Pancreatic cancer

Symptoms of pancreatic cancer may be absent or difficult to detect since it may be asymptomatic (cause no symptoms) in its early stages. The following symptoms typically only occur as the cancer progresses:

• nausea or vomiting
• problems with digestion or other bowel changes, including abnormal stools, diarrhoea or constipation
• upper abdominal pain and back pain
• indigestion symptoms, such as feeling bloated
• loss of appetite
• sudden or unintentional weight loss
• jaundice, with yellowing of the skin and whites of the eyes, and sometimes itchy skin.
• very high glucose levels in diabetics

Some of these symptoms, however, may be similar to another condition, such as irritable bowel syndrome, and some people may become used to them or put them down to getting older. However, if these symptoms occur more frequently, change, worsen, or do not feel normal to you, you must get medical advice from your doctor as soon as possible. This is especially the case if you show signs of jaundice (the whites of your eyes or skin turn yellow), are sick for more than 48 hours, have diarrhoea lasting more than 7 days, or develop dark urine and pale coloured stools (poo).

The causes of pancreatic cancer are not well known but there are certain factors that increase the risk including smoking, being over 75, diabetes (remember that the vast majority of people with diabetes do not get pancreatic cancer), obesity, chronic pancreatitis and a family member with pancreatic cancer. Some inherited cancer syndromes can cause it, although this is uncommon.

If your GP suspects pancreatic cancer, they will refer you urgently to a hospital team for further investigations. They may order blood tests in the meantime to check your liver and certain markers that show if the pancreas is under stress or not working properly. The specialist gastroenterology team will examine your abdomen, and they will order an appropriate scan – such as an ultrasound, PET scan or MRI scan. You may also have a procedure to get a biopsy (a sample of pancreatic tissue) and you might have a procedure called an ERCP (endoscopic retrograde cholangiopancreatography) which is a combination of X-rays and a camera test via a tube passed from the mouth into the small bowel.

This will help inform the doctor the extent and severity of the pancreatic cancer if present.

The treatment of pancreatic cancer depends on the location, size, type, spread and grade of cancer, and someone’s overall health.

Surgery may be offered to remove cancer if it’s detected early although most pancreatic cancers are unfortunately not amenable to this. Chemotherapy can also be used to treat early cancer, control symptoms, to reduce the size of a tumour before surgery, or reduce the spread after surgery. Radiotherapy is sometimes but not often used alongside other therapies.

Pancreatic cancer can difficult to treat and treatment options are sometimes rather limited. In this case, supportive care may be offered to help manage and control symptoms and your specialists will talk to you about what treatment options are best for you.

Around 1 in 5 people diagnosed will survive to the first year after diagnosis, 3 in 100 live for five years or more and 1 in 100 survive for 10 years or longer.

Pancreatic Cancer UK is a charity that offers information, support, and it raises funds for research.