The symptoms of pancreatic cancer are usually ignored. Here is what you should know

    27 August 2015

    The pancreas is a leaf-shaped gland about 10 centimetres long situated just under the stomach. It produces digestive juices in addition to insulin (which controls blood sugar) and some other hormones.

    Pancreatic cancer is the fifth most common cause of cancer death in Britain. Unfortunately very few people currently survive with pancreatic cancer for more than five years because the disease is diagnosed too late.

    Some pancreatic cancers might result in jaundice — yellowing of the eyes and skin due to the drainage of bile from the liver being blocked. But, quite often, the initial symptoms of pancreatic cancer are non-specific — for example, stomach pain or discomfort, unexplained weight loss, sickness or loss of appetite — and are frequently disregarded.
    So what can be done to help to beat pancreatic cancer?

    1. Know your risks
    Pancreatic cancer is more common in men, cigarette smokers and individuals over the age of 45 years. Poor diet, lack of exercise, diabetes and obesity also increase the chances of developing pancreatic cancer.

    Pancreatic cancer runs in some families. It is estimated that up to 10 per cent of pancreatic cancer cases may have a hereditary element.

    2. Consider the possibility
    According to a review published in the British Medical Journal the diagnosis of pancreatic cancer should always be considered, and ruled out if possible, in:
    • Individuals who are jaundiced
    • Individuals who have recently developed diabetes (or been told by their doctor that they have impaired glucose tolerance)

    3. Don’t trust routine abdominal ultrasound
    It can be quite difficult to see small pancreatic cancers using conventional abdominal ultrasound scanning unless the individual is very thin. Therefore, if there is a concern, other — better — tests should be undertaken such as computed tomography (CT) scanning, magnetic resonance imaging (MRI) or endoscopic ultrasound.

    4. Consider CA19-9 blood testing
    CA19-9 is a substance released into the blood by pancreatic cancer cells. Low amounts of CA19-9 can be detected in healthy people but higher levels are associated with eight out of 10 pancreatic cancers.

    CA19-9 testing can be helpful in trying to assess the significance of vague symptoms such as stomach pain/discomfort, unexplained weight loss, sickness and loss of appetite. Research from Japan has shown that for every 1,000 people with such symptoms tested for CA19-9, 16 pancreatic cancers were identified with five of these being treatable by surgery.

    Although the CA19-9 test is not currently recommended as a routine screening test for pancreatic cancer, it might be considered by people at heightened risk for the disease, such as those with a family history of pancreatic cancer.