Pancreatic Cancer vs. Pancreatitis Symptoms and Signs

• Pancreatic cancer is uncontrolled growth of abnormal cells in the pancreas. Two main types of pancreatic cancer may occur, 1) pancreatic adenocarcinoma (cancer cells that arise from the exocrine glands) and 2) pancreatic neuroendocrine carcinoma (islet cell tumor).
• Pancreatitis is inflammation of the pancreas, the gland that produces digestive juices in exocrine glands and digestive hormones in endocrine glands.
• Pancreatic cancer and pancreatitis share similar signs and symptoms, for example:
  • Abdominal pain
  • Back pain
  • Loss of appetite
  • Nausea
  • Weight loss
  • Bloating
  • Mental status changes such as depression, irritability, and/or lethargy.
• People with pancreatic cancer and chronic pancreatitis may develop diabetes and stools that are oily, smelly, and float in water.
• People with pancreatic cancer usually have no symptoms until the cancer has advanced. When signs and symptoms of pancreatic cancer occur, they include (these to not occur in pancreatitis):
  • Palpable lymph nodes
  • Enlarged gallbladder
  • Blood clots
  • Jaundice
  • Abdominal masses
• Pancreatitis symptoms and symptoms that do not occur in pancreatic cancer include:
  • Fever
  • Rapid pulse
  • Tenderness when touching the abdomen
  • Cullen’s sign (superficially bruising and around the bellybutton)
  • Gray-Turner sign (bruising of the flank)
  • Erythematous skin modules
• Pancreatic cancer is caused by uncontrolled growth of abnormal pancreatic gland cells that are capable of spreading (metastasizing) to other organs.
• Any process that causes inflammation of the pancreas may cause pancreatitis, include:
  • Alcoholism
  • Gallstones
  • Cigarette smoking
  • Infections
  • Certain medications
  • Cystic fibrosis
• The prognosis for pancreatic cancer is generally poor because by the time it is diagnosed it has already spread (metastasized) to other organs.
• The majority of people that develop acute pancreatitis recovered completely from the illness unless they develop necrotizing pancreatitis or chronic pancreatitis. The prognosis for chronic pancreatitis depends upon the age you were diagnosed, how much alcohol you drink, and if you have cirrhosis of the liver.

Pancreatic adenocarcinoma is the most common type of pancreatic cancer. This type of cancer of the pancreas originates in the exocrine glands. Islet cell tumor or pancreatic neuroendocrine cancer is a different type of cancer that arises in the endocrine glands of the pancreas.

Pancreatic adenocarcinoma is among the most aggressive of all cancers. By the time that pancreatic cancer is diagnosed, many people already have disease that has spread to distant sites in the body (about 53%). Pancreatic cancer is also relatively resistant to medical treatment, and the only potentially curative treatment is surgery. In 2010, approximately 43,000 people in the United States were diagnosed with pancreatic cancer, and approximately 36,000 people died of this disease. These numbers reflect the challenge in treating pancreatic cancer and the relative lack of curative options.

Inflammation of the pancreas is termed pancreatitis and its inflammation has various causes. The pancreas is a gland located in the upper part of the abdomen. It produces two main types of substances, digestive juices, and digestive hormones. Once the gland becomes inflamed, the pancreatitis can progress to swelling of the pancreas and surrounding blood vessels, bleeding, infection, and damage to the gland, which causes digestive juices become trapped and start "digesting" the pancreas itself. If this damage persists, the gland may not be able to carry out normal functions.

Pancreatitis may be acute (new, short-term) or chronic (ongoing, long-term). Either type can be very severe, even life threatening. Either type can have serious complications.

Acute pancreatitis usually begins soon after the damage to the pancreas begins. Attacks are typically very mild, but about 20% of them are very severe. An attack lasts for a short time and usually resolves completely as the pancreas returns to its normal state. Some people have only one attack, whereas other people have more than one attack, but the pancreas always returns to its normal state unless necrotizing pancreatitis develops and becomes life threatening.

Chronic pancreatitis begins as acute pancreatitis. If the pancreas becomes scarred during the attack of acute pancreatitis, it cannot return to its normal state. The damage to the gland continues, worsening over time.

Pancreatic Cancer Symptoms and Signs

People with acute pancreatitis usually feel very sick. The initial signs and symptoms of pancreatic cancer are often nonspecific and have a gradual or slow onset. When signs and symptoms do occur, the most common are pain in the abdomen, back, or both. Often the the pain becomes constant.

