I'm a Doctor and Wish Everyone Knew This About Pancreatic Cancer Signs

Thanks to screenings that can help detect cancer early and advances in medicine, cancer has become more treatable and the survival rate has increased for several types of cancer. The American Cancer Society states, "The risk of dying from cancer in the United States has decreased over the past 28 years according to annual statistics reported by the American Cancer Society (ACS). The cancer death rate for men and women combined fell 32% from its peak in 1991 to 2019, the most recent year for which data were available. Some of this drop appears to be related to an increase in the percentage of people with lung cancer who are living longer after diagnosis, partly because more people are being diagnosed at an early stage of the disease."

That said, it's no easy journey to beat cancer and there's still many types that are difficult to diagnose in the early stages, which decreases the survival rate like pancreatic cancer. The ACS explains, "Pancreatic cancer is hard to find early. The pancreas is deep inside the body, so early tumors can't be seen or felt by health care providers during routine physical exams. People usually have no symptoms until the cancer has become very large or has already spread to other organs."

This year an estimated "62,210 people (32,970 men and 29,240 women) will be diagnosed with pancreatic cancer", according to the ACS and "About 49,830 people (25,970 men and 23,860 women) will die of pancreatic cancer. Pancreatic cancer accounts for about 3% of all cancers in the US and about 7% of all cancer deaths. It is slightly more common in men than in women." CNN reports, "About 95% of people with pancreatic cancer die from it, experts say. It's so lethal because during the early stages, when the tumor would be most treatable, there are usually no symptoms. It tends to be discovered at advanced stages when abdominal pain or jaundice may result. Presently, there are no general screening tools."

Knowing the risk factors and early symptoms can save your life and Eat This, Not That! Health spoke with experts who share what to know about pancreatic cancer. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

1. What to Know About Pancreatic Cancer

Dr. Kimmerle Cohen, a hepatopancreaticobiliary surgeon and surgical oncologist with Palm Beach Health Network Physician Group (PBHNPG), Vice Chief of Surgery at Palm Beach Gardens Medical Center and on-staff at Good Samaritan Medical Center tells us, "Pancreatic cancer has the highest mortality rate of all major cancers. It is currently the third leading cause of cancer-related death in the United States, after lung and colon. It is difficult to detect because its symptoms may not be present until late in the disease."

Debashish Bose, MD PhD FACS, Director of Surgical Oncology, Director of the Center for Hepatobiliary Disease, Mercy Medical Center, Baltimore says, "People should know that, unfortunately, pancreas cancer carries a very poor prognosis and is on the rise. The pancreas is a gland that makes digestive enzymes and hormones that control blood sugar and the activities of the digestive tract. Most pancreas cancer arises from cells that make up the lining of the tubes that conduct digestive juices into the intestine, called ducts." 

2. It's Difficult to Screen for Pancreatic Cancer

Dr. Cohen says, "Pancreatic cancer has no test for early detection and no routine screening process to detect it. Only patients with strong genetic factors have screening protocols for early detection. Pancreatic cancer will require more research and more funding to find early detection testing. As of now, the survival rate of pancreatic cancer is a grim 9 percent. Surgery is the only chance of cure and only 20 percent of cases with pancreatic cancer are surgical candidates. If no further research or development comes along, pancreatic cancer will become the second leading cause of cancer death." 

Dr. Bose adds, "Because of its location, pancreas cancer does not usually cause symptoms until it is advanced.  There is no screening tool for pancreatic cancer, like a colonoscopy or a mammogram. There are no good blood tests to screen for pancreatic cancer, like a PSA. For some people it is possible to perform surgery to remove pancreatic cancer, which is the only way to achieve "long" term survival, but under the best of circumstances people with pancreatic cancer live an average of 2-3 years after diagnosis, and only about 1 in 4 people who are able to undergo surgery survive to 5 years."

3. Signs of Pancreatic Cancer

Dr. Cohen explains, "Pancreatic cancer symptoms include weight loss, increased blood sugar, epigastric pain, jaundice, and nausea."

