New recommendations to help diagnose pancreatic cancer earlier

Recommendations to support the early diagnosis of pancreatic cancer are now available to Australian GPs, thanks to a project led by researchers at QIMR Berghofer Medical Research Institute.

Pancreatic cancer is a leading cause of cancer death in Australia, with most people being diagnosed after the disease has spread.

The new recommendations aim to support doctors to pick up these cancers earlier, by providing advice about which patients should undergo specific investigations of their pancreas, based on combinations of their symptoms and risk factors.

“The symptoms of pancreatic cancer are often very non-specific,” explains Professor Rachel Neale from QIMR Berghofer.

“Someone who presents with abdominal pain is much more likely to have another less serious condition, but if you combine that symptom with other issues like a history of smoking or heavy drinking or obesity, investigation of the pancreas may be warranted.

“There can be a lot of distress when there has been a delay in diagnosis, because patients feel they haven’t been given a decent chance to fight the disease,” Professor Neale said.

The Director of the Jreissati Family Pancreatic Centre in Melbourne, Associate Professor Andrew Metz, said the new recommendations could help save lives and reduce distress.

 “Data shows pancreatic cancer patients have presented to their GP between three to six times before pancreatic cancer has been considered,” Associate Professor Metz said.

“That’s not a criticism. There is so much overlap between the symptoms of pancreatic cancer and more common, but much less serious, diseases. Symptoms like stomach pain, bloating, loose bowels, loss of appetite, or feeling nauseous occur in most patients that present to GPs with conditions affecting their gastrointestinal system, such as irritable bowel disease.

“It really is a case of finding the few people who have pancreatic cancer from among the many people who present with other conditions.”

Michelle Stewart, the CEO of PanKind, The Australian Pancreatic Cancer Foundation, said the recommendations supported GPs to use their own clinical judgement in determining whether the pancreas should be investigated.

“The average time from pancreatic cancer diagnosis to death is just five short months, so every moment is crucial for patients and their families,” Ms Stewart said.

“Earlier diagnosis will give patients and their families time to access treatment and adjust to the realities of the disease.”

Volunteers Needed

Australians diagnosed with pancreatic cancer are encouraged to contact QIMR Berghofer Medical Research Institute to take part in the next stage of research.

Researchers are looking to recruit several hundred pancreatic cancer patients to better understand how patients can receive rapid and efficient diagnosis in the future.

“Implementing our current recommendations will certainly improve diagnosis rates but what we need now is more data about the range of early symptoms experienced by patients, and about what happened between early symptoms and final diagnosis,” Professor Neale said.

Anyone interested in participating in the Pathways Study can call 1800 344 007 or register their interest at https://www.qimrberghofer.edu.au/pathwaysStudy/.

Statistics on pancreatic cancer

According to PanKind, 3 out of 10 people will survive one year after diagnosis with pancreatic cancer, while the five-year survival rate is only 11.5%.

The vast majority of people, around 80 percent, are diagnosed when it has already spread to nearby blood vessels or other areas like the liver, which means it is incurable.

Pharmaceutical company Viatris funded the development of the new recommendations. They have been published in the journal Pancreatology and can also be accessed on the QIMR Berghofer website.