What to Know About Pancreatic Cancer and Jaundice

Pancreatic cancer has a clear connection with jaundice. A cancerous growth may press on the bile duct carrying bile from the liver to the small intestine, causing the yellowing of the skin known as jaundice. 

Jaundice is often among the first symptoms of pancreatic cancer. Signs include yellowing of the whites of the eyes, dark urine, pale stools and itchy skin. 

Management may involve placing a tube to keep the bile duct open or surgery to relieve the blockage.

The Link Between Pancreatic Cancer and Jaundice

Jaundice is frequently one of the first symptoms people experience. A cancer in the pancreatic head may cause it, whereas cancers elsewhere in the pancreas may not cause jaundice unless they have spread to other parts of the body.

Jaundice means yellowing of the skin and the whites of the eyes. Other signs include:

• Dark urine
• Itchy skin
• Pale or greasy stools

What Causes Jaundice?

Jaundice results from bilirubin buildup. This dark brown-yellow substance is a component of bile produced by the liver. Bile travels through the common bile duct to the small intestine to break down fats, and is eventually eliminated in stools.

A common bile duct blockage prevents bile reaching the small intestine, causing bilirubin buildup and jaundice. 

When Does Jaundice Develop in Pancreatic Cancer?

It may occur at any stage, generally depending on the cancer's location. A tumor in the pancreatic head is near the common bile duct and may compress it, producing jaundice even while small.

In contrast, a tumor in the body or tail may not compress the bile duct until it spreads through the pancreas, so jaundice may initially be absent. If it develops in this setting, it suggests spread around the pancreas, usually with liver metastases. 

Many conditions other than pancreatic cancer can also cause jaundice. 

Treating Jaundice in Pancreatic Cancer

In some cases, placing a short, narrow tube called a stent to keep the bile duct open can relieve jaundice symptoms. 

Another option is pancreatic biliary bypass surgery. The surgeon cuts the bile duct above the blockage and reconnects it to the small intestine. This is generally effective for relieving jaundice. 

Neither approach suits everyone. Antihistamines such as diphenhydramine and keeping the skin cool and moisturized may help reduce itching in these circumstances. 

What Are the Other Symptoms of Pancreatic Cancer?

Other symptoms include:

• Unintentional Weight Loss: Very common, because affected people often lose their appetite.
• Back or Abdominal Pain: Also common: a tumor in the body or tail may grow large and press on nearby organs, causing pain. However, back or abdominal pain usually has a cause other than pancreatic cancer.
• Nausea and Vomiting: A tumor pressing on the stomach's outlet may partially obstruct it, making food passage difficult and causing nausea or vomiting.
• Blood Clots: In some people, the first sign is a clot in a large vein, usually in the leg. It can cause redness, pain, warmth and swelling. A fragment reaching the lungs may cause chest pain and can be life-threatening.
• Enlarged Liver or Gallbladder: A blockage may cause bile to accumulate in the gallbladder, enlarging it. Cancer spreading to the liver may also enlarge that organ.
• Diabetes: Diabetes may develop if cancer destroys insulin-producing cells, although this is rare. More often, pancreatic cancer causes small changes in blood glucose.

Pancreatic Cancer Survival Rates

These depend largely on when the diagnosis is made. The 5-year relative survival rate, or 5-year RSR, compares people with and without pancreatic cancer and expresses the percentage alive after 5 years. 

The Surveillance, Epidemiology, and End Results (SEER) database's pancreatic cancer RSR figures are shown below. 

Does Jaundice Mean End-Stage Pancreatic Cancer?

It may occur at any stage, depending on where the cancer starts. A pancreatic head tumor can cause jaundice early, whereas body or tail tumors may cause no jaundice even at later stages. 

What Are the Symptoms of End-Stage Pancreatic Cancer?

Symptoms generally develop after the tumor has spread to other organs or grown very large, so they may appear later rather than earlier. Nonspecific symptoms include weight loss, appetite loss and abdominal pain. 

Summary: Pancreatic Cancer and Jaundice

Jaundice, or yellow skin, is a very common symptom. A tumor can block the bile duct, causing bilirubin buildup. Signs include yellowing of the whites of the eyes, dark urine and pale stools.

Two management approaches are stenting to keep the duct open and biliary bypass surgery.

Pancreatic cancer may also cause unintentional weight loss, blood clots, nausea and vomiting. 

Survival depends on how early diagnosis occurs, but the overall 5-year relative survival rate is 13%.