Published:  Jan 3, 2023

This is why pancreatic cancer is often found late.

The pancreas is a small organ deep in the belly. It helps digest food. It also helps control blood sugar by producing insulin and other hormones.

When cancer starts in the pancreas, symptoms may be mild. You may notice tummy pain, back pain, weight loss, yellow skin or eyes, dark urine, pale stools, itching, nausea, or new diabetes.

For more cancer and digestive-health education, visit our Cancer Awareness & Prevention Hub, Digestive Health & Gut Hub, Medical Tests & Screenings Hub, and Health Hub.

Medical note: This article is for education only. It does not diagnose or treat cancer. If you have yellow skin or eyes, dark urine, pale stools, unexplained weight loss, severe belly or back pain, vomiting that will not stop, black or bloody stools, chest pain, fainting, confusion, or symptoms that feel like an emergency, seek medical care quickly.

Quick Answer: What Is Pancreatic Cancer?

Pancreatic cancer starts when cells in the pancreas grow out of control.

The most common type starts in the ducts of the pancreas. These ducts help carry digestive juices.

Pancreatic cancer may cause no symptoms at first. When symptoms happen, they may include:

• Yellow skin or yellow eyes
• Dark urine
• Pale, greasy, or floating stools
• Itchy skin
• Upper belly pain
• Back pain
• Pain that is worse after eating or lying down
• Pain that feels better when leaning forward
• Unexplained weight loss
• Loss of appetite
• Nausea or vomiting
• Diarrhea or constipation
• Indigestion or bloating
• New diabetes
• Diabetes that becomes harder to control
• Blood clots
• Extreme tiredness

These symptoms can have many causes. Most people with these symptoms do not have pancreatic cancer. But symptoms that are new, persistent, or unexplained should be checked.

What Does the Pancreas Do?

The pancreas sits deep in the upper belly, behind the stomach.

It has two major jobs.

1. It Helps Digestion

The pancreas makes digestive enzymes. These help break down fat, protein, and carbohydrates.

2. It Helps Control Blood Sugar

The pancreas makes hormones, including insulin. Insulin helps move sugar from the blood into cells.

Because the pancreas helps with digestion and blood sugar, pancreatic cancer can cause digestive changes and diabetes changes.

Why Pancreatic Cancer Can Be Hard to Find Early

The pancreas is deep inside the body. Small tumours may not be felt from the outside.

Early symptoms can be vague. They may look like:

• Indigestion
• Gas
• Back strain
• Stress
• Low appetite
• Stomach upset
• Diabetes changes

There is also no simple screening test for everyone. People at high genetic or family risk may need special medical advice.

Early Warning Signs: What People Often Notice

Some people later say they noticed small changes before diagnosis. These changes do not prove cancer. But they are worth taking seriously when they are new or persistent.

Possible early clues include:

• Upper belly discomfort that keeps coming back
• Back pain without a clear injury
• Eating less because you feel full fast
• Unexplained weight loss
• New indigestion that does not feel normal
• Loose, greasy, pale, or floating stools
• Dark urine
• Itching without a clear rash
• Yellow eyes or skin
• New diabetes after age 50
• Diabetes is suddenly getting harder to control
• Deep tiredness

Do not wait for all symptoms. One strong red flag, like jaundice, is enough to get checked quickly.

1. Yellow Skin or Yellow Eyes

Yellow skin or yellow eyes is called jaundice.

Jaundice can happen when bile cannot drain normally. A tumour in the head of the pancreas can block the bile duct.

Jaundice may come with:

• Dark urine
• Pale stools
• Itchy skin
• Yellow eyes
• Yellow skin
• Nausea
• Loss of appetite

Jaundice can also happen from gallstones, liver disease, infection, medication effects, or blood problems. It should always be checked quickly.

2. Dark Urine

Dark urine may look tea-colored, cola-colored, or very deep yellow.

It can happen from dehydration. But dark urine with yellow eyes, pale stools, or itching can be a bile-flow warning sign.

Get medical advice quickly if dark urine is new and not explained by dehydration.

3. Pale, Greasy, or Floating Stools

The pancreas helps digest fat. If pancreatic or bile flow is blocked, stool can change.

You may notice stools that are:

• Pale
• Clay-colored
• Greasy
• Oily
• Very smelly
• Floating
• Hard to flush

Stool changes can also happen from gallbladder disease, liver disease, celiac disease, infection, diet changes, or other digestive problems.

