
Pancreatic cancer is known as the silent killer, thanks to how it can initially advance without any obvious symptoms. "Pancreatic cancer can develop from two kinds of cells in the pancreas: exocrine cells and neuroendocrine cells, such as islet cells. The exocrine type is more common and is usually found at an advanced stage. Pancreatic neuroendocrine tumors (islet cell tumors) are less common but have a better prognosis," says the National Cancer Institute. While pancreatic cancer is more difficult to catch than other cancers, there are certain warning signs to be aware of: Here are five pancreatic cancer signs doctors want you to take note of. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.
Diabetes

Pancreatic cancer is strongly linked to diabetes—but there is uncertainty about whether the cancer causes diabetes, or vice versa. "It is possible that, in some patients, diabetes leads to development of pancreatic cancer. It is also possible pancreatic cancer leads to development of diabetes," says Max Petrov, MD, PhD, MPH, professor of pancreatology at The University of Auckland School of Medicine.
"Factors such as inflammation or altered immune markers might play a role," says Mark O. Goodarzi, MD, PhD, FACP, director of the division of endocrinology, diabetes and metabolism and Eris M. Field chair in diabetes research at Cedars-Sinai. "As far as longstanding diabetes, obesity may be a key contributor. People who are obese and have diabetes often have high insulin levels, and insulin can stimulate cell division. Over time, high levels of insulin could promote tumor formation. This is not proven, but it is a theory. The concept with new-onset diabetes is that the pancreatic cancer cells themselves might be producing some factor that causes diabetes."
Abdominal Pain

Unexplained abdominal pain that spreads to the back could be a sign of pancreatic cancer. "A common symptom of pancreatic cancer is a dull pain in the upper abdomen (belly) and/or middle or upper back that comes and goes," according to Johns Hopkins Medicine. "This is probably caused by a tumor that has formed in the body or tail of the pancreas because it can press on the spine. Some patients describe pain starting in the middle abdomen and radiating into the back. Pain can be worse when lying down and can often be relieved by leaning forward. Pancreatic cancer pain can differ from person to person, so be sure to discuss any new pain-related symptoms with your doctor."
Jaundice

One warning sign of pancreatic cancer is jaundice, a yellowing of the skin or eyes caused by high levels of bilirubin in the blood. "It's one of the first symptoms a patient may notice," says Jason A. Castellanos, MD, MS, surgical oncologist at Fox Chase Cancer Center. "Jaundice doesn't automatically mean that you have cancer. But no matter what's behind the jaundice, the patient needs to have a thorough workup and get their bilirubin levels back to normal. The bottom line is, it's crucial to identify the cause of jaundice quickly."
Obesity

Being overweight or obese is strongly correlated with pancreatic cancer, with one study showing that a high BMI was linked to lower survival rates. "This study adds to mounting evidence for the role of weight control in improving outcomes for patients with cancer. It also reinforces the importance of maintaining a healthy weight throughout your life, which may lead to better outcomes after diagnosis and help prevent pancreatic cancer from developing," says Brian M. Wolpin, MD, MPH, assistant professor of medicine at Dana-Farber Cancer Institute and Harvard Medical School in Boston, MA.
Smoking Is a Huge Risk

Aside from being extremely hazardous to your health in general, smoking is strongly linked to pancreatic cancer. "People who smoke are two times more likely to develop pancreatic cancer compared to those who don't," says Joseph Herman, MD, MSc, a member of the Scientific and Medical Advisory Board at the Pancreatic Cancer Action Network (PanCAN). "About 20 to 30% of exocrine pancreatic cancer cases – the most common kind of pancreatic cancer – are thought to be attributable to smoking."
When Should I See a Doctor?

If you have concerns about pancreatic cancer and want to get more information, speak to your healthcare provider as soon as possible to rule out any issues. Your doctor will likely start with "an exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken," says the National Cancer Institute. As well as a variety of tests like "a procedure in which a blood sample is checked to measure the amounts of certain substances, such as bilirubin, released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease."