If you have indigestion and abdominal pain, or maybe you don’t eat food and feel a little sick, you might think you just got a stomach worm. And while this is by far the most likely cause, always be aware that these are also symptoms of something much worse – the fifth biggest cancer killer in the UK, pancreatic cancer.
The symptoms of the disease, which is diagnosed in around 10,500 people in the UK every year, can often be mistaken for other, much milder conditions, which is why many people do not seek medical help until the cancer is at a later stage and much more difficult to treat.
As a result, pancreatic cancer is the deadliest common cancer – more than half of people with the disease die within three months of diagnosis, says Pancreatic Cancer UK (PCUK, pancreaticcancer.org.uk).
PCUK specialist nurse Jeni Jones says: “The vast majority of cases are diagnosed when the cancer is already in its late stages, as symptoms often overlap with other conditions such as indigestion and irritable bowel syndrome. If you have a persistent symptom you should talk to your GP – this could be a sign that you are being diagnosed early.”
Here are some symptoms that can easily be dismissed as something less serious…
Indigestion and/or heartburn can be a common symptom of pancreatic cancer – but one that most people wouldn’t necessarily think is related to a serious illness.
“Often people can just take over-the-counter remedies for persistent indigestion – it’s not something that will automatically send you to the GP,” says Jones. “But there are times when it can go hand in hand with other symptoms, such as abdominal or back pain, and a few nagging things that could suggest pancreatic cancer.”
2. Abdominal or back pain
It can be anything from a dull ache to pain that radiates from the abdomen to the back, explains Jones. “It might be around your bra line if you’re a woman,” she says. “It’s not lower back pain and it’s often between the shoulder blades. It may be worse after eating something, and it doesn’t tend to go away easily.”
She says combined abdominal and back pain is a fairly common symptom, but some people may only have one or the other.
3. Unexplained weight loss
Pancreatic cancer-related weight loss can initially be seen when people are not really trying to lose weight and are eating relatively normally. “They may just notice that their clothes have come loose,” says Jones.
4. Loss of appetite
Weight loss is of course sometimes associated with loss of appetite, which is another pancreatic cancer symptom that can be easily ignored, at least at first. “It could be people who think they’re not that hungry, not having an appetite and not being able to face food, or feeling full after eating very little,” says Jones, who explains that such changes in appetite may be due to this that the tumor is pressing on the stomach or simply reduces the ability to eat.
Jaundice is a less easily ignored symptom of pancreatic cancer, but it only occurs in people whose tumor is located towards the head of the pancreas, explains Jones. “Not everyone with pancreatic cancer will develop jaundice, although it is very common,” she says. “It’s a red flag symptom – you may notice it when the whites of your eyes turn a bit yellow before your skin begins to take on a yellow tinge.”
Your skin can become incredibly itchy before jaundice develops because bile salts build up under the skin first. “It’s incredibly itchy,” Jones points out. “I’m not talking about a little itch, it would cause crazy scratching.”
7. Changes in bowel habits
“This is very, very important,” Jones points out, “because there are many, many causes of diarrhea, but this is what we call fatty diarrhea – when there is fat in the stool that turns yellow, which also happens with jaundice. That oily, yellowish poop that won’t flush is a sure sign that something is wrong in your digestive system.
“If a patient does not describe the specifics of their diarrhea, they may lose time in making a diagnosis, and time is of the essence.”
8. Recently diagnosed diabetes
Jones warns that a very small number of people newly diagnosed with diabetes may have pancreatic cancer because cancer can stop the pancreas from producing enough insulin, which can lead to diabetes. It explains: “If you have some of the symptoms of pancreatic cancer and are suddenly diagnosed with diabetes, this should be a red flag symptom for your GP to think about whether you need a scan to check your pancreas.”
Nausea or vomiting can be another symptom of pancreatic cancer, though she points out, “Sometimes people can vomit, but it’s not as common as nausea.”
10. Blood clots
Jones says blood clots are a rare symptom of pancreatic cancer, which would probably be seen in people who, for example, are younger and don’t smoke, so they’re usually not at risk of clots.
“They might have shortness of breath or a swollen leg, go for a scan and find out they have pancreatic cancer,” she says. “It’s unique, but clots are a symptom and can lead to there being an underlying problem.”
Fatigue can, of course, be caused by many factors, but if you have other symptoms as well, it could be related to pancreatic cancer, warns Jones. “If you’re resting and unable to recharge your batteries, coupled with some other symptoms such as constant pain or fatty diarrhea that exhaust the person physically, it could be another sign of pancreatic cancer.”
12. Fever, chills and malaise
Such symptoms are rare symptoms of pancreatic cancer, but they are not uncommon and could be related to the cancer itself or possibly an infection related to jaundice, which Jones says will require immediate medical attention.
13. Difficulty swallowing food
“Cancer can make a person feel full, so while they think the problem is with their swallowing, it’s often just that they can’t fit in the food,” says Jones, who explains that pancreatic cancer is actually does not cause problems with the esophagus, it may just make swallowing seem abnormal.
14. Depression and anxiety
Depression and anxiety for no apparent reason are common symptoms of pancreatic cancer, says Jones. “By itself, it’s probably not something that would make you think you probably have pancreatic cancer,” she says, “but a low mood can go hand in hand with pain and fatigue. Again, he takes these things as a whole, not in isolation.”