Pancreatic cancer symptoms often don't appear until the disease is spreading, but among those to heed are jaundice, abdominal pain (especially in the upper abdomen), back pain, loss of appetite, weight loss, and nausea.

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In the cardiology world, high blood pressure has been dubbed “the silent killer” because it produces no obvious symptoms as it damages the heart, kidneys, and other areas of the body. In the oncology world, that same label could apply to pancreatic cancer. Symptoms may not show up until a patient has developed the disease.

According to the American Cancer Society, pancreatic cancer accounts for only about 2 percent of new cancer cases diagnosed in the United States each year. Pancreatic cancer is the fourth-leading cause of cancer death in the U.S., partly because it can spread rapidly. But a major reason is that pancreatic cancer symptoms generally do not appear until the cancer has reached an advanced stage, so the disease is seldom detected early.

If you experience pancreatic cancer symptoms, tell your doctor right away. Yes, the disease is difficult to detect in its initial stages. However, as with any cancer, the earlier pancreatic cancer is identified, the better the odds of successful treatment—once the cancer has reached a later stage, it’s much more difficult to control. And, given its highly lethal nature and the fact that no screening test has been shown to reduce the risk of dying from pancreatic cancer, knowing the risk factors for the disease and taking steps to avoid them are paramount.

Pancreatic Cancer Symptoms

In most cases, pancreatic cancer causes no symptoms until the cancer has spread through the pancreas and beyond. As the disease advances, symptoms can include:

• Jaundice, which causes the skin and eyes to appear yellow and urine to darken
• Abdominal pain (especially in the upper abdomen) and back pain
• Loss of appetite; weight loss
• Nausea and vomiting
• Weakness

Note that because these are common signs of other conditions, tests are needed to confirm pancreatic cancer symptoms. These tests may include blood, urine, and stool tests, imaging tests such as computed tomography or magnetic resonance imaging, endoscopic retrograde cholangio-pancreatography (an endoscopic inspection of the pancreas), endoscopic ultrasound, and a biopsy.

Know Your Risk

The causes of pancreatic cancer remain a mystery, but some potential risk factors have been identified. Some are beyond your control:

• Age: Most pancreatic cancers occur in people over age 60.
• Gender: Men face a greater risk of pancreatic cancer than women.
• Race: The risk of pancreatic cancer is higher in African-Americans.
• Family history: People with a family history of cancer of the pancreas, colon, or ovaries face an increased risk of pancreatic cancer.

However, several other risk factors are modifiable. For instance, smokers are two to three times more likely than non-smokers to develop pancreatic cancer. If you smoke, talk to your physician about nicotine replacement therapy, medications, counseling, and other strategies to help you quit.

People who are overweight or obese also face a greater likelihood of pancreatic cancer. Obesity is a leading risk factor for type 2 diabetes, and type 2 diabetes has been linked to increased pancreatic cancer risk. If you’re overweight or obese, work with your healthcare team to lose weight through exercise and a healthful diet.

Other risk factors have an indirect or unclear effect on the risk of pancreatic cancer. Some research suggests a link between alcohol abuse and pancreatic cancer. Although this association has not been proven conclusively, alcohol abuse can cause conditions such as liver cirrhosis and chronic pancreatitis, both of which are known risk factors for pancreatic cancer. If you imbibe, limit your alcohol intake to two drinks a day if you’re a man and one drink a day if you’re a woman or over age 65.

Also, some studies have found that drinking large quantities of soft drinks and eating high amounts of red meat—in particular, processed meats like hot dogs, sausage, and bacon—might raise a person’s risk of pancreatic cancer. More research is needed to understand these potential links.

Conversely, certain nutrients may play a protective role against pancreatic cancer, although clear evidence of an association has not been proven. Specifically, in the fight against pancreatic cancer, some studies have identified the importance of obtaining adequate amounts of vitamin D (good sources include salmon and other fatty fish, as well as fortified foods), vitamin B6 (found in fortified cereals, beans, fish, fruits, and vegetables), vitamin B12 (found in fish, meat, eggs, dairy, and poultry), and folate (found in grains).

Researchers are looking for genes that indicate a person is at especially high risk for pancreatic cancer. Some possible candidates have been identified. Knowing the genes that put people at risk for pancreatic cancer could potentially lead to a screening blood test for people with a family history of the disease. This testing could help doctors diagnose the disease at an earlier stage, when treatment is most successful.

Originally published in July 2016 and updated.