The silent cancer killer: how to spot the signs of pancreatic cancer

It's an unfortunate fact, and one that we are so often reminded of, that one in two of us will get cancer in our lifetime.

So it's more vital then ever before that we as a society are clued up on the symptoms of the many different types of cancer. However, there's one cancer that recently, appears to have emerged as one of the most terrifying of them all, due to a distinct lack of symptoms in the early stages.

21st November marks World Pancreatic Day, which aims to raise awareness of this deadly form of cancer. “On World Pancreatic Cancer Day, we unite as a global movement to advocate for early detection and better outcomes for pancreatic cancer patients,” said Julie Fleshman, JD, MBA, WPCC chair. “By raising awareness of pancreatic cancer risks and symptoms, we hope that people will be aware and alert their doctor sooner when there is more opportunity for intervention.”

Pancreatic cancer, according to Pancreatic Cancer UK, is now the 5th biggest cancer killer in the UK, with around 7,800 pancreatic cancer-related deaths per year. In fact, the stats mean that it's often named 'the deadliest common cancer', with the lowest survival rate of all common cancers.

So why is the prognosis for pancreatic cancer so grim?

The problem is that the disease very often doesn't present symptoms in the early stages.

As such, it's hard to get an early diagnosis - something experts say is key for increasing survival rates. Pancreatic Cancer UK report that a huge 3 in 5 people are diagnosed with the cancer when it has reached an advanced stage (stage 3 and stage 4), where the cancer has spread and survival is less likely, while just 1 in 5 people (18%) are diagnosed at an early stage of the disease.Plus, symptoms can often be vague, making it difficult to notice them when they do present themselves.

New statistics reveal more could be done to educate people about the symptoms and risk factors for the disease; 74% of people in the UK cannot name a single symptom of pancreatic cancer, according to a 2019 survey carried out by Pancreatic Cancer Action. Dr Chris, of Pancreatic Cancer UK, explained that it's all too easy for doctors to miss the early signs of the cancer, hence why it isn't usually picked up until the illness has progressed much further.

He told us, “There are symptoms of pancreatic cancer at an early stage but these are vague and indistinguishable from symptoms from other far more common and less serious conditions, so doctors often miss the early signs.

"GPs see thousands of patients a year with back pain, indigestion and weight-loss, for example, but currently no tools or early detection tests exist to help them determine in which patients these symptoms may be the warning signs of pancreatic cancer and require urgent investigation."

A recent study in The Lancet revealed that the disease is only getting worse too, with cases of pancreatic cancer having actually risen in the last 30 years.

Dr Chris MacDonald, Head of Research at Pancreatic Cancer UK explained, “This study confirms what we already know about increasing incidence of pancreatic cancer. A combination of factors can explain the increase, much of it by the growth of the population and, that overall, people are living to an older age."

However, it's not entirely hopeless. Dr Chris said that, despite the number of cases rising, "the percentage survival for pancreatic cancer is slightly better than 30 years ago.

"But progress for treating pancreatic cancer has been very slight and unacceptably slow. Not enough investment has been made in vital research to deliver earlier diagnosis and badly needed new treatments."

Pancreatic cancer symptoms

• Unexplained weight loss

If you've seen a rapid and significant weight loss, and haven't been following a specific weight loss plan or regime, it could be a sign of pancreatic cancer. Pancreatic Cancer UK explained, "This is because the pancreas plays an important role in digesting food. Pancreatic cancer can affect this, causing weight loss."

• Indigestion

Indigestion, which often comes in the form of an uncomfortable burning sensation in your throat and chest, and can leave a bitter taste in your mouth, can also be a sign of cancer.However, it's important to note that indigestion is very common, and could be due to plenty of other things that aren't pancreatic cancer. You could also experience indigestion if you smoke, drink alcohol, or take certain medicatons.

• Problems eating food

Pancreatic cancer UK explain that problems with eating and digesting food could be a symptom of pancreatic cancer. "This is because the pancreas plays an important role in breaking down food (digestion)," the organisation said.

If you find difficulty swallowing your food, feel full very quickly, experience bloating, or lots of wind or burping, it could be indicative of something related to pancreatic cancer. But once again, these issues can present themselves for lots of other reasons.

• Loss of appetite

Equally, another symptom of pancreatic cancer is feeling that you don't want to eat much. Many people can feel full after a single bite of food.

• Yellowing of the skin (jaundice)

A common symptom of pancreatic cancer, and usually one of the first, is jaundice - when your skin and the whites of your eyes turn a yellowish colour. Jaundice is caused by the build-up in your body of a yellow substance called bilirubin, says the NHS, and it's normally always serious.