Persistent pale, greasy, or floating stools should be checked.

4. Itchy Skin

Itching can happen when bile builds up in the body. It may happen before yellowing is easy to see.

Itching can also come from dry skin, allergies, eczema, kidney disease, liver disease, thyroid disease, and medicines.

See a doctor if itching is strong, unexplained, or linked with dark urine, pale stools, or yellow eyes.

5. Upper Belly Pain

Pancreatic cancer may cause pain in the upper belly. The pain may be dull, deep, or hard to locate.

It may:

• Come and go
• Get worse after eating
• Get worse when lying down
• Feel better when leaning forward
• Spread to the back

Upper belly pain can also happen from reflux, ulcers, gallbladder disease, gas, pancreatitis, liver problems, muscle strain, and many other causes.

Persistent or worsening pain should be checked.

6. Back Pain

Back pain is common and is usually not cancer. But pancreatic cancer can cause pain that spreads from the upper belly to the back.

Get checked if back pain is:

• New and unexplained
• Deep and persistent
• Linked with weight loss
• Linked with jaundice
• Linked with appetite loss
• Worse when lying down
• Not linked to movement or injury

Do not panic over back pain alone. But do not ignore back pain with other warning signs.

7. Unexplained Weight Loss

Weight loss without trying should be checked.

Pancreatic cancer may cause weight loss because:

• You eat less
• You feel full quickly
• Digestion is not working well
• The body uses more energy
• Nausea reduces appetite
• Pain makes eating harder

Weight loss can also happen from diabetes, thyroid disease, infection, depression, gut disease, and other cancers.

If you are losing weight without trying, book a medical visit.

8. Loss of Appetite

Loss of appetite can happen for many reasons. But in pancreatic cancer, it may happen with weight loss, nausea, pain, or fullness.

Get checked if appetite loss is new and lasts, especially with:

• Weight loss
• Jaundice
• Dark urine
• Pale stools
• Upper belly pain
• Back pain

9. Nausea or Vomiting

A pancreatic tumour can press on nearby organs. This may cause nausea or vomiting in some people.

Vomiting can also happen with infection, stomach flu, gallbladder disease, migraine, medicines, pregnancy, and many other causes.

Seek urgent care if vomiting will not stop, you cannot keep fluids down, you have severe belly pain, blood in vomit, black stool, confusion, or signs of dehydration.

10. Diarrhea, Constipation, or bowel changes

Pancreatic cancer may affect digestion. Some people have diarrhea. Some have constipation. Some have stool colour or texture changes.

Get medical advice if bowel changes are:

• New
• Persistent
• Linked with weight loss
• Linked with blood in stool
• Linked with pale or greasy stools
• Linked with severe pain
• Linked with jaundice

For digestive symptom education, visit our Digestive Health & Gut Hub.

11. New Diabetes or harder-to-control diabetes

The pancreas helps make insulin. Pancreatic cancer can sometimes be linked to th e new diabetes or diabetes that suddenly becomes harder to control.

This does not mean most new diabetes is cancer. Diabetes is common and has many causes.

But ask your healthcare professional about further checks if you have new diabetes with:

• Unexplained weight loss
• Loss of appetite
• Upper belly pain
• Back pain
• Jaundice
• Dark urine
• Pale stools

For blood sugar help, visit our Diabetes & Blood Sugar Management Hub.

12. Blood Clots

Pancreatic cancer can raise the risk of blood clots in some people.

A blood clot in the leg may cause:

• Leg swelling
• Leg pain
• Warm skin
• Redness
• Pain in one calf

A clot that travels to the lung can cause:

• Sudden shortness of breath
• Chest pain
• Coughing blood
• Fast heartbeat
• Fainting

Sudden shortness of breath or chest pain needs urgent care.

13. Extreme Tiredness

Tiredness is common and has many causes. But cancer-related fatigue can feel deep and unusual.

It may come with:

• Weight loss
• Loss of appetite
• Pain
• Poor sleep
• Anemia
• Inflammation
• Digestive problems

Get checked if tiredness is severe, long-lasting, or linked with other warning signs.

How “I Knew I Had Pancreatic Cancer,” Stories Can Help

Personal stories can help people notice symptoms. But every person is different.

One person may notice jaundice first. Another may notice back pain. Another may notice weight loss. Another may notice new diabetes. Another may have no clear symptoms until tests are done.

Do not use someone else’s story as a diagnosis.

