‘It comes and goes’: The overlooked symptoms of cancer that precede a diagnosis by years

This Morning: Dr Zoe explains symptoms of pancreatic cancer

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Cancer becomes increasingly difficult to deal with the longer it is left untreated. That’s because cancerous cells spread to other areas of the body. Stymieing early detection is the vague nature of symptoms, many of which are brushed off as non-serious.

That’s the conclusion of a study published in the BMJ, which looked at how people with pancreatic cancer interpreted pre-diagnostic signs and symptoms.

A qualitative interview was performed on 40 people affected by pancreatic cancer (32 patients and eight relatives of people who had died).

Respondents interviewed at home were recruited from different parts of the UK during 2009/2010.

An analysis of the interviews suggested that intermittent symptoms were not “uncommon in the months, or even years, before diagnosis”, the researchers wrote.

But that the fact that the symptom did not persist was often taken by the patient as a “reassuring indicator” that it could not be “very important”, they observed.

One patient reportedly said: “It can’t be very important because it comes and goes.”

“Such symptoms were rarely acted upon until a pattern became apparent, the frequency of symptom episodes increased, there was a change in the nature of the intermittent symptoms or additional symptom(s) appeared,” the researchers wrote.

According to the researchers, these findings build on social science theories of consultation behaviour.

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They concluded: “Our study – the largest reported collection of qualitative interviews with people with pancreatic cancer —reports for the first time that symptoms of an intermittent nature may precede a pancreatic cancer diagnosis.”

The researchers warned that patients (and potentially their doctors as well) may be falsely reassured by symptoms that come and go.

“Pancreatic cancer might be identified at a stage where curative treatment is more likely if there were greater awareness that intermittent gastrointestinal symptoms can have a serious cause, and if patients with intermittent pancreatitis-like symptoms were investigated more readily.”

What should you be looking for?

Pancreatic cancer may not have any symptoms, or they might be hard to spot.

Symptoms of pancreatic cancer can include:

• The whites of your eyes or your skin turn yellow (jaundice), you may also have itchy skin, darker pee and paler poo than usual
• Loss of appetite or losing weight without trying to
• Feeling tired or having no energy
• A high temperature, or feeling hot or shivery.

Other symptoms can affect your digestion, such as:

• Feeling or being sick
• Diarrhoea or constipation, or other changes in your poo
• Pain at the top part of your tummy and your back, which may feel worse when you are eating or lying down and better when you lean forward
• Symptoms of indigestion, such as feeling bloated.

According to the NHS, if you have another condition such as irritable bowel syndrome you may get symptoms like these regularly.

The health body says: “You might find you get used to them. But it’s important to be checked by a GP if your symptoms change, get worse, or do not feel normal for you.”

See a GP if you have:

• Lost a noticeable amount of weight over the last six to 12 months without trying
• Other symptoms of pancreatic cancer that get worse or do not get better after two weeks
• A condition that causes symptoms with your digestion that are not getting better after two weeks of using your usual treatments.

Am I at risk?

Anyone can get pancreatic cancer. It’s not always clear what causes it.

Your risk of developing cancer depends on many things including age, genetics, lifestyle and environmental factors. Anything that can increase your risk of cancer is called a risk factor.

According to Cancer Research UK, pancreatic cancer is more common in older people. “Almost half of all new cases are diagnosed in people aged 75 and over. Pancreatic cancer is uncommon in people under 40 years old.”

Other risk factors include:

• Smoking and smokeless tobacco
• Being overweight or obese
• Family cancer syndromes and genetic factors
• Other medical conditions.

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