Pancreatic cancer is often called a silent killer because its symptoms mimic so many other conditions that patients overlook them until the disease is advanced. In India, where most patients are diagnosed at a late stage, acting quickly on warning signs is critical.
Dr. J. Saravanan, Surgical Gastroenterologist and GI Cancer Surgeon at Shasti Gastro Care, Kilpauk, specialises in HPB surgery and GI oncology. Early detection remains the single biggest factor in survival outcomes.
Why Pancreatic Cancer Is Difficult to Detect Early
The pancreas sits deep in the abdomen, behind the stomach. A growing tumour can exist for months without noticeable symptoms. By the time most symptoms appear, the tumour has often spread to nearby structures.
7 Early Warning Signs Not to Ignore
- Jaundice (yellowing of skin and eyes): Often the first visible sign, especially when a tumour blocks the bile duct. Skin and eyes turn yellow; urine becomes dark and stools pale.
- Persistent upper abdominal or back pain: A deep, gnawing pain in the upper abdomen radiating to the back, worse when lying down and slightly better when leaning forward.
- Unexplained weight loss: Rapid, unintentional weight loss without any change in diet or activity.
- New-onset diabetes after age 50: Pancreatic tumours can interfere with insulin production. New diabetes without obvious cause after age 50 warrants pancreatic evaluation.
- Loss of appetite: Persistent, unexplained decrease in appetite with early satiety (feeling full quickly).
- Digestive problems: Oily, foul-smelling stools (steatorrhoea), bloating and indigestion not responding to standard treatment.
- Fatigue and weakness: Profound, persistent fatigue disproportionate to activity level and not improving with rest.
Any single symptom may have a benign cause. But two or more together — especially jaundice, weight loss, and back pain — require immediate specialist evaluation.
Risk Factors
- Smoking — the single largest modifiable risk factor
- Chronic pancreatitis (long-standing pancreatic inflammation)
- Family history of pancreatic cancer or BRCA gene mutations
- Obesity and a high-fat, low-fibre diet
- Long-standing Type 2 diabetes
- Age above 60
Diagnosis
- CT scan abdomen (Triple Phase): Primary imaging for staging pancreatic tumours
- MRI / MRCP: Detailed assessment of bile and pancreatic duct involvement
- Tumour markers: CA 19-9 (useful in combination, not diagnostic alone)
- Endoscopic Ultrasound (EUS): For tissue biopsy
- PET-CT scan: To assess for distant spread
Treatment: Surgery Is the Only Cure
Surgery remains the only potentially curative treatment for pancreatic cancer. Type of surgery depends on tumour location:
- Whipple procedure (Pancreaticoduodenectomy): For tumours in the head of the pancreas — the most complex abdominal surgery, performed with excellent outcomes at specialised centres
- Distal pancreatectomy: For tumours in the body and tail
- Total pancreatectomy: In rare cases of entire pancreatic involvement
When surgery is not possible, palliative procedures (biliary stenting, bypass) significantly improve quality of life. Chemotherapy and radiation play important roles in both curative and palliative settings.
Frequently Asked Questions
Consult Dr. J. Saravanan
Expert care at Shasti Gastro Care, Kilpauk, Chennai. By prior appointment only.