Use stories as a reminder to act when symptoms are new, persistent, or unexplained.

Red Flags That Need Fast Medical Care

Get medical care quickly if you have:

• Yellow skin or yellow eyes
• Dark urine with pale stools
• Unexplained weight loss
• Upper belly pain that spreads to the back
• Persistent vomiting
• New diabetes with weight loss
• Severe belly pain
• Blood in vomit or stool
• Black stools
• Chest pain
• Sudden shortness of breath
• Leg swelling with pain
• Fainting
• Confusion

Jaundice should not be ignored. It needs medical review.

What Causes Pancreatic Cancer?

Pancreatic cancer starts when DNA changes cause cells to grow out of control.

Doctors do not always know why this happens in one person. But some risk factors can raise risk.

Risk Factors for Pancreatic Cancer

Risk factors include things you can change and things you cannot change.

Risk Factors You Can Change

• Smoking
• Heavy alcohol use
• Obesity or excess weight
• Low physical activity
• Long-term poor diet pattern
• Uncontrolled diabetes
• Workplace exposure to certain chemicals in some cases

Risk Factors You Cannot Fully Change

• Older age
• Family history of pancreatic cancer
• Inherited gene changes
• Chronic pancreatitis
• Long-standing diabetes
• Certain inherited cancer syndromes

Having a risk factor does not mean you will get pancreatic cancer. Having no known risk factor does not mean risk is zero.

Smoking and Pancreatic Cancer

Smoking is one of the strongest changeable risk factors.

Stopping smoking can lower risk over time and also helps heart, lung, blood vessel, and overall health.

If you smoke, ask for support. Quitting is hard, but help works.

Chronic Pancreatitis and Pancreatic Cancer

Chronic pancreatitis means long-term inflammation of the pancreas.

It can cause:

• Upper belly pain
• Back pain
• Weight loss
• Diarrhea
• Greasy stools
• Diabetes

Some people with chronic pancreatitis have a higher pancreatic cancer risk. They should follow medical advice and monitoring plans.

Family History and Genetic Risk

Some people have a higher risk because of family history or inherited gene changes.

Ask a doctor about genetic counselling if you have:

• Two or more close relatives with pancreatic cancer
• Several family cancers at young age
• Known inherited cancer gene in the family
• Family history of breast, ovarian, colon, melanoma, or pancreatic cancer patterns

High-risk people may need specialist advice. Screening is not for everyone.

Can pancreatic cancer be prevented?

You cannot prevent every case. But you can lower some risk.

Helpful steps include:

• Do not smoke
• Avoid tobacco products
• Limit alcohol
• Keep a healthy weight if needed
• Move often
• Eat more whole foods
• Eat more vegetables, fruit, beans, and whole grains
• Limit processed meat
• Manage diabetes
• Treat pancreatitis and gallbladder problems
• Know your family history
• Ask about genetic risk if family history is strong

For cancer prevention basics, read Cancer Prevention: Practical Steps That Support Lower Risk.

How Pancreatic Cancer Is Diagnosed

Doctors use symptoms, exam findings, blood tests, scans, and sometimes biopsy.

Tests may include:

• Blood tests
• Liver function tests
• Blood sugar tests
• CA 19-9 tumour marker in some cases
• Ultrasound
• CT scan
• MRI scan
• MRCP scan
• Endoscopic ultrasound
• ERCP in some cases
• Biopsy in some cases

CA 19-9 is not a screening test for everyone. It can be normal in some pancreatic cancers and high in some non-cancer problems. Doctors use it with other information.

For test education, visit our Medical Tests & Screenings Hub.

Staging: Why It Matters

Staging means finding out how far the cancer has grown or spread.

Staging helps guide treatment.

Doctors may describe pancreatic cancer as:

• Resectable: Surgery may be possible.
• Borderline respectable: Treatment may shrink or control it before surgery is considered.
• Locally advanced: It has grown near major blood vessels or nearby tissues and may not be removable right away.
• Metastatic: It has spread to distant parts of the body.

Your care team can explain your stage and options.

Pancreatic Cancer Treatment

Treatment depends on:

• The type of pancreatic cancer
• Where is it in the pancreas
• Its size
• Whether it has spread
• Whether surgery is possible
• Your age and general health
• Your goals and preferences

Treatment may include surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy in some rare genetic cases, pain control, nutrition care, enzyme support, diabetes care, and palliative care.

