Carcinoma of the pancreas in nonjaundiced patients. A silent disease

This report deals with the study of 25 patients with carcinoma of the pancreas without jaundice. Carcinoma of the pancreas is the fourth most common cause of death among men who suffer from cancer. The extremely high mortality associated with pancreatic cancer is due to failure of early diagnosis. Those cases associated with obstructive jaundice can be diagnosed much earlier than those in which jaundice is absent. In the absence of jaundice, symptoms and signs of pancreatic cancer are so vague that they may be confused with those of other conditions. Routine laboratory tests aid little in the definitive diagnosis of the disease. Sophisticated new modalities of diagnosis such as ultrasonography, endoscopic retrograde cholangiopancreatography (ERCP), and CT-scanning frequently will lead to a correct diagnosis, but these tests are seldom performed unless there is a strong suspicion that carcinoma of the body of the pancreas exists. When pancreatic carcinoma without jaundice is ultimately diagnosed, it is found to be less amenable to surgery than lesions located in the head where early jaundice is more often encountered. Most patients with cancer of the body of the pancreas suffer from persistent unexplained abdominal pain, marked anorexia, and weight loss. Such patients must be subjected to sophisticated diagnostic tests in order to arrive at an early diagnosis.