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Guidelines updated for the diagnosis and treatment of pancreatic cancer

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The National Institute for Health and Care Excellence (NICE) have updated their guidance on diagnosis and treatment of pancreatic cancer.

Pancreatic cancer is the fifth leading cause of cancer deaths in the UK. It mainly affects people who are between 50 and 80 years of age. NICE estimate that about 23 people die every day from this type of cancer. Its symptoms can be similar to many other conditions, meaning that diagnosis can often be difficult to pick out, and patients are consequently often diagnosed late.

NHS Choices advise that symptoms can include:

  • Pain in the back or stomach area. This may come and go at first, and is often worse when you lie down or after you’ve eaten;
  • Unexpected weight loss;
  • Jaundice. The most obvious sign is yellowing of the skin and the whites of the eyes. It also causes your urine to be dark yellow or orange, and your faeces to be pale-coloured.
  • Nausea;
  • Vomiting;
  • Bowel changes;
  • Fever and shivering;
  • Indigestion;
  • Blood clots;
  • Symptoms of diabetes.

NHS Choices says that diagnosis usually involves a physical examination by your GP and some questions about your general health. They will check your skin and eyes for signs of jaundice and may request a urine sample and a blood test. If your GP suspects pancreatic cancer, you would usually be referred to a specialist at a hospital for further investigation. These investigations include ultrasound scans, a computerised tomography (CT) scan, a magnetic resonance imaging (MRI) scan, or a positron emission tomography (PET) scan.

NICE published guidance in 2015 to help GPs recognise the signs and symptoms of cancer, and refer people for the right tests more quickly.

The guidance for diagnosis and management of pancreatic cancer in adults has been updated again in February 2018. NICE now recommends that clinicians use a more accurate scan (the PET scan) sooner, to diagnose and determine the stage of pancreatic cancer in patients. The aim is to remove the tumour completely and any other cancerous cells. However, if it is apparent that the cancer is inoperable, NICE estimate that this scan will result in a 20% reduction in surgery to remove the cancer, limiting unnecessary surgeries and their damaging side effects for patients.

The guidance also recommends that people who have two or more close relatives, e.g. siblings, children or parents with pancreatic cancer or lynch syndrome are checked regularly due to their inherited higher risk of the disease.

NICE also recommend an increased level of psychological support, to help patients who are suffering from anxiety or depression.