Pancreatic cancer is tough to diagnose, tough to treat and tough to research. Ultimately, this makes it tough to survive.
Around 10,000 people in the UK are diagnosed with pancreatic cancer each year – around 800 of whom are in Scotland. Like many cancers, these diagnoses are often made too late. However, for pancreatic cancer, there are many unique challenges that act as major barriers to improving rates of diagnosis and, consequently, improving survival:
- It is unclear what causes pancreatic cancer. It is linked to certain risk factors (for instance, smoking and obesity appear to disproportionately increase the risk, and the risk also appears to increase if one or more family members have had pancreatic cancer), but there is little evidence to identify specific causation – and therefore, it is a difficult cancer to specifically try to prevent.
- It is a difficult cancer to spot. The symptoms of pancreatic cancer are vague and non-specific – such as abdominal pain, weight loss, changes in bowel habits and jaundice. Many people are unaware that these may be the signs of pancreatic cancer. As a result, people with pancreatic cancer may delay visiting a GP and, when they do, it may take multiple visits until they are referred with suspected pancreatic cancer. Around half of pancreatic cancer patients visit their GP with their symptoms 3 times before being referred to hospital, whilst 16% visit their GP 7 times or more before receiving the correct diagnosis.
- A lack of early detection tools can be fatal: There is not a simple early detection test or screening programme for pancreatic cancer. By the time a diagnosis is made, it is highly likely the cancer will be at a late stage. Unless it is diagnosed early, it is very likely that a person’s tumour will be inoperable.
- Treatment is rare and surgery is the only curative solution: Surgery to remove the tumour – often removing most of the pancreas – is the only possible way to ‘cure’ pancreatic cancer; other treatments – like chemotherapy and immunotherapy – can help manage the cancer and can try to slow the growth of the tumour, so that surgery becomes an option. But because it’s often diagnosed late, it’s typically too late to treat. 7 in 10 people with pancreatic cancer will never receive any treatment and only 1 in 10 will receive surgery. Sadly, this means the survival rate remains poor and deaths often happen very quickly.
- It is not a research priority: As a consequence of the speed of mortality, there are impacts on the quality and quantity of research into pancreatic cancer and on the number of patients able to participate in clinical trials. This has led to pancreatic cancer being historically underfunded and a lack of research breakthroughs to better understand the disease and to develop better, faster methods of diagnosis and treatment.
Key statistics on pancreatic cancer:
- Pancreatic cancer is the deadliest common cancer in Scotland.
- The five-year survival rate in Scotland is only 5.6%. For other, more survivable cancers, the average five-year survival rate is 69%.
- Despite only being the 12th most common cancer in Scotland, pancreatic cancer is responsible for the 6th highest number of cancer deaths in Scotland – a significant disproportionate impact.
- Less than 20% of people with pancreatic cancer are diagnosed at an early stage.
- Less than 10% of people with pancreatic cancer receive surgery – the only treatment which could save lives
- Two-thirds of people in the UK cannot name a single symptom of pancreatic cancer.
Improving survival in Scotland
The Scottish Government published its five-year strategy to improve cancer services, Beating Cancer: Ambition and Action, in 2016. The strategy places very welcome priority on improving survival and sets a specific ambition to “reduce variation as much as is possible in survival rates in different types of cancer”. However, as the least survivable cancer, pancreatic cancer is in desperate need of dedicated action and specific targets if we are to make any progress in improving survival.
With Scotland’s cancer strategy having passed its halfway point, it is a key time to assess success and identify future priorities. Following the absence of targeted action on the least survivable cancer by governments in every nation in the UK, it is important that any future action reflects the unique needs and challenges of pancreatic cancer to ensure it does not continue being left behind.
Scotland has a major opportunity to lead the way on pancreatic cancer survival. Researchers in Scotland are leading the way in developing new exciting approaches to tackle pancreatic cancer, particularly through the Precision Panc programme based in Glasgow – which Pancreatic Cancer UK is delighted to be the patient engagement partner for. Pancreatic Cancer UK also chose Scotland as the location for our first ever Future Leader’s Academy, which we fund at the Beatson Centre, to further drive our ambition to attract the next generation of bright minds into the pancreatic cancer field.
We are urging the Scottish Government to develop a national plan for pancreatic cancer – a plan to boost research, transform treatment and care, and raise awareness of symptoms. By taking targeted, coordinated action on these three issues, we will be able to improve survival rates that have otherwise barely improved for five decades.
We know that change is possible. When governments and the clinical community come together to prioritise less survivable and historically neglected cancers, survival can improve. Pancreatic Cancer UK’s ‘Demand Survival Now’ report sets out a blueprint to act on the three cornerstones of cancer care: symptom awareness, treatment and care – from diagnosis to post-treatment support, and research. We welcome all support for adopting and implementing our recommendations.