Pancreatitis vs Pancreatic Cancer: Signs, Symptoms and Pain

Pancreatitis and pancreatic cancer are two different conditions that affect the pancreas. One type of pancreatitis known as chronic pancreatitis can increase the risk of pancreatic cancer. Despite the similarity of symptoms in both pancreatitis and pancreatic cancer it is important to understand how these two conditions differ. One is an inflammatory condition and the other is due to an abnormality in the cells of the pancreas.

The pancreas is an important gland located in the upper abdomen. It is a large gland that has multiple functions. Firstly, the pancreas secretes hormones into the bloodstream. This is known as the endocrine functions of the pancreas. Hormones like insulin and glucagon are produced and secreted by the pancreas.

Digestive enzymes are also produced and secreted by the pancreas.  This is known as the exocrine functions of the pancreas. These enzymes are stored in the inactive form and activated only when needed. It is secreted into the duodenum of the small intestine where it assists with the digestion of food.

The pancreas is surrounded by he liver, gallbladder, stomach and duodenum. Conditions affecting these organs may involve the pancreas and similarly conditions of the pancreas can sometimes affect these other organs.

Difference between Pancreatitis and Pancreatic Cancer

Pancreatitis is inflammation of the pancreas. It can be acute or chronic. Acute pancreatitis is often due to excessive alcohol consumption although other factors like trauma to the pancreas and viral infections may also cause acute pancreatitis. Chronic pancreatitis is recurrent episodes of acute pancreatitis that is often linked to chronic alcoholism. The pancreas becomes permanently damaged over time.

Pancreatic cancer is where cells of the pancreas become abnormal, multiple rapidly and destroy healthy pancreatic tissue. The malignant cells may arise from the pancreas and eventually spread throughout the body where it destroys other organs and tissues. Sometimes malignant (cancerous) cells may arise from elsewhere in the body and then spread to the pancreas where it causes cancer (metastasis).

Read more on pancreas problems.

Which pancreas condition is more serious?

Pancreatitis, both acute and chronic, are serious conditions and can even lead to death if not properly treated and managed. However, panceatic cancer is often considered to be more serious. It is an aggressive form and one of the five leading causes of cancer deaths. It is rarely detected in the early stages which is one of the reasons for the poor prognosis. Pancreatic cancer is responsible for approximately 7% of all cancer deaths.

Chronic pancreatitis is one of the major risk factors for developing pancreatic cancer. Even if it does not lead to pancreatic cancer, it nevertheless affects normal pancreatic functioning which can lead to serious and even deadly complications. Therefore pancreatitis, whether acute or chronic, should also be viewed as a serious condition and appropriately treated or managed.

Symptoms and Signs of ACUTE Pancreatitis

Symptoms of acute pancreatitis include (1):

  • Alcoholic related acute pancreatitis usually occurs after some years of excessive daily drinking
  • Gallstones related acute pancreatitis occurs mostly in old people with history of gallstones or upper right abdominal pain after the meal. This type of pancreatitis is often present with jaundice
  • Constant, dull, deep, often severe  pain in the upper middle abdomen (below the breastbone), that may radiate to the sides or to the back; may worsen when lying down. Rarely the pain may be on the right side or in lower abdomen (other causes of right side abdominal pain and left side abdominal pain)
  • Nausea and vomiting
  • Fever

During physical examination, a doctor may find the following signs of acute pancreatitis:

  • Tenderness and rigid muscles in the upper abdomen
  • Jaundice
  • Fever
  • Increased heart rate
  • Dehydration

Diagnosis. Elevated pancreatic enzymes: amylase, lipase and trypsin, together with the history of alcohol abuse or gallstones is usually enough for diagnosis (1). In doubtful cases, a CT (computed tomography) scan may be needed.

Symptoms  and Signs of CHRONIC Pancreatitis

Chronic pain, either constant or recurrent, in the upper abdomen is the main symptom. Other symptoms resemble acute pancreatitis (see above). With time, other symptoms, due to complications, may develop:

  • Bulky, whitish, sticky, greasy, floating, foul smelling stool or diarrhea (steatorrhea) from undigested fats, unabsorbed due to lack of pancreatic enzymes
  • Weight loss due to fat malabsorption
  • Symptoms of fat soluble vitamin deficiency:
    • skin peeling and night blindness, due to vitamin A deficiency
    • bone pains or fractures from osteoporosis, due to vitamin D deficiency
    • easy bruising, due to vitamin K deficiency
  • Diabetes, due to damage of insulin producing cells
  • Chronic pancreatitis is mainly caused by chronic alcoholism. In children, main causes are genetic disorders, like cystic fibrosis. Other causes of chronic pancreatitis.

Diagnosis is made from the history of repeating acute pancreatitis and chronic alcohol abuse. Pancreatic enzymes tests are not reliable (2).  Stool-fat test may reveal fat malabsorption. X-ray may show calcifications (Picture 1). CT (with contrast) of abdomen may be needed in doubtful cases.

Chronic pancreatitis with calcifications (X-ray image)

Picture 1. Chronic pancreatitis: calcifications in the pancreas (X-ray of abdomen)

Symptoms of Pancreatic CANCER

Symptoms of pancreatic cancer often appear only in its advanced stage. Risk factors are genetic predisposition, chronic pancreatitis, smoking, fat-rich diet, and age after 60. Symptoms are not specific and may include:

  • Chronic upper abdominal pain (may appear only in advanced stages)
  • Jaundice
  • Poor appetite
  • Nausea
  • Weight loss

Diagnosis. Blood tests often show increased liver enzymes, bilirubin and CA 19-9 marker. Cancer can be seen on CT (with contrast) of abdomen.

Pancreatic CYST Symptoms

Pancreatic cyst is an enclosed sac within the pancreas, which sometimes may be cancerous. Another type of similar condition is known as a pancreatic pseudocyst. This type of cyst is a “false” cyst. It can develop as a result of severe pancreatitis. A pancreatic cyst often presents with no signs and symptoms but it may sometimes cause:

  • Upper abdominal pain
  • palpable mass in the upper abdomen
  • Nausea

Pancreatic cysts are often found during ultrasound, CT or MRI investigations performed because of other abdominal problems. A needle aspiration of the fluid from the pancreatic cyst (performed during endoscopic ultrasound) may reveal if a cyst is cancerous or not (4).

Related Aricles:

References:

  1. Acute pancreatitis  (aafp.org)
  2. Chronic pancreatitis  (aafp.org)
  3. Pancreatic cancer  (pancreatica.org)
  4. Pancreatic cyst  (mayoclinic.com)
About Jan Modric (249 Articles)
Health writer

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