Full transcript of “10 Early Signs of Pancreatic Cancer You Should Never Ignore”. Click a timestamp to open the video at that moment. Need another video? Use the YouTube transcript generator.
0:00 Pancreatic cancer has one of the lowest survival rates of any major cancer. But it's not because it's untreatable. It is because less than 20% are caught early. And that's because the signs are so subtle. Hello, health champions. Today, we're going to talk about what you really need to know to detect pancreatic cancer early. I want to let you know that if there was ever a video that you want to pay close attention to, this would probably be the one. And the title is 10 early signs of pancreatic cancer. But to be totally honest, there aren't really 10 early signs. And that what makes it so problematic and these signs are easy to miss. And that's why pancreatic
0:50 cancer can be so devastating. And I'm going to go through everything that you need to understand from the first part is to explain why it's so hard to catch. Then we'll talk about some of the early signs before we move on to some of the later signs. And throughout this video, when we're talking about a cancer, a tumor that grows, then we're going to treat this progressively so that we start with the signs when it's very small and then we move on to the later signs as the tumor grows. So why does it stay silent for so long? Well, location has a lot to do with it and it's hidden away. So in this picture we have removed the stomach because normally it sits right behind
1:36 the stomach and then it's kind of wrapped in as you can see by the dadum and the gallbladder and some of the ducts from the gallbladder and the pancreas as well as some major blood vessels. It also has very limited pain sensation. So the active visceral tissue, the active organ cells in the pancreas, they have no pain receptors. It's not until it grows to where it pushes on something else that we can detect a sensation. So a small growth, which is how they start out, does not trigger any pain at all. Only as it gets larger can it start pressing on other things. But even then, it's going to press on things that have a very diffuse pain perception like ducts and
2:27 blood vessels. And if you look at this picture, the pancreas usually is divided into different parts where the head and the tail are the main parts. And if you notice that the head portion here is where everything else is going on. That's where it's wrapped in. And that accounts for about 60 to 70% of the pancreatic tumors. And if it's in the head, it's going to give rise to pain signals earlier than if it's over in the tail because there's nothing over here to really press on that's going to give pain. And sign number one is if we get diabetes with an onset after age 50. And here we need to realize that the pancreas is really two organs. It's exocrine and
3:12 endocrine. Endocrine has to do with hormones that are secreted and released into the bloodstream. And exocrine means outside. So, it's dumping it into the small intestine, which really is just a tube going through the body. So, it's acting on things that aren't part of you yet. So, the endocrine has to do with insulin and glucagon to regulate blood sugar. And the exocrine has to do with digestive enzymes to help us break down food. Now, the way it can get you diabetes is if a tumor starts growing and it starts interfering with the beta cells, which are the cells that make insulin. And if they destroy those cells and you can't make insulin, now you have diabetes. But what we need
4:00 to understand, what's not typical about this is that it would be a relatively sudden onset of diabetes and it wouldn't match the typical risk factors of type 2 diabetes. And here the problem is that most doctors are going to assume that it's type 2 diabetes because that's what most cases of diabetes are after age 50. So, they're just going to say, "Well, according to the statistics, this is probably type 2 diabetes." So, they're not even going to think that there's a lack of insulin. Another reason that they don't suspect it is that pancreatic cancer is extremely rare before the age of 45. Most cases are detected after 50 with a peak around 70. So, if you come in before age 50,
4:52 they're going to assume that you're just someone who eats poorly and it must be type 2 diabetes. But the thing to realize is that this diabetes actually is more of a type 1 diabetes because it is a lack of insulin. And here's of course the problem again. Nobody tests the insulin. If they had, they would see that, hey, your blood sugar is going up, but your insulin is low. And that doesn't match type two diabetes at all. And if all they did was just test insulin, like I talk about every time, then this would just be one more reason to test insulin. Such an easy thing to add to a test, and you would know almost without a doubt that this was not type two diabetes. It was
5:40 something else worth investigating. The second sign is weight loss. And this is if it's not explained by any lifestyle changes. Like if you start eating low carb and you start exercising, then you know why the weight loss happens. But if you're not doing any of that and you're losing weight, now you have to start wondering why. And what we talked about on the last slide would be the first cause is if you have diabetes which now again is a type one diabetes which going to drive that you don't have enough insulin to absorb the glucose to absorb the nutrients. A lot of stuff that you eat just goes straight through you. And the second thing here with type 1 diabetes is when the glucose goes high enough now you lose a lot of those calories. They just get flushed out through
6:29 the urine. The second part of this is that when a tumor starts growing then it starts releasing cytoines inflammatory signaling molecules such as interlucan 6 and tumor necrosis factor alpha. And again names are not important. They're just common inflammatory signaling molecules that can result from a tumor. And now they can actually increase your metabolism. you they increase your state of energy expenditure while at the same time they can make you lose a little bit of appetite but this is still at a very early stage and therefore this can be very mild and very easy to miss. Sign number three is early satiety meaning you start eating but sooner than normal you start feeling full and
