Pancreatic Cancer

Survival rates for pancreatic cancer are sadly low.

This makes getting timely investigations and treatment when symptoms develop absolutely vital in order to give patients as much time with their loved ones as possible.

The pancreas is a large gland that is part of the digestive system and has two primary functions:

1. It makes pancreatic juices which contain enzymes. These help to break down food so that the body can absorb it. The juices flow down a tube called the pancreatic duct, which runs the length of the pancreas and empties into the duodenum (first part of the small intestine).
2. The pancreas also makes hormones, including insulin which control sugar levels in the blood.

Both of these functions can be affected if the pancreas is not working properly.

Symptoms

Part of the reason why survival rates for Pancreatic cancer are poor is that in the early stages a tumour does not usually cause any symptoms. This makes it particularly difficult to diagnose.

The first noticeable symptoms are often:

• Pain in the back or stomach area which may come and go at first and is often worse when lying down or after eating
• Unexplained weight loss
• Jaundice (yellowing of the skin and whiteness of the eyes. It can also cause urine to be dark yellow or orange, faeces to be pale and skin to be itchy)
• Nausea or vomiting
• Changes in bowel movements
• Fever and shivering
• Indigestion
•  Blood clots

Pancreatic cancer can also cause the symptoms of diabetes to develop. This is because the tumour can stop the pancreas producing insulin as it normally would.

Diagnosing pancreatic cancer

A GP will firstly ask about the symptoms and then should carry out a physical examination of your abdomen checking for a lump or to see if the liver is enlarged. They will check for signs of jaundice and take a urine and blood sample. A referral to hospital should be made for anyone over 40 with jaundice.

A CT scan should performed if you are over 60 and have weight loss with any one of the following symptoms: back or abdominal pain; diarrhoea or constipation; nausea or vomiting; or new-onset diabetes.

If cancer is suspected and you should be seen in the hospital within two weeks.

Monitoring in high risk groups

In about 1 in 10 cases pancreatic cancer is inherited. It is also thought that certain genes can increase the risk of developing the condition. If you have two or more close relatives who have had pancreatic cancer, or you have an inherited disease such as Lynch or Peutz-Jeghers syndrome, your doctor is likely to recommend regular check ups as there may be an increased risk of pancreatic cancer.

Treatment

Depending on the extent of disease, some people may be offered chemotherapy or surgery, but only 8% of cases will be suitable for surgery. Due to the generally poor prognosis in cases of pancreatic cancer, NICE Guidance also recommends offering pain management and psychological support.

Early stage cancer

Early stage cancer is defined as a tumour that has not spread outside the pancreas and surgery is possible. Of those early stage cancers, between 7% and 25% of all cases will survive for 5 years or more.

Advanced stage cancer

An advanced cancer is one that has spread beyond the pancreas into surrounding tissues is called locally advanced cancer or stage 3. It probably cannot be removed by an operation but you may be offered chemotherapy if you are well enough to tolerate it. The median survival in this group is about 6-11 months.

Where the cancer that has spread to another part of the body (known as stage 4 or metastatic disease), the median survival is between 2 and 6 months. This can vary depending on how much the cancer has grown and where it has spread.

Causes

It is not fully understood what causes pancreatic cancer, but a number of risk factors for developing the condition have been identified.

•  Age: The risk of developing pancreatic cancer increases with age. In the UK, almost half (47%) of people diagnosed with pancreatic cancer are aged over 75.
•  Smoking: Smoking causes nearly 1 in 3 pancreatic cancers (29%) in the UK. This risk increases the more you smoke and the longer you have smoked for. It is also thought that stopping smoking can reduce the risk of pancreatic cancer. After 5-10 years after stopping smoking, your risk may return to what it would have been had you never smoked.
• Being Overweight: Being overweight or obese increases the risk of pancreatic cancer. 1 in 8 (12%) of cases are thought to be related to being overweight or obese.

The reason behind the poor prognosis of this type of cancer is because diagnosis in the early stages is hampered by the lack of symptoms.

How can we help?

If you think that you or a friend or family member has suffered from a delay in diagnosis of pancreatic cancer and has suffered as a result, you may be able to claim compensation.

As well as providing redress for mistakes made, we believe that raising concerns about treatment and claiming compensation is important to raise awareness and improve learning in hospitals and GP Surgeries. Our specialist team will guide you through the process from beginning to end.