Depression

According to an article written by doctors T. Geukens, MD and J. Verheezen, MD, "Ever since the early 1930's, an association between pancreatic cancer and depression has been noticed. The prevalence of depression is higher in patients with pancreatic cancer than it is in patients with other abdominal neoplasms, and psychiatric symptoms often precede somatic symptoms. Despite further research on this co-occurrence, the true mechanism of interaction is still not clear. Knowing what it is that forms the biological link between depression and the pancreatic tumour, could be of great importance to the future diagnostic and therapeutic workup of these patients. Different theories are proposed. Plausible are the depression being induced through cytokines more specifically IL-6, alterations in the tryptophan-kynurenine, glutamate and serotonin pathways, and antibodies disturbing brain functioning directly or through serotonin. Depression causing cancer is also possible, but to date of unknown importance in pancreatic cancer. All this information brought together makes depressive symptoms of diagnostic importance in pancreatic cancer. The insights pave the way for the development of targeted therapies, hopefully to be implemented in clinical practice in the future."

Gallbladder or Liver Enlargement

The American Cancer Society says, "If the cancer blocks the bile duct, bile can build up in the gallbladder, making it larger. Sometimes a doctor can feel this (as a large lump under the right side of the ribcage) during a physical exam. It can also be seen on imaging tests. Pancreatic cancer can also sometimes enlarge the liver, especially if the cancer has spread there. The doctor might be able to feel the edge of the liver below the right rib cage on an exam, or the large liver might be seen on imaging tests."

Nausea and Vomiting

The ACS states, "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."

Belly or Back Pain

According to the ACS, "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. Pain in the abdomen or back is fairly common and is most often caused by something other than pancreatic cancer."

Blood Clots

The ACS explains, "Sometimes, the first clue that someone has pancreatic cancer is a blood clot in a large vein, often in the leg. This is called a deep vein 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."

The Mayo Clinic says, "Signs and symptoms of pancreatic cancer often don't occur until the disease is advanced. They may include:

• Abdominal pain that radiates to your back
• Loss of appetite or unintended weight loss
• Yellowing of your skin and the whites of your eyes (jaundice)
• Light-colored stools
• Dark-colored urine
• Itchy skin
• New diagnosis of diabetes or existing diabetes that's becoming more difficult to control
• Blood clots
• Fatigue

4. It's Common to Have Pancreatic Cancer and Not Know It

Dr. Cohen states, "It is very common to have pancreatic cancer and not know that you have it. Pancreatic cancer is hard to find early. The pancreas is deep inside the body, so early tumors can't be seen or felt by healthcare providers during routine physical exams. People usually have no symptoms until the cancer has become very large or has already spread to other organs."

Nancy Mitchell, a Registered Nurse with Assisted Living Center shares, "The signs and symptoms of pancreatic cancer tend to mimic other ailments. For example, middle back pain may be a sign of pancreatic pain and inflammation. But most people pass it off as a muscle strain or a possible back injury.  Patients tend to wait until they have a triad or more of symptoms to visit a doctor. By then, the cancer had already developed."

5. Modifiable Risk Factors to Help Reduce the Risk

Dr. Cohen says, "Pancreatic cancer risk factors include obesity, smoking, chronic pancreatitis, and long-standing diabetes. The most important risk factor is a family history of pancreatic cancer. "

Mitchell adds, "Limit or abstain from alcohol consumption. Alcohol causes pancreatic juices to become thick, which can create blockages in the ducts, leading to inflammation. This condition is what we call "pancreatitis." Inflammation is a cancer promoter, so the goal is to limit inflammatory triggers in the body." 

The ACS says, "Smoking is one of the most important risk factors for pancreatic cancer. The risk of getting pancreatic cancer is about twice as high among people who smoke compared to those who have never smoked. About 25% of pancreatic cancers are thought to be caused by cigarette smoking. Cigar smoking and the use of smokeless tobacco products also increase the risk. However, the risk of pancreatic cancer starts to drop once a person stops smoking.

Being very overweight (obese) is a risk factor for pancreatic cancer. Obese people (body mass index [BMI] of 30 or more) are about 20% more likely to develop pancreatic cancer. Gaining weight as an adult can also increase risk. Carrying extra weight around the waistline may be a risk factor even in people who are not very overweight.

Pancreatic cancer is more common in people with diabetes. The reason for this is not known. Most of the risk is found in people with type 2 diabetes. This type of diabetes is increasing in children and adolescents as obesity in these age groups also rises. Type 2 diabetes in adults is also often related to being overweight or obese. It's not clear if people with type 1 (juvenile) diabetes have a higher risk."