Introduction
Pancreatic cancer is a serious and life-threatening disease whose symptoms are not always easy to recognise and interpret. This is partly because the symptoms, which are typical for this disease, do not appear until the final stage of pancreatic cancer, but also because the early symptoms are very unspecific and can also occur in many harmless diseases. One of these unspecific symptoms is back pain.
Not all patients with pancreatic cancer describe a previous back pain. These are often symptoms that have been present for a long time and which finally make the patient go to the doctor after no improvement. However, back pain, even if it has been present for some time, is not necessarily associated with pancreatic cancer.
Tensions, slipped discs of BWS, degenerative vertebral body diseases and many other diseases, which are much more common than pancreatic cancer, are initially short-listed. Thus, it can happen that the doctor first starts an anti-inflammatory pain treatment, e.g. with Diclofenac (Voltaren®), and looks to see whether the patient’s symptoms are reduced. The spine and kidneys are also usually examined to see whether this is the source of the pain.
If there are no other pancreas-specific complaints, such as yellowing of the skin (icterus), lightening of the stool or darkening of the urine, back pain is in most cases not associated with a malignant disease. Back pain is one of the most common reasons for consulting a family doctor. In the vast majority of cases, the cause of back pain is more or less severe back muscle or spinal column pain.
When describing the complaints, the family doctor will arrange for a number of examinations to be carried out in order to be able to make an appropriate diagnosis as to why the back pain occurs. Since medical science is always guided by more frequent diagnoses, pancreatic cancer is often relegated to the background as a possible cause. It usually takes a few days before a patient visits his or her family doctor, especially since the back pain of pancreatic cancer is not initially so severe that a doctor is consulted.
If the standard diagnosis for back pain is now initiated by the family doctor, a few days usually pass. During this time, it should also be checked whether any prescribed painkillers are having the desired effect. If they do not, a referral is often made to the orthopaedic surgeon, whose appointments are usually not in the near future.
By the time the patient returns from the orthopaedist, so much time has passed that the other symptoms of pancreatic cancer have gained the upper hand. In the rarest cases, the back pain indicated will immediately lead to pancreatic cancer. The reasons why pancreatic cancer is not immediately ruled out are both economic and patient-friendly.
The only diagnostic measure to see a pancreatic cancer or to get a further clue is a CT of the abdomen. Since this would not only put an extreme strain on every patient in terms of radiation protection, but would also tear a huge financial hole in the doctor’s budget, this examination method is not among the first choice. The frequency of new cases must also be taken into account, and the number of new cases (10 new cases per 100,000 people) of pancreatic cancer in Germany every year is relatively high, but not as high as the rate of new cases of back pain.
All articles in this series: