Terminal pain
Most patients experience severe pain, which is sometimes also interpreted as back pain. Mostly the pain is located in the upper abdomen or in the middle of the abdomen (abdominal cavity). Where the pain occurs also has something to do with the spread of the metastases in the body.
Where daughter tumours (=metastases) occur, characteristic symptoms then occur. Depending on where the primary tumour is located in the pancreas, lymph nodes in the immediate vicinity, the duodenum, the bile duct, the spleen, the stomach, the liver, the lungs, the colon or the bones are affected. The tumour can cause bone pain, which can then be perceived as leg or back pain, depending on its location. You can find more information here: Pancreatic Cancer Back Pain Pancreatic cancer is usually only discovered when the tumor has spread to other tissues, so at the time of diagnosis it is usually already in the final stage of pancreatic cancer.
Jaundice (icterus)
As the growth of the tumour leads to an increasing bloating of the pancreas, constrictions of the bile ducts often occur, which result in the accumulation of bile in the liver. In most cases, this severely limits the liver‘s ability to work and results in a yellowing of the skin (icterus), which is usually the very first symptom of pancreatic cancer. In most cases, patients go to the doctor first, which is usually the final stage of pancreatic cancer.
First the conjunctiva of the eyes begin to turn yellowish, followed by the rest of the skin of the body. As the bile fluids are missing from the digestive tract, the stool may also become discoloured (light, grey stool) and dark urine may appear. In addition to the yellowish skin colour, moderate to severe itching of the skin may also occur because metabolic products of the bile fluids are deposited in the skin.
Water in the stomach
In advanced pancreatic cancer there is almost always an accumulation of water in the abdomen. This condition, also known as ascites, is caused on the one hand by the fact that, as the tumour grows, there is a change in pressure in the blood circulation and in the abdominal cavity, and blood and lymph vessels are sometimes severely compressed. Due to the disturbed blood flow, fluid leaks out of the blood and is “filtered” into the abdominal cavity.
If the peritoneum is also affected by the tumour cells, this leads to peritoneal carcinoma and thus also to an accumulation of water in the abdomen. On the other hand, the disturbances of liver function and digestion lead to an imbalance of the necessary protein. All these components lead to the accumulation of a not inconsiderable amount of abdominal fluid.
This can become so large that it presses on other neighbouring organs and impairs them. Thus a severely swollen ascites abdomen can also lead to shortness of breath. Water in the abdomen can be detected very easily and quickly in two different ways: In the case of a patient lying on his or her back, the doctor’s physical examination of ascites would result in an undulating movement of the abdominal surface when tapping on one side.
On the other hand, the free fluid in the abdomen can be easily seen with ultrasound. Severe ascites can be punctured to relieve the patient. For this purpose, a small needle is inserted under ultrasound control into the area that is particularly affected by ascites. It is not uncommon for a few litres of the clear fluid to be drained, which on the one hand immediately relieves the patient, and on the other hand very often leads to a run-off of the fluid, which makes a new puncture necessary.
