Clinical Features

Presentation of pancreatic cancer

The three main symptoms of pancreatic cancer are jaundice, pain and weight loss.

Painless jaundice is the commonest presentation of pancreatic cancer and it is usually due to a tumour in the head of the pancreas obstructing the flow of bile as the bile duct flows through the head of the pancreas on its way to the duodenum. Sometimes jaundice may be due to a secondary cancer in the liver and this implies inoperability and incurability. Approximately 1:20 patients who are diagnosed with pancreatic cancer will have developed diabetes within the previous two years.

Pain is usually a dull intermittent ache in the upper part of the abdomen. Depending on the site and spread of the tumour it may radiate to the left. A gnawing backache present at night time is a bad prognostic sign suggesting infiltration of the back of the abdominal cavity.

Weight loss may be quite severe and this may be due to lack of the flow of pancreatic juice into the duodenum thus leading to malabsorption.