A pilot treatment pathway for pancreatic cancer increased the number of patients whose surgery was successful by more than a fifth (22 per cent), and saved the NHS an astonishing £3,200 per patient, research published in HPB Journal today (Tuesday 1st August) has found (1).
The pilot, funded by Pancreatic Cancer UK and held at University Hospitals Birmingham NHS Foundation Trust, reduced the average time to surgery from two months to just over two weeks.
Pancreatic Cancer UK says these results are incredibly exciting because if the pathway was rolled out UK-wide, each year it could see hundreds more patients having surgery which successfully removes their tumour. This is the one treatment for pancreatic cancer which can save lives. The charity says this would be a significant breakthrough for a cancer which has seen very little progress in treatments since the early 1970s.
Consultant Hepatobiliary and Pancreatic Surgeon Keith Roberts and his team focused on ways of reducing the time it takes for eligible patients to have surgery, to see if this meant that more of those patients had their tumour successfully removed.
The team worked with hospitals to speed up referrals for patients and reorganised the way surgery was carried out. They also cut out a treatment generally given to patients before surgery for the symptom of jaundice (yellow skin or eyes or itchy skin).They reduced the time to surgery from an average of 65 days to 16 days. This meant that 97 per cent of patients who were eligible for surgery went on to have the treatment successfully, compared to a current average of 75 per cent of eligible patients.
The savings to the NHS were made by cutting out the treatment for jaundice before surgery, as well as reducing complications and hospital readmissions after surgery.
Keith Roberts, who is also a member of Pancreatic Cancer UK’s Medical Advisory Board, said: “We have shown that it is possible to create a much faster path to surgery for pancreatic cancer patients within the NHS, which could have a significant impact on survival. We carried out surgery earlier, avoided unpleasant and costly pre-surgery treatment, and yet there was no significant increase in complications post-surgery. At University Hospitals Birmingham NHS Foundation Trust we hope to permanently fund the pathway, and I am sharing the results of our pilot far and wide, in the hope that more trusts will roll it out.”
Alex Ford, Chief Executive of Pancreatic Cancer UK, said: “These results are incredibly exciting. Surgery is the only treatment for pancreatic cancer that can save lives. If we can ensure that hundreds more patients have their tumour successfully removed each year, it could be a huge breakthrough in treatment.
“The exceptional element of this pilot is that it saved the NHS £3,200 per patient. If we could see this pathway rolled out across the board, those savings could be reinvested into specialist nurses who could make the journey to surgery even quicker. Those nurses would in turn be a game-changer for pancreatic cancer care, and create more savings for the NHS too. We urge NHS England and specialist health commissioners across the UK to take heed of these results and allow hundreds more patients each year to have potentially life-saving surgery far more quickly.”
Kate Rigby, aged 69 from Minsterley near Shrewsbury, is a pancreatic cancer patient who was fast-tracked to surgery as part of the pilot. She said: “Within a week of receiving my diagnosis, I had surgery to have my tumour removed. I barely had time to worry about undergoing such an extensive operation. I had jaundice, but this wasn’t treated prior to surgery and this hasn’t caused me problems. People, including friends in the medical profession, have been astounded about how quickly I’ve been able to receive my treatment and how well I’ve recovered.
“I had a myriad of support from the nurses both before and after the operation. Their professionalism and care was exemplary. It’s now been 11 weeks since my operation and I’m feeling amazing, I had my first round of chemotherapy this week. I’m so fortunate to have been fast-tracked and to have undergone a successful surgery. I hope more pancreatic cancer patients will be given the chance of receiving surgery as speedily as I did.”
Currently, just eight per cent of pancreatic cancer patients in the UK have surgery to successfully remove their tumour. This is because the vast majority of patients are diagnosed at an advanced stage, when surgery is not an option.
Less than seven per cent of pancreatic cancer patients will live beyond five years after diagnosis in the UK.
Pancreatic Cancer UK gave the team at University Hospitals Birmingham NHS Foundation Trusta grant of £50,000 through its Clinical Pioneers Awards. The scheme funds innovative research in a clinical or community setting which can benefit current patients and their families, as well as bring about the breakthroughs in diagnosis, treatment and care which must be delivered for the future.
(1) Keith J. Roberts et al, ‘A reduced time to surgery within a ‘fast track’ pathway for periampullary malignancy is associated with an increased rate of pancreatoduodenectomy’, published in HPB Journal, Tuesday 1st August 2017