7:20 this could be a tumor in the head of the pancreas. So if you recall this is the head and this is the dadum. So we've just removed the stomach from this picture and the stomach empties into this upper portion. So right where this cut off is is where the stomach would normally empty out. Well if the tumor starts growing and it presses on the dadum then the tube is smaller. So it's going to be harder for the stomach to empty into the dadum and therefore you could feel full much sooner because you're slowing down the emptying. And then these cytoines that we talked about on the previous slides, they can also contribute to an feeling of fullness earlier. Now here's the key to understand
8:09 for this video for all these early signs that on its own this is doesn't really mean very much. It's a very nonspecific sign, but if you know what to look for and you start suspecting that something isn't quite right, it becomes a concern if it's persistent and if it's combined with some of the other symptoms. Number four is a vague upper abdominal discomfort. And with vague, we mean it's it's dull. It's hard to describe. It's more of a discomfort. It's not a sharp pain. It's an ache or a pressure. And it is vague and poorly localized. You can't really pinpoint where it is.
8:54 Now, I want to point out that at this stage, the tumor is large enough to exert some kind of pressure to cause this discomfort. And this is often mistaken for gas or indigestion which is something else that can exert pressure and and create these sensations. And most of the time it probably is indigestion or gas. So again by itself it doesn't mean very much. And that's why we need to understand these things so we can start putting it together. Number five is mild intermittent nausea which means it comes and goes. it's not there all the time and oftentimes it's not severe enough for you to mention it to a doctor not again by itself and this can be due to like
9:44 we said slow gastric emptying now that can leave you feeling a little bit queasy. It could be due to the cytoines the signaling messengers that we talked about. They can affect these nausea centers in the brain directly. And it could also be a general digestive disruption from a tumor that's growing in the head of the pancreas where a lot of other stuff is going on. So these are basically the five early signs and there's nothing about each one that looks very dramatic and most people are going to assume, oh, I must have just eaten something. which again usually that's the case. It's something that happens to everyone now and then and you get over it. They're very subtle and
10:33 easy to miss. They're very easy to ride off when we look at them individually. So again, this is where we have to understand this so that if we get several, we can put it together and now it's worth taking seriously. And then after these symptoms, after this stage, now we get to the later stages, which again is more serious. Sign number six is painless jaundice. And what's jaundice? Well, your red blood cells, you have trillions and trillions of blood cells. They live about a 100 days. They break down and the liver recycles them. So they contain something called Billy Rubin, which is a pigment. It's a has a strong yellow orangey color and then it gets mixed in with a bile and the bile
11:23 of course is released through the gallbladder and into the small intestine to move further down to the bowel for us to get rid of it for excretion. But now if there's a blockage for the bile, if the bile can't get out the way it's supposed to into the intestines, now it's going to typically back up into the blood. And if we can't get rid of it, it's going to accumulate. And then this yellow color is going to show up in places where it doesn't belong. And one of the first places it's going to show is in the scara. That's the white area of the eye. And then as it keeps building, we will probably see it in the skin as well. So now why is it important to look for the painless
12:10 jaundice? Because a lot of jaundice are caused by something like a gallstone block. If we have a gallbladder attack, now that's going to happen very suddenly. Something moves and this gallstone blocks this passage the duct and now the duct goes into spasm and it's extremely painful. Now we want to contrast that with a tumor in the pancreas which can also press on the bile duct. But the tumor is going to grow very very slowly over a matter of years most likely. And now that bile duct has time to adapt and now it's going to create the same phenomenon but because it happens slowly there's no spasm and there's no pain. Sign number seven is pale stool. And this pale stool
13:01 can also be accompanied by the stool being greasy and floating known as staturatoria which means there's fat in the poop. And this builds on this mechanism that we just talked about that if the tumor starts exerting pressure now we can create a bile blockage. And this Billy Rubin is not just yellowy orange, but it's turns brown in the bowel. So that provides the brown color that we typically see in stool. But if the Billy Rubin doesn't end up going into the bowel, now we can end up with very pale stool. And then the second part of this is where we get greasy and floating stool with fat in it. And we need to remember that bile is an emulsifier. It helps disperse fat pieces into
13:54 much smaller pieces so that it's easier for the enzymes to act on them and digest it. So that's step one of fat digestion. So we could get a bile duct blockage. But step two separate mechanism is also we could get a pancreatic duct blockage. So you could see here from the gallbladder we have the hpatic ducts coming down together with the bile duct and they're all joining the pancreatic duct. So there's bile and liquids and enzymes from three different directions that join into this little tube and that empties out into the deadinum. And you see this little tree of vessels of ducts going through the pancreas. Well, that's where these little cells release.
