What are the symptoms of pancreatic cancer?

Written by Zhou Chen
Oncology
Updated on September 13, 2024
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The clinical manifestations of pancreatic cancer mainly depend on the location of the cancer, the stage of the disease, whether there is metastasis, and the involvement of adjacent organs. The clinical characteristics include a short disease course, rapid progression, and swift deterioration. The most common symptom is upper abdominal distension and discomfort, pain, though not all patients experience tenderness; if tenderness is present, it aligns with the area of pain felt. Pain is a primary symptom of pancreatic cancer, present whether the cancer is located in the head or the body/tail of the pancreas. Jaundice is a main symptom of cancer in the head of the pancreas, and patients often exhibit more severe gastrointestinal symptoms, most commonly loss of appetite, followed by nausea and vomiting. There might also be diarrhea or constipation, even melena. Diarrhea is often steatorrhea. In the early stages of pancreatic cancer, common symptoms include weight loss and fatigue.

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Written by Zhou Chen
Oncology
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How is pancreatic cancer diagnosed?

Ultrasound, CT, MRI, ERCP (Endoscopic Retrograde Cholangiopancreatography), PTCD (Percutaneous Transhepatic Cholangio Drainage), angiography, laparoscopy, tumor markers measurement, cancer gene analysis, etc., are significantly helpful in confirming the diagnosis of pancreatic cancer and determining whether it is resectable surgically. Generally, ultrasound, CA199, and CEA can be used as screening tests. Once pancreatic cancer is suspected, a CT scan is necessary. If the patient has jaundice, especially severe, and a CT scan cannot confirm the diagnosis, ERCP and PTCD can be considered. If internal drainage is successful, surgery can be delayed for one to two weeks for patients with severe jaundice. The diagnostic value of MRI for pancreatic cancer is not superior to CT. If pancreatic cancer has been confirmed but it is uncertain whether it can be surgically removed, choosing angiography and laparoscopy is also clinically meaningful.

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Written by Cui Fang Bo
Oncology
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What are the abnormalities in blood indicators for pancreatic cancer?

Blood markers for pancreatic cancer often show multiple abnormalities. Pancreatic cancer itself can lead to an increase in related tumor markers. The two most common markers are carcinoembryonic antigen and carbohydrate antigen 19-9, especially carbohydrate antigen 19-9, which has a certain specificity. If pancreatic cancer progresses further, leading to compression of the biliary system, corresponding jaundice indicators can increase. This includes an increase in total bilirubin and direct bilirubin, as well as alkaline phosphatase and gamma-GTP. The most common metastasis site for pancreatic cancer is the liver, and after liver metastasis occurs, corresponding liver transaminases can increase.

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Written by Shen Jiang Chao
Radiology
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Can pancreatic cancer be detected by a CT scan?

Pancreatic cancer can be detected by CT, which shows both direct and indirect signs. The direct signs of pancreatic cancer are manifested as pancreatic masses, which are mostly lobulated. On plain scans, the tumor appears isodense or slightly hypodense compared to the pancreatic parenchyma. When the tumor is large, it appears as a local protrusion, mostly located within the pancreas. In the early phase after enhancement, the tumor enhances less than the surrounding normal pancreatic tissue because pancreatic cancer is a hypovascular tumor. Indirect signs are mainly secondary changes caused by pancreatic cancer, mainly affecting the common bile duct and the main pancreatic duct, which can lead to pancreatic duct dilation, characterized by the typical double duct sign.

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Written by Liu Liang
Oncology
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Is pancreatic cancer contagious?

Pancreatic cancer, like other malignant tumors, is not contagious. Therefore, in clinical settings, including patients' families and accompanying healthcare staff often ask doctors if they might catch the disease while interacting with cancer patients. It is important to educate that malignant tumors, including pancreatic cancer, are not contagious. Contagious diseases refer to chronic conditions like hepatitis B, hepatitis C, tuberculosis, AIDS, etc., which can spread through contact with bodily fluids or blood of the affected individuals. However, malignant tumors are not infectious.

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Written by Liu Liang
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What department should pancreatic cancer patients see?

For the treatment of pancreatic cancer, if it is in the early stages and the surgeons assess that surgery is feasible, surgical treatment is the main approach. If surgery is not feasible according to the surgeon's assessment, or if the cancer is found at an advanced stage without the opportunity for surgery, then the treatment involves chemotherapy or some symptomatic supportive treatments. Therefore, patients at their first consultation should initially visit the Department of Hepatobiliary Surgery to see if surgery is possible, and then consult the Department of Oncology for further treatment steps, especially for patients who do not have the opportunity for surgery, who need to visit the Department of Oncology.