The symptoms that a patient with the final stage of pancreatic cancer may come from the disease in the pancreas, or from the spread of the cancer.
If the pancreas cancer originates in the head portion of the pancreas, the patient will develop jaundice (yellowing of sclera and skin) due to obstruction of the bile duct [1]. If this is not resolved, they may develop easy bruising as well as generalized itch. As the tumour continues to grow, they may experience an inability to eat and frequent vomiting due to the compression of the pancreas tumour on the duodenum [2].
In addition, the patient may also experience tumour bleeding, which may present as vomiting of blood or altered blood [3]. They will also pass out altered blood in the stool. With these episodes of tumour bleeding, the patient will progressively become more anaemic and will thus be more and more lethargic and eventually lapse into a coma.
If the pancreas cancer originates in the tail and body portions, the patient is likely to get progressively weaker from loss of appetite. They may also experience abdominal bloatedness and even abdominal pain after eating.
When the disease has spread, the patient may experience abdominal swelling from fluid accumulating in the abdomen. This is often due to the cancer depositing in the abdominal cavity. Progressively, these secondary tumours in the abdomen will also cause the intestine to be obstructed. If the pancreas cancer spread to the liver, the patient may develop liver failure if the spread to the liver progressively replaces the liver [4].
This again will present with jaundice and usually accompanied by generalized swelling (ascites and oedema). Less often, pancreatic cancer can spread to other organs such as the bone, which will give rise to bone pain [5].
References:
1. Bornman PC. ABC of diseases of liver, pancreas, and biliary system: Pancreatic tumours. BMJ. 2001;322(7288):721-723. doi:10.1136/bmj.322.7288.721
2. Cancer P. A Patient’s Guide To. https://www.rogelcancercenter.org/files/pancreatic-cancer/handbook.pdf. Accessed December 17, 2019.
3. Signs that the end of life may be near | Pancreatic Cancer UK. Pancreatic Cancer UK. https://www.pancreaticcancer.org.uk/information-and-support/end-of-life-care-for-pancreatic-cancer/information-for-families-at-the-end-of-life/signs-that-the-end-of-life-may-be-near/. Published 2018. Accessed December 17, 2019.
4. Pancreatic cancer - Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/symptoms-causes/syc-20355421. Published 2019. Accessed December 17, 2019.
5. Pancreatic cancer. Vic.gov.au. Published 2012. Accessed December 17, 2019.
