Pancreatic Cancer - an end to nihilism

Sue lost her husband to inoperable pancreatic cancer in September 2003 at age 50. Unusually he did well surviving 27months after diagnosis. They experienced most treatments ie assessment for surgery, chemotherapy, laparoscopy, radiotherapy and immunotherapy and most known symptoms and complications eg pain , jaundice and stenting. However they had quality time in between treatment and despite excellent support from GP, palliative care consultant at local hospice and consultant oncologists and surgeons it was a constant battle against perception of incurable, untreatable cancer. Sue was determined to help raise the profile of pancreatic cancer and the need for more research funding and support for patients and families and formed Pancreatic Cancer UK in 2003.

It is time that priority is given to improving the survival rates for the high mortality cancers such as the digestive cancers pancreatic, oesophageal and stomach.

Pancreatic cancer has the lowest survival of any cancer - 1 year 13%, 5 year 2%. With 7000 deaths a year it is the 6th most common cause of cancer deaths in UK. Although recent improvements in treatment are encouraging, with better survival after surgery with adjuvant chemotherapy, and improved response rates for palliative chemotherapy, there is still much work to be done.

Research in pancreatic cancer has suffered from long term underfunding: pancreatic cancer has 5% of deaths from cancer but less than 1% of the NCRI spend on research.

The diagnosis is usually made too late for surgery due to lack of or non-specific symptoms. Many, even those in their 30s and 40s, can be too ill for treatment. Survival is often measured in weeks when the tumour cannot be removed. Even with surgery the cancer usually recurs within a few years.

Pancreatic cancer suffers from the perception that it is incurable and hard to work on and therefore it is not worth investing in research, diagnosis or treatment. This is no longer true.

Progress has been made in recent years with availability of microdissection techniques, proteomics and genetic profiling. Genes and proteins have been identified which offer potential for monitoring of high risk groups and early diagnosis. New treatments are becoming available such as vaccines and targeted therapy.

To build on these advances it is vital that increased resources are put into clinical and research infrastructure (such as tissue bank and laboratories), clinical audit, trials and research on diagnosis (especially pre-symptomatic), symptoms, novel treatments such as gene therapy, photodynamic therapy and immunotherapy and reasons for better response to treatment in certain patient groups as well as palliative care.

The existing pancreatic cancer research groups and specialists are eager to undertake more research and those affected by pancreatic cancer are keen to raise funds for research but this must be strengthened by a greater proportion of NCRI funds and increased government spending.