Late-stage symptoms of pancreatic cancer

Written by Liu Liang
Oncology
Updated on September 18, 2024
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Late symptoms of pancreatic cancer include abdominal pain, or sore and swollen back pain, as well as nausea, vomiting, decreased appetite, indigestion, and discomfort of upper abdominal fullness. These are some symptoms affecting the digestive tract. Additionally, there is jaundice caused by tumor compression of the bile duct, as well as skin itching, and even fever. Some patients show clinical manifestations such as ascites when there is metastasis to the liver, or abdominal or retroperitoneal lymph nodes.

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What are some symptoms of early pancreatic cancer?

Patients with early-stage pancreatic cancer generally do not exhibit many symptoms, as the tumors are relatively small. Clinically, many patients may experience intermittent mild abdominal pain that does not affect their daily lives. A small number of early-stage patients may exhibit symptoms of general fatigue, mild loss of appetite, nausea, mild acid reflux, or other symptoms of indigestion. Additionally, a few patients in the early stages may experience intermittent episodes of diarrhea. Because these symptoms are not distinctive, patients rarely seek medical attention early. When symptoms like significant epigastric pain and jaundice become apparent, it often indicates that the pancreatic cancer has progressed to a more advanced stage.

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What are the abnormalities in blood indicators for pancreatic cancer?

Blood markers for pancreatic cancer often show multiple abnormalities. Pancreatic cancer itself can lead to an increase in related tumor markers. The two most common markers are carcinoembryonic antigen and carbohydrate antigen 19-9, especially carbohydrate antigen 19-9, which has a certain specificity. If pancreatic cancer progresses further, leading to compression of the biliary system, corresponding jaundice indicators can increase. This includes an increase in total bilirubin and direct bilirubin, as well as alkaline phosphatase and gamma-GTP. The most common metastasis site for pancreatic cancer is the liver, and after liver metastasis occurs, corresponding liver transaminases can increase.

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How is pancreatic cancer diagnosed?

The most common symptoms of pancreatic cancer are pain in the upper abdomen and jaundice. During physical examination, a mass in the upper abdomen can be felt, which is a common symptom. When these symptoms appear, further abdominal ultrasound or CT scans should be performed, as these two are the most commonly used imaging methods for diagnosing pancreatic cancer. Additionally, pancreatic MRI or PET-CT can also help enhance the diagnostic accuracy for pancreatic cancer. MRCP and ERCP are also used to assess the bile ducts and to evaluate the feasibility of surgery. Blood tests for pancreatic cancer-related tumor markers, such as carcinoembryonic antigen (CEA) and CA19-9, are commonly performed, with CA19-9 being particularly sensitive and specific for the diagnosis of pancreatic cancer.

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Which test for pancreatic cancer is the most accurate?

Abdominal ultrasound and abdominal CT scans are the most commonly used imaging methods for diagnosing pancreatic cancer. Additionally, it is important to consider the patient's symptoms and blood tests for tumor markers, mainly IP antigen, CEA, and CA19-9. Confirming pancreatic cancer requires a biopsy to find cancer cells, which is the gold standard for diagnosis. Other tests can serve as screening and adjunct diagnostic tools. Confirmation requires a biopsy for pathological diagnosis or direct radical surgery followed by a postoperative pathological confirmation.

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Written by Liu Liang
Oncology
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What is used for pain relief in pancreatic cancer?

If a pancreatic cancer patient is experiencing pain, the choice of pain medication can be based on the specific severity of the pain. For mild pain, mild pain relievers such as ibuprofen sustained-release capsules can be chosen initially. For moderate pain, pain relievers like tramadol can be used. If the daily dosage of tramadol exceeds eight tablets, which is two tablets each time, taken every six hours, and if the pain relief is still inadequate after 24 hours, then it might be appropriate to switch to opioid painkillers such as hydromorphone sustained-release tablets, morphine sustained-release tablets, or morphine.