It is vital to know its symptoms, to suspect and diagnose it as soon as possible, preventing it from growing too much and being more difficult to manage Let me tell you a fundamental aspect of pancreatic cancer growth: Pancreatic cancer prefers the head of the organ. Between 60 and 70% of the tumors are located there, and only 20-25% of cancers are seated in the body or in the pancreas tail. This distribution has practical consequences in the different symptoms that appear initially in some tumors or in others.
We’ll see that. Now let’s start with the symptoms that pancreatic cancer can produce directly in the pancreas when it has not escaped to other parts of the body. Let’s start with the possibility of our skin getting yellow
Symptom 1: We notice our skin and mucous membranes progressively yellow The most common form of pancreatic cancer, especially those on the right side (this includes the areas of the head and uncinate process)is jaundice, caused by the obstruction of the bile outflow into the small intestine. Bile is a secretion that is produced in the liver, and its function is participating in food digestion. It is stored in the gallbladder until, after we eat, it is needed in the intestine to digest the fats. It is also the mean we use to eliminate bilirubin to the intestine. Bile is poured into the small intestine through the common bile duct, which is surrounded by the head of the pancreas. When pancreatic cancer grows in this area, it can compress the bile duct, not allowing it to pour bile into the small intestine. When the normal path of bile is interrupted, bilirubin will go another way. It will go from the liver to the blood vessels, which make bilirubin blood levels increase. Excess bilirubin in the blood tends to deposit in the elastic fibers of the skin and in the mucous membranes (especially in the sclera of the eye), which will give rise to a yellow tint, a phenomenon called jaundice.
Symptom 2: Urine becomes progressively darker When pancreatic cancer interferes with the elimination of bilirubin by the liver, as direct bilirubin increases inside the liver, this bilirubin will get into the blood and will have to be eliminated through urine. That elimination by the kidney will motivate the change of the color of the urine, darkening it. The urine will appear with the color of cola.
Symptom 3: Feces progressively lose their color Related to the feces, when bilirubin is not expelled into the intestine what would be its natural path, the urobilinogen, the pigment that gives color to the feces, will not form inside the stool. That is why the feces progressively lose their color, with their brown tone becoming clearer. They may even become colorless stools if the obstruction to the bilirubin outlet from the liver is complete.
Symptom 4: We will suffer more and more itching Especially in tumors of the head of the pancreas that interrupt the exit of the bile towards the small intestine, the person can begin to have itching in the skin. This itching worsens at night and with heat, and it’s not relieved by scratching. The cause of this symptom is not clear. It seems to be related to the accumulation of bile acids in the skin.These bile acids when can not go out into the intestine, go to the blood and from there go to the skin.
Symptom 5: We start to have episodes of inflammation of the pancreas The pancreatic duct is responsible for pouring the small intestine the chemicals produced by the pancreas, that help the digestion and absorption of the nutrients that come with food. These chemicals in the pancreas, called enzymes, help break down proteins, such as those that are part of the meat or fish we eat. The problem arises when these enzymes cannot go from the pancreas to the intestine because their outlet is obstructed by pancreatic cancer. Enzymes only have one function: to break down proteins. If they can not break the food in the duodenum, they will break the tissue of the pancreatic gland itself, digesting its own proteins. With the breakdown of these own proteins the pancreas becomes inflamed, and recurrent chemical pancreatitis appears that will gradually destroy the entire land. This destruction will produce a constant pain that will accentuate when we eat, since food is the signal for the pancreas to produce more enzymes and, therefore, continue to self-destruct.
Symptom 6: Diabetes suddenly appears, or existing diabetes worsens This is a symptom closely related to the previous mechanism. At least in part. Part of the pancreas is dedicated to producing hormones (which are substances that are poured into the blood and exert their effect throughout the body). Specifically, the pancreas produces two hormones, insulin, and glucagon, which are responsible for controlling the metabolism of sugars in the body. The reflection of the state of this metabolism is the level of glucose in the blood. When the blood glucose is very high, the pancreas will produce insulin, which makes blood glucose enter into the cells and decrease its blood concentration. Conversely, if there is too little glucose in the blood, the pancreas will produce glucagon, which forces the liver to release its glucose reserves into the blood, increasing its concentration, then normalizing it. That is the normal situation. But when cancer appears in the pancreas, the production of these hormones suffers due to two phenomena: The first phenomenon: Pancreatic cancer directly destroys part of the gland responsible for producing insulin and glucagon, since it compresses and crushes it as it grows. That is why the production of insulin and glucagon will be progressively lower. Second phenomenon: Pancreatic cancer prevents the pancreatic enzymes from going to the intestine. Because of this, these enzymes begin to destroy the pancreas itself. When the damage to the gland is established by these chemicals that digest proteins, the production of insulin and glucagon is further diminished because there is less pancreatic tissue to produce them. So, if we were not yet diabetics, we will be. And if we were already typing II diabetics, the type of diabetes in which the patient still has insulin reserve in the pancreas, the control of blood glucose levels will worsen, and we will be more likely to have elevated blood glucose levels.
