Research published in The Lancet Gastroenterology & Hepatology shows there are no initial warning signs for pancreatic cancer, but as symptoms evolve there are a range of subsequent symptoms that predict a diagnosis including jaundice, change in bowel habit and weight loss. This is the first research project worldwide that has looked at symptoms and diagnostic intervals in people before they are diagnosed with pancreatic cancer.
Pancreatic cancer has the worst survival rate of the ten most common cancers. Just 5% of patients survive five years after diagnosis. Pancreatic cancer is very difficult to diagnose, with the majority of patients only diagnosed when the disease has spread.
The charity Pancreatic Cancer Action part-funded the research led by Dr Fiona Walter at the University of Cambridge. The study looked at the symptoms of 391 people who had been referred to hospital on suspicion of pancreatic cancer. Of these patients, 30% were diagnosed with pancreatic cancer, 12% with other cancers and 58% with no cancer.
The study found no initial symptoms that could predict a pancreatic cancer diagnosis, but it found a number of subsequent symptoms that predicted pancreatic cancer, including jaundice, fatigue, change in bowel habit, weight loss, decreased appetite, indigestion and 'feeling different'. Other symptoms, such as back pain, nausea or vomiting, and a change in urine or stool colour, were less commonly experienced and not predictive of pancreatic cancer among the study's participants.
The research found that the time it took for people to be diagnosed depended on other medical conditions and the symptoms they presented with. People with jaundice and decreased appetite as their first symptoms took less time to diagnose, but people with other illnesses such as diabetes and mental health problems took longer.
''GPs and hospital doctors should all have an increased awareness of the risk of pancreatic cancer among people with diabetes and beware of misattributing potential symptoms of pancreatic cancer in those with mental health problems," said Fiona Walter, GP and Principal Researcher in Primary Care Cancer Research at the University of Cambridge, who led the study.
The results of this study mirror the experience of Ali Stunt, the founder and CEO of Pancreatic Cancer Action, and a rare survivor of pancreatic cancer. Aged 40, she was diagnosed with type 2 diabetes, despite having no obvious risk factors; a year later she experienced excruciating back pain, weight loss and a change in her bowel habit. It took six visits to the doctor over an eight week period before she was finally referred to a pancreatic surgeon, who confirmed a diagnosis of pancreatic cancer.
"I hope this research will raise awareness among people and medical professionals about the variety of warning signs for pancreatic cancer. It's only by going to the doctor earlier and getting a quicker diagnosis that we can improve the appalling survival rates for pancreatic cancer, "said Ali.
November is Pancreatic Cancer Awareness Month. On 7 November, Pancreatic Cancer Action launched a nationwide advertising campaign to raise awareness of the symptoms of pancreatic cancer. The adverts will be shown in service stations, railway stations and shopping centres across the UK, as well as in regional newspapers and online. For more information, see wwww.pancreaticcanceraware.org.
Article: Symptoms and patient factors associated with diagnostic intervals for pancreatic cancer (SYMPTOM pancreatic study): a prospective cohort study, Dr Fiona M Walter, MD, Katie Mills, PhD, Silvia C Mendonça, MSc, Gary A Abel, PhD, Bristi Basu, PhD, Nick Carroll, FRCR, Sue Ballard†, John Lancaster†, Prof William Hamilton, MD, Prof Greg P Rubin, PhD, Prof Jon D Emery, DPhil, The Lancet Gastroenterology & Hepatology, doi: 10.1016/S2468-1253(16)30079-6, published 4 October 2016.