Jaundice: When Yellow Skin Is a Warning Sign

Jaundice — the yellowing of the skin and whites of the eyes — is a symptom that demands attention. In Pakistan, where liver disease is widespread, recognising jaundice and understanding when it may indicate cancer is vital.

What is jaundice? Jaundice occurs when bilirubin (a yellow pigment produced when red blood cells break down) builds up in the blood. It causes yellowing of the skin, eyes, and mucous membranes, along with dark urine and pale stools.

Cancer-related causes of jaundice:

• Liver cancer
• Pancreatic cancer (most common cancer cause of painless jaundice)
• Gallbladder cancer
• Bile duct cancer (cholangiocarcinoma)
• Lymphoma pressing on bile ducts

Red flag features suggesting cancer:

• Painless jaundice (especially in an older adult)
• Progressive worsening over weeks
• Significant weight loss
• No fever (helps distinguish from infection)
• Pale stools + very dark urine

What to do: Any new jaundice in an adult requires urgent blood tests (liver function tests, hepatitis screen) and imaging (ultrasound). In Pakistan, ultrasound is widely available and should be the first investigation.

Key message: Painless, progressive jaundice in a middle-aged or older adult must be investigated for cancer — particularly pancreatic or liver cancer. Don't delay.