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More pancreatic cancer patients could receive surgery if treated faster

Posted by: Policy and campaigning 31 October 2018

Hundreds more early-stage patients with the quickest killing cancer could be eligible for surgery - the only potential cure - if avoidable delays to their treatment were removed according our new report.

Nearly two thirds (57 per cent) of stage one and stage two pancreatic cancer patients in England do not have surgery and the charity believes too many are being denied their only chance of survival because the extremely aggressive cancer spreads while they await treatment.

Over 800 pancreatic cancer patients diagnosed at stage one or stage two each year in England will not receive surgery despite the fact that a significant proportion should be eligible for this potentially life-saving or life-extending treatment. Our report reveals that pancreatic cancer patients who have surgery are ten times more likely to live for five years or more than patients who do not (22.3 per cent compared with 2.3 per cent). However, at least 90 per cent of all patients diagnosed with pancreatic cancer do not have surgery. Currently one in four people with pancreatic cancer in England die within a month of diagnosis.

The report coincides with the launch of our Demand Faster Treatment campaign, which urges the Government and devolved administrations across the UK to set a new ambition to begin treatment for all pancreatic cancer patients within 20 days of diagnosis by 2024. To help achieve this the report recommends the UK-wide roll-out of a fast-track surgery programme successfully piloted in Birmingham, which reduced the time to surgery from two months to just over two weeks.

Our new analysis shows that if even a modest increase in the proportion of patients receiving surgery (from the current rate of less than ten per cent, to just 15 per cent) was sustained over five years, it could give 2,100 more patients across the UK at least a year of precious time with their loved ones and potentially be lifesaving.

To help achieve the increase, we are calling for the introduction of accelerated treatment models for pancreatic cancer within the NHS similar to those which are already in place for more well-known cancers such as breast and prostate. This would include establishing one-stop clinics where patients can have all tests to determine their suitability for surgery in one place. Clinical nurse specialists would be recruited to coordinate with other NHS services addition to supporting patients.  Implementing both of these measures would significantly speed-up treatment decisions. The number of tests required, the wait for results, and the need to consult doctors from multiple specialisms due to the complexity of pancreatic cancer are major causes of delays in treating the disease when there is no time to waste. 

Diana Jupp, Chief Executive of Pancreatic Cancer UK, said: “The awful truth behind this report is that too many pancreatic cancer patients are being denied their only chance of survival because they are simply not being treated fast enough. One in four people diagnosed with this devastating disease die within a month, making it the quickest killing cancer. It’s so ferocious that patients cannot afford to wait.

“Our new analysis clearly shows that fast-tracking patients to surgery could, at least, give them more precious time with their loved ones and potentially save lives. However for that to become a reality it is imperative governments across the UK recognise that pancreatic cancer is an emergency. In recent years we have seen outstanding progress in other cancers such as breast and prostate, and a shocking lack of progress for pancreatic. We owe it to all those affected by pancreatic cancer to be more ambitious and make sure that everyone is treated within 20 days of diagnosis. 

“The team at University Hospitals Birmingham NHS Foundation Trust have proven that this is possible. Rolling-out their innovative approach to surgery across the UK can be cost-saving for the NHS and, most importantly, will significantly improve survival for the deadliest common cancer.”

The fast-track to surgery programme piloted by University Hospitals Birmingham NHS Foundation Trust (UHB) and we jointly funded found that the longer people waited for surgery to remove their tumour, the less likely they were able to have the operation, massively reducing their life-chances.  Of patients who waited 21 to 40 days for surgery, 15 per cent were then unable to have surgery; of patients who waited between 40 and 60 days, 24 per cent were then unable to have surgery. By reducing the time to surgery from two months to just over two weeks, the pilot increased the number of patients whose surgery was successful by more than a fifth (22 per cent). The programme was also more cost-effective, saving the NHS £3,200 per patient.

Consultant Hepatobiliary and Pancreatic Surgeon Keith Roberts and his team at UHB Foundation Trust focused on ways of reducing the time taken for eligible patients to have surgery, working 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).

Tom Adeney, 42, was diagnosed with pancreatic cancer in January 2018 after becoming jaundice. Fortunately his GP and doctors acted quickly and within three weeks of diagnosis he underwent Whipple’s surgery at The Royal Free Hospital to remove his tumour. He is now supporting Pancreatic Cancer UK’s campaign calling for all future patients to be treated as quickly as possible.

Tom said: “I was surprised by how quickly it happened but actually looking back I understand that time is of the essence and there wasn’t any time to waste. My friend and colleague also had pancreatic cancer and died earlier this year. It’s been tough because in comparison my story is much more optimistic. It only makes me realise how fortunate I was.

“The statistics are really daunting for people diagnosed with pancreatic cancer and I was so lucky that my cancer was picked up and I was able to have surgery so quickly. I’m still waiting to have a conversation with my oncologist about my latest scan. I don’t really know what to expect but they have said I have the chance of a ‘full life’ which would not have been the case if it was too late for me to have surgery.”

Survival for the incredibly tough disease has lagged behind other cancers since the 1970s, with less than 7 per cent of people with pancreatic cancer patients living for 5 years (5). UK survival for pancreatic cancer is behind that of European counterparts: Belgium and Germany have a five-year survival of 12 per cent and 11 per cent respectively.  

We are calling on the UK Government and devolved administrations to set a new ambition to treat all patients diagnosed with pancreatic cancer in 20 days by 2024.

To find out more about the Demand Faster Treatment campaign and sign the petition, visit: www.pancreaticcancer.org.uk/demandfastertreatment

If you or a loved one is affected by pancreatic cancer and would like to speak to a Specialist Nurse call 0808 801 0707 or email nurse@pancreaticcancer.org.uk.