Which symptom might indicate pancreatic cancer when present with jaundice?

Jaundice occurs when there is a buildup of bilirubin in the bloodstream, often due to obstructed bile ducts. In the context of pancreatic cancer, the presence of jaundice is particularly significant because the tumor can block the bile duct due to its location in the abdomen. Itchy skin is known as pruritus, which can be caused by the accumulation of bile salts in the bloodstream when bile cannot flow normally. Therefore, when jaundice is present alongside itchy skin, it can be a strong indicator of a potential issue with the liver or bile ducts, such as pancreatic cancer.

The other symptoms listed—painful urination, weight gain, and increased appetite—are not typically associated with pancreatic cancer and jaundice. Painful urination is more likely related to urinary tract issues, weight gain may occur for various metabolic reasons but does not correlate directly with pancreatic conditions, and increased appetite is not a common symptom of cancer, where appetite loss is more prevalent. Thus, itchy skin serves as a direct connection to the bilirubin buildup and is a pertinent symptom in the context of diagnosing pancreatic cancer.