key tests.
Warning signs
- Yellow eyes and skin with itching, often without pain (cancer of the head of the pancreas)
- Upper belly pain spreading to the back, often worse at night or when lying flat
- Loss of appetite and weight loss without trying
- New diabetes after age 50, especially with weight loss
- Oily stools or new indigestion that does not settle
Risk factors
- Smoking, the most important avoidable risk
- Long-standing chronic pancreatitis
- Diabetes and obesity
- A family history of pancreatic cancer, or some inherited conditions
- Some types of pancreatic cysts
Tests
A special CT scan of the pancreas shows the tumour and whether it can be removed. EUS gives a close view and allows a needle biopsy through the stomach or duodenum, without any cut. CA 19-9 blood test helps in follow-up.
Treatment
- Surgery, such as the Whipple operation, offers the best chance of cure when the cancer has not spread
- Chemotherapy, before or after surgery, or as the main treatment
- Stents placed by ERCP or EUS relieve jaundice and blockage of the stomach outlet
- EUS-guided nerve block can ease pain
- Care is planned together by a gastroenterologist, surgeon and oncologist
Eating well with pancreatic cancer
Eat more
- Small, energy-rich meals every 2 to 3 hours
- Protein at every meal, and nutrition drinks if advised
- Enzyme capsules with meals if stools are oily or weight is falling
Cut down
- Smoking and alcohol
- Large meals that cause fullness or vomiting
- Unproven 'cancer diets' that cut out whole food groups
Good to know
- Weight loss makes treatment harder; a dietitian early in treatment helps.
- New diabetes is common and needs its own care.
Common questions
Is pancreatic cancer hereditary?
Most cases are not. Having two or more close relatives with it, or some inherited conditions, raises the risk; such families may be advised screening.
Is the EUS biopsy safe?
Yes. It is done through the stomach or duodenum without any cut, and serious complications are uncommon.
Can every pancreatic cancer be operated on?
No. Surgery is possible when the cancer has not spread or involved major blood vessels. Chemotherapy sometimes makes surgery possible later.