Given that the main bile duct that drains the excretions form the liver runs through the head of the pancreas and that the majority of cancers of the pancreas arise in the head of the pancreas (that part that lies in the fold/curvature of the duodenum), it is not surprising that the commonest clinical presentation of this disease is with compression of the bile duct and the development of clinical jaundice.
The silent development of jaundice is always a suspicious sign to the doctor. Weight loss, loss of appetite and lethargy are common accompanying symptoms. Abdominal pain is common and this not infrequently goes through to the back; this last symptom suggests a degreee of spread locally into the surrounding tissues. Sometimes the cancer has spread to the liver at the time of diagnosis and some of the patient’s languor and ill health are due to metastatic cancer. Cancers of the body and tail (those parts away from the duodenum and bile duct system) usually present as larger tuours because obstruction of the bile ducts does not call them to attention sooner.
