Pancreatic cancer has few early warning signs. The pancreas is located deep in the abdomen, so a tumor in its early stages cannot be felt on physical examination by a doctor. If early symptoms occur, they are very general and vague and can be caused by many conditions other than pancreatic cancer.

As the cancer spreads beyond the pancreas it can cause symptoms related to its location. The symptoms depend on the part of the body the cancer is in.

There are two main types of pancreatic cancer: exocrine (adenocarcinoma), which is the most common by far; and pancreatic neuroendocrine tumors, which are rare.

Main symptoms of adenocarcinoma

Tail of the pancreas

The tumor presses on the stomach and small intestine. If the tumor is toward the middle of the pancreas it can be near the celiac nerve. Tumors in the tail can cause:

Middle or body of the pancreas

A tumor in this location is also more likely to be near the celiac nerve. Tumors in this location cause:

Head of the pancreas

The tumor is more likely to be near the bile duct. Tumors in the head can cause:

General Symptoms

These symptoms may occur before any of the more common symptoms and MAY indicate the presence of pancreatic cancer.

• Depression
• New-onset diabetes
• Fatigue
• Loss of appetite
• Acute pancreatitis attacks

Unusual symptoms

These symptoms occur rarely but have been known to indicate the presence of a tumor in the pancreas.

• Taste aversions —sudden dislike of tastes that used to be favored. Examples include coffee, smoking, wine
• Early fullness when eating
• Notable weakness when eating
• Blood clots
• Odd fatty deposits under the skin

Neuroendocrine tumor symptoms

This rare form of pancreatic cancer can cause some of the same symptoms as adenocarcinoma, including abdominal pain, weight loss, nausea, and vomiting. However, this cancer affects the islet cells, which make hormones. There are also some symptoms that mostly only occur with this form of pancreatic cancer, depending on the type of tumor.

Insulinomas make excess insulin and can cause low blood sugar, with symptoms including sweating, anxiety, lightheadedness, and fainting.

Somatostatinomas make excess somatostatin which regulates other hormones, and result in diarrhea, weight loss, abdominal pain, foul-smelling fatty stools.

Glucagonomas make excess glucagon, raising blood sugar levels, and can cause diarrhea, excessive thirst or urination, weight loss.

VIPomas make excess vasoactive intestinal peptide, causing abdominal cramping, watery diarrhea, facial flushing.

Gastrinomas make excess gastrin, leading to more stomach acid, causing abdominal pain, nonhealing stomach ulcers, reflux, weight loss.

PPomas make pancreatic polypeptide, which regulates endocrine and exocrine cells in the pancreas, and causes belly pain and an enlarged liver.