What are the signs and symptoms of pancreatic cancer?

Updated: Oct 02, 2020
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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The initial symptoms of pancreatic cancer are often quite nonspecific and subtle in onset. Patients typically report the gradual onset of nonspecific symptoms such as anorexia, malaise, nausea, fatigue, and midepigastric or back pain.

Patients with pancreatic cancer may present with the following signs and symptoms:

  • Significant weight loss: Characteristic feature of pancreatic cancer
  • Midepigastric pain: Common symptom of pancreatic cancer, sometimes with radiation of the pain to the midback or lower-back region
  • Often, unrelenting pain: Nighttime pain often a predominant complaint
  • Onset of diabetes mellitus within the previous year
  • Painless obstructive jaundice: Most characteristic sign of cancer of head of the pancreas
  • Pruritus: Often the patient's most distressing symptom
  • Depression
  • Migratory thrombophlebitis (ie, Trousseau sign) and venous thrombosis: May be the first presentation
  • Palpable gallbladder (ie, Courvoisier sign)
  • Developing, advanced intra-abdominal disease: Presence of ascites, a palpable abdominal mass, hepatomegaly from liver metastases, or splenomegaly from portal vein obstruction
  • Advanced disease: Paraumbilical subcutaneous metastases (or Sister Mary Joseph nodule or nodules)
  • Possible presence of palpable metastatic mass in the rectal pouch (Blumer shelf)
  • Possible presence of palpable metastatic cervical nodes: Nodes may be palpable behind the medial end of the left clavicle (Virchow node) and other areas in the cervical region

See Presentation for more detail.

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