Top tips for healthcare professionals

The Key Signs and Symptoms of Pancreatic Cancer

Patients frequently present to general practice with a range of undifferentiated symptoms that may or may not signify serious disease.

It is common for a pancreatic cancer patient to present early symptoms at different times over a six month to a year time period, not always to the same GP or healthcare professional.

Our diagnosis guide for GPs provides a good overview of the key symptoms, including the current NICE referral guidelines.  

Explanation of the symptoms

  • Treatment resistant dyspepsia

    dyspepsia

    • Indigestion symptoms that are not responding to PPIs
  • New onset type 2 diabetes mellitus

    type2

    • Underweight
    • Normal weight
    • When there is no associated metabolic condition or family history of diabetes.
  • Back and/or epigastric pain

    • epiRadiating dorsally
    • Relieved by sitting & leaning forward
    • The back pain is often described as where the bra strap would sit
  • New Onset IBS like symptoms in those > 45 years

    ibs

    • Common misdiagnosis of pancreatic cancer.
    • It is essential to rule out pancreatic cancer as a cause for bloatedness, flatulence and change of bowel habit especially if a patient has never had an IBS diagnosis before.
  • Painless obstructive jaundice

    jaund

    • Yellowing of the skin and whites of the eyes
    • Pruritus
    • Dark urine and pale stools
  • Altered bowel movements

    stools

    • Increased frequency
    • Offensive smelling stools
    • Steatorrhea
  • Unexplained weight loss, vomiting & anorexia

    weight

    • Possible signs of malignancy
    • Unexplained weight loss is a red flag
    • Can occur without any pain or apparent change in digestion.

NICE Guidelines for suspected pancreatic cancer: recognition and referral (2015)

Refer using a ‘suspected cancer pathway referral’ (for an appointment within 2 weeks) for pancreatic cancer if they are aged 40 and over and have jaundice.

Urgent (within two weeks) direct access CT scan, or urgent ultrasound scan if CT is not available.

Consider for patients aged 60 and over with weight loss AND any of the following:

  • Diarrhoea
  • Back pain
  • Abodominal pain
  • Nausea
  • Vomiting
  • Constipation
  • New-onset diabetes

Symptoms diary

Our symptoms diary is a useful tool to give to your patients who are concerned that they may have pancreatic cancer. If you are concerned about a patient, or a patient has expressed concern about their symptoms, the symptoms diary can be used to record the nature and frequency of their symptoms. 

The diary will provide a clearer picture of a patient's symptoms and they will feel that their concerns are being taken seriously.  You can download a copy here.  

Symptoms Study

A symptoms study conducted by the University of Cambridge, which was part-funded by Pancreatic Cancer Action, was carried out between January 2011 and December 2014 to identify the key symptoms of pancreatic cancer. As part of the study, 119 patients with pancreatic cancer, 47 with other cancers and 225 with no cancer were interviewed.

The following table shows symptoms present in ten or more participants, sorted by frequency in total cohort. Column percentages might total more than 100% because of multiple symptoms.

 

Pancreatic Cancer Signs and Symptoms.

For full details visit Symptoms and patient factors associated with diagnostic intervals for pancreatic cancer (SYMPTOM pancreatic study): a prospective cohort study.

Get In Touch

If you would like to get in touch, please fill our contact form or contact the Pancreatic Cancer Action office on 0303 040 1770.