Other signs and symptoms of pancreatic cancer

• Weight loss associated with:
  • Bloating
  • Diarrhea
  • Fatty bowel movements that float in water (steatorrhea)
• Weight loss and nausea in some people newly diagnosed with diabetes (within the first year).
• Jaundice (yellowing of the skin)
• Itching (pruritis)
• Enlarged gallbladder
• Abdominal problems (ascites, abdominal mass)
• Depression
• Venous thrombosis
• Palpable lymph nodes (cervical, clavicular)

The symptoms of pancreatic cancer generally are vague and can easily be attributed to other less serious and more common conditions. This lack of specific symptoms explains the high number of people who have a more advanced stage of disease when pancreatic cancer is found.

Acute Pancreatitis Symptoms and Signs

The most common symptom of acute pancreatitis is abdominal pain that:

• Comes on suddenly or builds up gradually. If the pain begins suddenly, it is typically very severe. If the pain builds up gradually, it starts out mild, but may become severe.
• Usually is centered in the upper middle or upper left part of the belly (abdomen)
• Is often described as if it radiates from the front of the abdomen through to the back
• Often begins or worsens after eating
• Typically lasts a few days
• May feel worse when you lye flat on your back

Besides pain, other signs and symptoms of pancreatitis include:

• Nausea (Some people do vomit, but it does not relieve the symptoms.)
• Fever, chills, or both
• Swollen abdomen, which is tender to the touch
• Rapid heartbeat (A rapid heartbeat may be due to the pain and fever, dehydration from vomiting and not eating, or it may be a compensation mechanism if a person is bleeding internally.)
• Low blood pressure and dehydration in severe pancreatitis with infection or bleeding.

Severe acute pancreatitis is medical emergency. Signs and symptoms include:

• Weakness or feeling tired (fatigue)
• Feeling lightheaded or faint
• Lethargy
• Irritability
• Confusion or difficulty concentrating
• Headache
• Cullen's sign (bluish skin around the belly button)
• Grey-Turner sign (reddish-brown skin discoloration along the flanks)
• Erythematous skin nodules

Chronic Pancreatitis Symptoms and Signs

Pain is less common in chronic pancreatitis than in acute pancreatitis. Some people with chronic pancreatitis have pain, but many people do not experience abdominal pain. In people with chronic pancreatitis who have pain, the pain usually is constant, may be disabling, and often goes away as the condition worsens. Lack of pain is a sign that the pancreas has stopped working.

Other symptoms of chronic pancreatitis are related to long-term complications, for example:

• Diabetes (The pancreas can no longer produce insulin.)
• Inability to digest food (weight loss and nutritional deficiencies)
• Bleeding (low red cell blood count or anemia)
• Liver problems (jaundice)

Chronic pancreatitis can encourage the growth of abnormal cells in the pancreas, which can become cancer. The prognosis for pancreatic cancer is very poor.

Pancreatic Cancer

If you have any of the symptoms of pancreatic cancer Seek immediate medical attention If the pain, unexplained weight loss, or jaundice persists despite initial medical treatments, further evaluation should be pursued in as soon as possible.

Acute and Chronic Pancreatitis

In most people, the pain and nausea associated with pancreatitis are severe enough to seek medical attention from a doctor or other health-care professional.

If you have any of these symptoms, call your doctor right away and get medical attention.

• Inability to take medication or to drink and eat because of nausea or vomiting
• Severe pain not relieved by nonprescription medications
• Unexplained pain
• Difficulty breathing
• Pain accompanied by fever or chills, persistent vomiting, feeling faint, weakness, or fatigue
• Pain accompanied by presence of other medical conditions, including pregnancy

Your doctor or other health-care professional may tell you to go to a hospital emergency department. If you have seen a doctor for pancreatitis and your symptoms worsen go to an emergency department immediately.

• Despite recent advances in the surgical and medical treatment of pancreatic cancer, the prognosis associated with this disease is still relatively poor.
• Most people with acute pancreatitis recover completely from their illness unless they develop necrotizing pancreatitis. The pancreas returns to normal function with no long-term effects. Pancreatitis may return, however, if the underlying cause is not eliminated.
• Chronic pancreatitis does not resolve completely between attacks. Although the symptoms may be similar to those of acute pancreatitis, chronic pancreatitis is a much more serious condition because damage to the pancreas is an ongoing process. This ongoing damage can have cause complications.