A three-year study recently revealed the “outrageous” five-year survival of the most common type of pancreatic cancer - pancreatic ductal adenocarcinoma (PDAC). 
The research, commissioned by Pancreatic Cancer UK and carried out by the London School of Hygiene & Tropical Medicine, found that in England, just 3% of people with pancreatic ductal adenocarcinoma (PDAC) will live for five years or more; compared with a ten times higher five-year survival (34%) for patients with another type called pancreatic neuroendocrine tumours or PNET.

Although 95% of people with pancreatic cancer are diagnosed with PDAC, survival data has previously been published together with PNET. This has meant that the true survival for PDAC has appeared better than it really is; the most recent survival statistics for England show that less than 7% of patients overall will live for five years or more.

Pancreatic Cancer UK has labelled the survival of PDAC as completely unacceptable, and is determined to bring about urgent change for all patients to allow them to have a fairer chance of surviving, by calling for research investment into the disease to be increased as an absolute priority.

Currently, the disease attracts an unacceptable 2.1% of the annual UK cancer research budget.  With 60% of pancreatic cancer patients currently diagnosed at an advanced stage, the charity is also calling for far more patients to be diagnosed earlier, when the one potentially life-saving treatment of surgery may be an option.

Diana Jupp, Chief Executive of Pancreatic Cancer UK, said: “For the first time, our study has revealed the truly outrageous survival for the vast majority of people with pancreatic cancer. This survival is completely unacceptable and it simply cannot be ignored. Due to increased research investment, in recent years we have seen outstanding progress in other cancers such as breast and prostate, and a shocking lack of progress for pancreatic. But together, we can turn this around and transform the future for people affected. Now we are armed with a clear picture of this disease overall, it must be confronted as an emergency by Governments, research funders, and health commissioners alike."

The charity is also calling for data on pancreatic cancer to be broken down by type in addition to the overall figures about the disease from now on, to allow a more accurate picture of the disease in future, increase understanding as to why the prognosis for PDAC is so poor, and identify how to improve outcomes for patients. This will also enable progress to be tracked and inform the charity’s plans as it drives improvements in care and treatment to transform the future for everyone affected.

Symptom awareness

Clinical features of pancreatic cancer are notoriously vague and early diagnosis remains a major problem. 

Particular red flag symptoms of painless jaundice, pain, weight loss and new-onset diabetes should alert early investigation, especially in patients with relevant risk factors. Painless jaundice is commonly associated with head of pancreas tumours and jaundice in association with body or tail tumours usually represents advanced disease.

Diabetes mellitus is a presenting feature in up to 10% of cases, thus one should be clinically suspicious when treating elderly patients with new-onset diabetes.1

Breath analyses could offer new hope

Pancreatic cancer carries a very poor prognosis as most patients are diagnosed at an advanced stage. But a new BJS (British Journal of Surgery) study indicates that breath analyses may help detect pancreatic cancer earlier, when curative treatments may be possible.

For the study, investigators examined volatile organic compounds in breath samples from patients with localised and metastatic pancreatic cancers, compared with patients with benign pancreatic disease and some with a normal pancreas. Tests identified 12 compounds that were indicative of pancreatic cancer. These compounds were from three main chemical groups, namely aldehydes, alkanes and alcohols.

"The final application of breath testing in the patient care pathway will depend on test sensitivity and specificity in large multicentre clinical trials, and its performance in early pancreatic cancer and high-risk groups," the authors wrote.

New research group launched in Northern Ireland

A new awareness and research collaboration called NIPanC was launched yesterday in Northern Ireland that aims to promote better outcomes for pancreatic cancer sufferers in Northern Ireland.

1. https://www.gponline.com/clinical-review-management-pancreatic-cancer/palliative-end-of-life-care/palliative-end-of-life-care-cancer/article/1125653