Surgery

Surgery may be possible if the cancer is found early enough and has not spread too far.

Types of surgery may include:

• Whipple procedure for some cancers in the head of the pancreas
• Distal pancreatectomy for some cancers in the body or tail
• Total pancreatectomy in some cases
• Bypass or stent procedures to relieve blockage in some cases

Surgery is complex. It should be done by experienced teams when possible.

Chemotherapy

Chemotherapy uses medicines to kill cancer cells or slow their growth.

It may be used:

• Before surgery
• After surgery
• With radiation in some cases
• When surgery is not possible,
• When cancer has spread

Your cancer team will choose the plan based on your cancer and health.

Radiation Therapy

Radiation uses high-energy beams to target cancer cells.

It may be used with chemotherapy in some cases. It may also help control symptoms in selected people.

Targeted Therapy and Immunotherapy

Some pancreatic cancers have gene changes that can be treated with targeted medicines. This is not common for everyone.

Your doctor may order tumour testing or genetic testing in some cases.

Immunotherapy helps the immune system attack cancer. It only helps a small group of pancreatic cancers with certain markers.

Supportive and Palliative Care

Palliative care is support for symptoms and quality of life. It is not only end-of-life care.

It can help with:

• Pain
• Nausea
• Weight loss
• Appetite loss
• Digestive problems
• Fatigue
• Emotional stress
• Family support
• Care planning

Supportive care can be used at any stage of cancer treatment.

Nutrition and Pancreatic Cancer

Pancreatic cancer can make eating hard.

People may need help with:

• Small meals
• High-calorie foods
• High-protein foods
• Nausea control
• Digestive enzyme replacement
• Blood sugar control
• Food safety during chemotherapy
• Hydration

Ask for a registered dietitian if weight loss, poor appetite, greasy stools, or low intake is a problem.

Pancreatic Enzyme Replacement

Some people with pancreatic cancer cannot digest fat well. This can cause greasy stools, bloating, gas, weight loss, and vitamin problems.

Doctors may prescribe pancreatic enzyme replacement therapy.

Take it only as prescribed. It is not the same as a general supplement.

Diabetes Care During Pancreatic Cancer

Pancreatic cancer can affect insulin. Some people develop new diabetes. Others have diabetes that becomes harder to control.

Care may include:

• Blood sugar checks
• Food planning
• Diabetes medicines
• Insulin in some cases
• Dietitian support
• Monitoring during chemotherapy

Do not change diabetes medicine without medical advice.

Pain Control

Pain can happen in the belly or back. Pain should be treated.

Options may include:

• Pain medicines
• Nerve block in some cases
• Radiation in some cases
• Stents or procedures if blockage causes pain
• Palliative care support

Tell your care team if pain is not controlled. Do not suffer in silence.

Questions to Ask Your Cancer Team

• What type of pancreatic cancer do I have?
• Where is it in the pancreas?
• What stage is it?
• Has it spread?
• Is surgery possible?
• Should I have chemotherapy before surgery?
• Should I have genetic testing?
• Should the tumor be tested for treatment targets?
• Do I need pancreatic enzymes?
• Do I need diabetes care?
• Can I see a dietitian?
• What symptoms should I report fast?
• What is the goal of treatment?
• What side effects should I expect?
• Should I get a second opinion?

What Not to Do

• Do not ignore jaundice.
• Do not ignore unexplained weight loss.
• Do not assume new back pain is always muscle strain.
• Do not treat persistent pale stools or dark urine as normal.
• Do not use detox drinks to treat cancer.
• Do not replace cancer treatment with supplements.
• Do not stop diabetes medicine without advice.
• Do not take pancreatic enzymes unless prescribed.
• Do not delay care because symptoms seem mild.
• Do not rely on one personal story for diagnosis.

Simple 7-Day Pancreatic Cancer Awareness Plan

This is not a diagnosis plan. It is a safety plan.

Day 1: Learn the Red Flags

Know the key signs: jaundice, dark urine, pale stools, weight loss, belly pain, back pain, and new diabetes.

Day 2: Check Your Symptoms

Write down what changed, when it started, and what makes it better or worse.

Day 3: Look at Stool and Urine Changes

Notice dark urine, pale stools, greasy stools, or floating stools.

Day 4: Check Weight

Unexplained weight loss should be discussed with a healthcare professional.

Day 5: Know Your Risk

Think about smoking, chronic pancreatitis, diabetes, family history, and inherited cancer risk.

