Pancreatic cancer is a cancer that starts in the pancreas, the organ involved in digestion and hormone secretion. In the UK, more than 10,500 people are diagnosed with pancreatic cancer each year.
Here, renowned consultant general surgeon Mr Charles Imber provides an expert insight into pancreatic cancer. The London-based specialist discusses symptoms, diagnosis, advances in treatment, and more.
What are the early signs and symptoms of pancreatic cancer?
Early signs and symptoms of pancreatic cancer can be vague and easily mistaken for other conditions. However, they may include:
- jaundice (yellowing of the skin and eyes), which can be associated with itching, dark urine, and pale stools.
- abdominal or back pain
- unexplained weight loss
- loss of appetite
- digestive problems, such as nausea, vomiting, or changes in stool
- new-onset diabetes or worsening of existing diabetes
- blood clots
It is important to note that these symptoms can be caused by non-cancerous conditions as well, so a proper medical evaluation is necessary for an accurate diagnosis.
How is pancreatic cancer diagnosed, and what tests are commonly used?
Pancreatic cancer is typically diagnosed through a combination of medical history review, physical examination, and various tests.
Commonly used diagnostic tests for pancreatic cancer include:
- Imaging tests: These include CT scans, MRI scans, ultrasound, and sometimes PET scans. These tests can help visualise the pancreas and detect any abnormalities or tumours.
- Biopsy: A biopsy involves taking a tissue sample from the pancreas for examination under a microscope. This can be done through a fine-needle aspiration or surgical biopsy. It is not always necessary to confirm the diagnosis with a biopsy prior to surgery, and I often operate without a tissue diagnosis if the imaging is typical so as not to delay treatment.
- Blood tests: Certain blood tests can help evaluate pancreatic function and identify specific tumour markers associated with pancreatic cancer, for example CA 19-9
What are the treatment options for pancreatic cancer?
The treatment options for pancreatic cancer depend on several factors, including the stage and location of the cancer, and the overall health of the patient. Treatment approaches may include:
- Surgery: If the cancer is localised and has not spread, surgery to remove the tumour (a pancreaticoduodenectomy or a distal pancreatectomy) may be an option. More and more, I am able to offer minimally invasive surgical techniques, including laparoscopic and robotic surgery.
- Radiation therapy: This treatment uses high-energy X-rays or other particles to destroy cancer cells or reduce tumour size. Radiation therapy can be used before surgery (neoadjuvant), after surgery (adjuvant), or for palliative purposes. I am able to offer high-dose MR-Linac therapy, which is a very accurately-targeted, high-dose treatment.
- Chemotherapy: This treatment uses drugs to kill cancer cells or to inhibit their growth. Chemotherapy may be used before or after surgery, or in cases where surgery is not possible. I am now able to downstage a locally advanced cancer involving major blood vessels with a combination of chemo-radiotherapy prior to an operation (neo-adjuvant treatment). This has an added bonus of selecting out the patients that benefit most with surgical treatment.
- Targeted therapy: These medications target specific abnormalities or genetic mutations in cancer cells to disrupt their growth and survival.
What are the survival rates for pancreatic cancer?
Pancreatic cancer has a relatively low survival rate compared to other cancers. However, survival rates can vary depending on the stage of cancer at diagnosis and the patient's overall health.
According to the American Cancer Society, the overall five-year survival rate for pancreatic cancer is around 10 per cent. However, it is important to note that survival rates are statistical averages, and individual cases may vary. With newer approaches to treatment, a greater proportion of patients are achieving successful surgical resection.
Are there any new advancements or emerging treatments for pancreatic cancer?
Research in pancreatic cancer treatment is ongoing, and there have been some advancements and emerging treatments. These include:
- Immunotherapy: This approach uses drugs to help the immune system recognise and attack cancer cells.
- Targeted therapies: New targeted therapies are being developed to specifically target genetic mutations or abnormal proteins in pancreatic cancer cells.
- Personalised medicine: Advances in genetic testing allow for a more personalised approach to treatment, identifying specific genetic alterations in a patient's tumour and tailoring treatment accordingly.
- Clinical trials: Participation in clinical trials provides access to innovative treatments that are being tested and that can potentially improve outcomes.
It is important to consult with healthcare professionals and specialists who can provide the most up-to-date information on advancements in pancreatic cancer treatment.
Mr Charles Imber is a leading consultant general surgeon with over 20 years’ experience.
If you require expert treatment and management for pancreatic cancer, do not hesitate to reach out to Mr Imber via his Top Doctors profile today.