Symptom 7: Our feces begin to float in the toilet water Is it normal for the stool to float in the toilet? Yes and no. When do feces float in the water? They float when they have a lot of fat inside That happens sometimes when we eat very greasy foods. If we eat a lot of fats, they will reach the intestine in such a large amount that they will overcome the capacity of the small intestine to absorb them. Therefore, fats will be expelled with defecation, mixed with feces. But in pancreatic cancer, the cause of surfaces to float is because the pancreas -which is responsible for producing a digestive enzyme, lipase, responsible for breaking the fat into smaller pieces to absorb it- is invaded by cancer or destroyed by the action of its own proteolytic enzymes. Without a lipase-producing gland, the fat will not divide and all the fat we eat, much or little, will end up leaving the anus with the feces, causing them to float in the toilet water.
Symptom 8: We begin to lose our appetite and we gradually lose weight Patients with pancreatic cancer usually begin to lose weight very soon. This weight loss has several mechanisms: Mechanism 1: We have already seen that pancreatic cancer can destroy the gland, directly or indirectly, so the digestion and absorption of proteins and fats are diminished. These proteins and fats are eliminated by the feces, so although we eat the same amount of food, we lose weight because we absorb fewer nutrients. Mechanism 2: As the intake of food triggers the production of enzymes that break down proteins, when these enzymes are not able to go out, they start digesting the gland itself. That’s why every time we eat, our stomach will hurt. To avoid the onset of such pain we will eat less and less, and because of this, we will lose weight. Mechanism 3: If the tumor has a big size and is located in at the head of the pancreas, it can grow to either compress the duodenum (which is the first part of the small intestine) or even press the final part of the stomach, the pyloric antrum. When this occurs, the food that is in the stomach can not progress to the small intestine. The stomach will fill, and once full it will try to empty its contents into the mouth, which will make nausea and vomiting appear. The person with nausea and vomiting will geta progressive aversion to any food. Mechanism 4: Pancreatic cancer is one of the malignant tumors most frequently associated with the onset of anorexia-cachexia syndrome, which is a metabolic syndrome in which the tumor produces chemicals that decrease our appetite. Once all these four mechanisms are in place, the person with pancreatic cancer will lose weight in an accelerated way, manifesting extreme thinness in a short time.
Symptom 9: We begin to notice intermittent and poorly defined belly pain The initial pain of pancreatic cancer is perceived as a rodent pain. It’s like we’re being gnawed inside. Usually, it is located in the upper part of the stomach, and it moves sideways to the back as if we were wearing a tight belt. It may be intermittent, and typically increases when we eat, as eating triggers the secretion of enzymes that break down proteins, as we have already seen. Pain also increases when we lie face up because in this position we stretch the pancreatic gland. Because of this, people with pancreatic cancer tend to mitigate the pain it causes them to lie on their side in a fetal position, pulling their legs up towards the abdomen.
Symptom 10: Thrombi are formed and the veins are inflamed in multiple parts of the body The formation of thrombi is due to the fact that pancreatic cancer induces the overactivity of the body’s coagulation system, what makes thrombi to appear when they should not be formed. When a thrombus forms inside a vein, it is like a stone moving inside a bathtub with the tap open. The stone will hit and hit the walls of the bathtub. These thrombi that collide against the walls of the veins will end up inflaming them, which will produce thrombophlebitis.
Symptom 11: Tumor pours chemicals into the belly, causing peritonitis We have seen that the pancreatic enzymes responsible for breaking down the proteins of the food we have eaten when they can not leave the pancreas through the pancreatic duct to the small intestine, they will digest the gland itself. Well, this does not stop there. From the pancreas, such enzymes can be poured into the peritoneal cavity, a cavity where the abdominal viscera are floating. This cavity is covered with an inner layer of cells: the peritoneum. The pancreatic enzymes reach the peritoneuminflame and destroy it, causing chemical peritonitis, which will produce severe abdominal pain with a diffuse localization throughout the abdomen. Where can pancreatic cancer more often produce metastasis? Pancreatic cancer cells can enter the blood because they penetrate into a blood vessel after breaking their wall. Once in the blood, these pancreatic cancer cells can get and live anywhere in the body, causing different symptoms depending on their location. The most frequent sites where pancreatic cancer that has escaped through the blood can produce metastasis are The liver And the lungs.