Day 6: Book Care if Symptoms Persist

Do not wait if symptoms are new or unexplained.

Day 7: Ask About Tests

Ask if you need blood tests, liver tests, blood sugar tests, an ultrasound, a CT, an MRI, or a specialist referral.

FAQ

What are the first symptoms of pancreatic cancer?

Early pancreatic cancer may cause no symptoms. Possible early signs include upper belly pain, back pain, unexplained weight loss, loss of appetite, indigestion, pale stools, dark urine, itching, jaundice, or new diabetes.

What is the biggest warning sign of pancreatic cancer?

Jaundice is a major warning sign. Yellow skin or eyes, dark urine, pale stools, and itching should be checked quickly.

Can pancreatic cancer cause back pain?

Yes. Pancreatic cancer can cause pain in the upper belly that spreads to the back. But most back pain is not cancer. Back pain with weight loss, jaundice, or appetite loss should be checked.

Can pancreatic cancer cause new diabetes?

Yes. Pancreatic cancer can sometimes be linked with new diabetes or diabetes that becomes harder to control. Most diabetes is not cancer, but new diabetes with weight loss or jaundice should be discussed with a doctor.

What causes pancreatic cancer?

Pancreatic cancer starts when cells in the pancreas grow out of control. Risk factors include smoking, older age, obesity, diabetes, chronic pancreatitis, family history, inherited gene changes, and some lifestyle or health factors.

How is pancreatic cancer diagnosed?

Diagnosis may include blood tests, liver tests, blood sugar tests, ultrasound, CT scan, MRI, endoscopic ultrasound, ERCP in some cases, and biopsy in some cases.

Can pancreatic cancer be treated?

Yes. Treatment may include surgery, chemotherapy, radiation therapy, targeted therapy in selected cases, immunotherapy in rare cases, nutrition care, pain control, pancreatic enzymes, diabetes care, and palliative care.

Is pancreatic cancer curable?

Some early pancreatic cancers can be treated with surgery and other treatments. Many cases are found later, which makes treatment harder. Your cancer team can explain your stage and the goals of treatment.

Can pancreatic cancer be prevented?

Not all cases can be prevented. Risk may be lowered by avoiding tobacco, limiting alcohol, keeping a healthy weight if needed, moving often, eating more whole foods, managing diabetes, and knowing family history.

When should I see a doctor?

See a doctor quickly for jaundice, dark urine, pale stools, unexplained weight loss, upper belly pain, back pain with weight loss, persistent vomiting, new diabetes with weight loss, or symptoms that do not go away.

Related Reading

• Cancer Awareness & Prevention Hub
• Digestive Health & Gut Hub
• Medical Tests & Screenings Hub
• Diabetes & Blood Sugar Management Hub
• Health Hub
• Cancer Prevention: Practical Steps That Support Lower Risk
• How I Knew I Had Colon Cancer: Warning Signs to Know
• Bowel Cancer and Stomach Noises: What to Know
• Stomach Pain After Eating: Causes, Quick Fixes, and When to Worry
• Stomach Gurgling and Gas: Causes, Quick Fixes, and When to Worry
• Kidney Disease Symptoms: Early Signs, Tests, Prevention, and Red Flags
• Type 2 Diabetes: Symptoms, Causes, Risk, and Prevention

Key Takeaway

Pancreatic cancer may not cause obvious symptoms early. That is why new and persistent changes matter.

Watch for jaundice, dark urine, pale or greasy stools, itching, upper belly pain, back pain, unexplained weight loss, appetite loss, nausea, vomiting, bowel changes, new diabetes, or blood clots.

Most symptoms have other causes. But some signs, especially jaundice and unexplained weight loss, should be checked quickly.

Treatment depends on stage and health. It may include surgery, chemotherapy, radiation, targeted treatment in selected cases, nutrition care, pain control, enzyme support, diabetes care, and palliative care.

Do not wait for symptoms to become severe. Early medical review can make a big difference.

 

Sources

• National Cancer Institute — Pancreatic Cancer Treatment
• NHS — Pancreatic Cancer Symptoms
• NHS — Pancreatic Cancer Treatment
• American Cancer Society — Signs and Symptoms of Pancreatic Cancer
• American Cancer Society — Pancreatic Cancer Risk Factors
• Mayo Clinic — Pancreatic Cancer Symptoms and Causes
• Cancer Research UK — Pancreatic Cancer Symptoms