Silent for many months, pancreatic cancer causes nearly 16,000 deaths in France each year, according to the National Cancer Institute (INCa). His big flaw? It is generally discovered at a (too) advanced stage. However, it can also manifest itself by an unexpected, little-known sign: pain in the legs. Dr. Gérald Kierkek, emergency physician, explains why deep vein thrombosis – or phlebitis – can be the first warning sign.
When the leg sends a warning signal
Leg pain, often accompanied by swelling, redness or a feeling of warmth, is a typical sign of phlebitis. This blood clot that forms in a vein may seem benign, but it should be taken very seriously. This complication, called deep vein thrombosis, can even be complicated by a pulmonary embolism if a fragment of the clot breaks off and migrates towards the lungs. This is therefore a vital emergency.
But sometimes it can be a warning sign for another illness. According to the American Cancer Society, it happens that “The first clue that a person has pancreatic cancer is a blood clot in a large vein, often in the leg. Questioned, Dr. Gérald Kierzek, emergency physician, confirms: “venous thrombosis (or phlebitis) can be a warning sign, sometimes the first, of an underlying cancer”
Why does the pancreas cause clots?
This surprising link between the pancreas and the leg veins can be explained by several biological mechanisms. As Dr. Kierzek describes, pancreatic cancer cells can secrete substances that change the blood. “Cancer cells, especially those in the pancreas, can produce substances that thicken the blood and make it more likely to form clots. This is called a pro-thrombotic state. he specifies.
Added to this is the location of the pancreas, deeply buried in the abdomen. A tumor growing there can put pressure on certain large veins, slowing the flow of blood. This slowdown then promotes the formation of clots, particularly in the legs or in the abdominal veins. “A pancreatic tumor, due to its position, can physically compress large veins and thus promote thrombosis. adds the doctor.
Finally, it is often the “spontaneous” occurrence of phlebitis – without apparent cause, without immobilization, or long journey – which alerts the doctor. “Phlebitis that occurs without an obvious risk factor should raise alarm. It can be the first visible manifestation of a still silent cancer. insists Dr. Kierzek.
When phlebitis should worry
However, the expert reminds us: phlebitis can occur in anyone! But some situations are more suspicious than others. “When it appears without an identified cause, when it recurs, or when it manifests itself at an advanced age, it must lead to a more in-depth evaluation”he emphasizes. Even more so if it is accompanied by other discreet signs:
- Weight loss;
- Unusual fatigue;
- Digestive disorders;
- Persistent abdominal or back pain;
- Jaundice.
But this concern is for your doctor to bear in mind. “It is undoubtedly up to the doctor to carry out the investigation and direct the research. It is even a classic reflex when faced with unexplained phlebitis” he reassures. The goal is not to scan blindly, but to move forward methodically.
According to Dr. Kierzek, in such a case, your doctor will begin with a detailed history, looking for possible associated symptoms, before prescribing a complete biological assessment. This may include the blood count and the dosage of the tumor marker CA 19-9, often elevated in cases of pancreatic cancer.
Depending on the results, an abdominal ultrasound, a CT scan or an MRI can then be considered to confirm or rule out cancer.
Better listen to body signals
This possible “messenger pain” in the leg is a reminder of how the body sometimes sends early signals that should not be neglected. “Phlebitis is not directly caused by cancer, but it is a frequent and sometimes revealing consequence. summarizes Dr. Kierzek.
So, leg pain, swelling or a feeling of heat, especially without an obvious cause, always merits medical advice. If this symptom can have many other origins, it could also be the key to early diagnosis. And in the case of pancreatic cancer, where every month counts, recognizing these subtle signs can really make a difference.
FAQ – Phlebitis and pancreatic cancer
Can phlebitis really reveal pancreatic cancer?
Yes. Phlebitis occurring without apparent cause (travel, immobilization, trauma) should alert you. Pancreatic cancer can make the blood “thicker,” leading to the formation of clots. It is sometimes the first visible sign of a still silent cancer. A complete medical evaluation is then necessary.What other signs should prompt you to consult?
In addition to phlebitis, certain discreet symptoms can guide the diagnosis: fatigue, weight loss, persistent abdominal or back pain, jaundice. Their gradual appearance should prompt consultation. Only a doctor will be able to link these signals to a specific cause.What to do if you have pain or swelling in your leg?
Don’t wait. Consult quickly to rule out phlebitis. A clinical examination, a venous ultrasound and sometimes a blood test can confirm the diagnosis. If no cause is identified, the doctor may look for a deeper origin, in particular pancreatic cancer.