14:45 They create their enzymes and they dump them into these little ducts and they all collect and come out this way. But anywhere along the way here, a tumor can grow and put pressure on these ducts so that the enzymes can't get out. And the pancreas is our main producer of digestive enzymes. So it makes proteasis, it makes amalasis and it makes lipase for fat breakdown. So no of course the pancreatic lipase could get blocked and now that second step of fat digestion would be reduced or eliminated. So we end up with a lot of undigested fat and fat floats on water. So now we end up with greasy and floating stool. But again, this is a fairly advanced stage because the tumor
15:34 had to be large enough to substantially reduce the flow of pancreatic enzymes. Number eight is midback pain. And this one is very different. First of all, it's based on your position. So, it's worse laying flat on your back. It is due to a larger tumor that is now directly invading the celiac plexus which is the a big nerve bundle that sits behind the pancreas. And this is different from the visceral pain that we talked about before because when it presses on ducts and blood vessels and capsules, the visceral pain is very diffuse and vague and poorly localized. Whereas now we're
16:21 directly invading nerves. So it's a sharp, deep, and well-defined pain. And this can be a boring ache that goes everywhere from the abdomen on back through to the midback. And like I said, this pain is worse when you're laying on the back because you're putting more direct pressure on it. And therefore, it could be reducing the pain if you lean a little bit forward or if you lay on the side and kind of curl up a little bit in a fetal position. Then you're moving away from that pressure. And number nine is blood clots. And these blood clots would be what we call migratory. They'll appear and then they resolve meaning they get dissolved by various blood enzymes
17:08 but then they happen again in maybe the same place maybe another place. A lot of times they're moving around these sensations. And the reason this happens is that tumors can release tissue factors. Those are signaling molecules that directly induce and activates clotting. And the pancreas tissue, pancreas tumors are especially prone to do this. And for the most part, you're going to experience this as DVT or deep vein thrombosis. And most often it's going to happen in the legs and in the calves. And what you would experience here would be swelling, heat, redness, and pain. And this would be when this happens. The reason we're thinking pancreas is if it happens in the
17:59 absence of the usual risk factors, which one some of the more common ones are going to be surgery, if you've had recent surgery, if you're coming off a long flight, if you've had any sort of injuries or if you've been immobilized for a longer time. And number 10 is weight loss or cexia. So, we mentioned that on number two, but this is a much more severe version of weight loss. Number two was where we could barely notice that you had to be really observant to catch it, but here it's very obvious and it happens at a much later stage. It's the same molecules that we talked about in number two. It's the TNF alpha and IL6. However, now it's to the degree on the scale that your whole
18:51 body metabolism gets hijacked. And here there is a severe and rapid loss of both fat and muscle. And the muscle, that's the key here because normally during starvation, if it's just a matter of the body not getting enough food and enough nutrients, it has mechanisms to protect and spare the muscle. But in this case, like we said, everything's been hijacked. So that stuff doesn't work anymore. And cexia actively breaks down body tissue, including muscle. And at this stage, it is very difficult to make people eat because they don't have much of an appetite. But even if you could, eating more wouldn't really help much because again, the metabolism has been hijacked. The body is actively
19:40 burning through tissue. And this is why it is so obvious and visible at this stage. There's visible wasting especially since the muscle is being degraded and broken down along with the fat. And this is not unique to pancreatic cancer. It's a sign of various forms of advanced cancer. Like I said initially, I think this is a very critical video to understand because none of these signs mean a whole lot by themselves, especially not on the early on the first half. And also, it's not a video you can skim through because you have to have an understanding beyond just the list. If someone looked at a list of these, then the first five would basically mean nothing. And yet this is
20:28 a cancer with very poor survival. And again, most of that, a lot of that is because the truly early signs where you could catch this in time to do something about it with great success are almost non-existent or they're very subtle. So, this would be a great video to share with people and to rewatch so you truly get it. If you enjoyed this video, you're going to love that one. And if you truly want to master health by understanding how the body really works, make sure you subscribe, hit that bell, and turn on all the notifications so you never miss a life-saving video.