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So even if you have none of the other symptoms of pancreatic cancer, you're advised to seek urgent medical advice, as it could be a symptoms of something else too, such as liver disease.

• Changes in your poo and bowel habits

As unpleasant as it may be to discuss, it's an important symptom of pancreatic cancer. For some people, pancreatic cancer can cause oily poo that floats. It can be large, smell much much worse than normal, and can be difficult to flush. It's often called steathorrheoa. Pancreatic Cancer UK explained that, "steathorrheoa is caused by fat in the poo. It happens if pancreatic cancer has affected digestion, meaning that fat in food isn’t digested properly."

As well as changes to the contents of your toilet, this type of cancer can also change your bowel habits, which could mean either diarrhoea or constipation.This is a significant symptom, with Pancreatic Cancer UK pointing out that "if you are over 60, have lost weight and have diarrhoea or constipation, your GP should refer you for a scan within two weeks."

• Back and tummy pain

Of course, we'll all experience twinges in our back and stomach every now and then, but general discomfort, tenderness, or pain in your stomach that spreads to the back could be indicative of pancreatic cancer.

But, as Pancreatic Cancer explain, it can be a complicated symptom and one that's hard to pinpoint. They said on their website, "Some people may have no pain at all. And pain can vary from person to person. For example, it may come and go at first but become more constant over time. It can be worse when lying down, and sitting forward can sometimes make it feel better. It may be worse after eating."

• Diabetes

If you have pancreatic cancer, you may also start to present symptoms of diabetes. The NHS explains, "This is because the tumour can stop the pancreas producing insulin as it normally would."

Symptoms of diabetes include excessive thirst and hunger, blurred vision, frequent urination, slow-healing wounds and nausea - so if you notice any of these symptoms, it's worth heading to your GP.

What are the first symptoms of pancreatic cancer?

Given that pancreatic cancer can be so hard to diagnose, due to the late presentation of the symptoms, knowing which can possibly be the first noticeable symptoms can be key.

The NHS has shared that there are three symptoms that may be noticeable first, which are: pain in the stomach, jaundice, and unexplained weight loss.

However, it's important to note that you may have many of these symptoms and not have pancreatic cancer. But, if you notice yourself experiencing these, it's definitely best to book an appointment with your GP as soon as possible.

Causes of pancreatic cancer: who is most at risk?

Some people are at a higher risk of pancreatic cancer than others.

It's generally considered to affect older people more, with people aged between 50 and 80 most commonly diagnosed. Pancreatic Cancer UK explain that almost half of those diagnosed (47%) are over the age of 75. However, younger people can still get it, so if you are under 50 and notice symptoms of the disease, do not hesitate to visit your doctor.

There is also good evidence that smoking can increase your risk of getting pancreatic cancer.Obesity is also considered to be a huge risk factor for cancer of the pancreas. "Around one in eight pancreatic cancers (12%) may be linked to being overweight or obese," say Pancreatic Cancer UK.

Less common risk factors include family history - although it's thought that just 10% of pancreatic cancer cases run in the family. Other things, such as eating red meat, drinking alcohol, your blood group (if you are A, AB, or B), and if you have had your gall bladder removed or have had gallstones, are all less significant risk factors, although in some studies a link has been identified.

Is pancreatic cancer curable?

The heartbreaking reality of pancreatic cancer is that it a lot of the time, it cannot be completely cured. This is because it is usually so advanced by the time symptoms arise, that surgery is not always suitable - and surgery is normally the only way that the cancer can be fully treated and cured.

This is because advanced cancer has usually spread to other parts of the body, so removing the initial tumour will not be enough to cure the patient.

Dr Chris explained, "Major symptoms like jaundice only present once the tumour has grown large enough to disrupt the digestive system, or after it has spread to other parts of the body. Tragically it is then often too late for someone to have surgery, the only potentially curative treatment. One in four people with pancreatic cancer die within a month of diagnosis.”

But there are options, and the NHS explain that, "If you have been diagnosed with pancreatic cancer, your treatment will depend on the type and location of your cancer and how far it's advanced, also known as its stage."

Pancreatic cancer treatment

As with many cancers, there are normally three main treatment options for pancreatic cancer.

If surgery is an option, it will be the first course of action. Dr Chris explained, “Surgery can cure pancreatic cancer, but only if people are diagnosed early enough to have that potentially lifesaving operation."

Then, doctors could suggest radiotherapy, to control the cancer and remove symptoms. This could be done before or after surgery. Chemotherapy is another option. If surgery isn't possible, chemo can be used to slow down the growth of the tumour, and control the disease.

Overall however, the situation is desperate, and Dr Chris explained to w&h that far more investment needs to be made in finding much better treatment, to improve the prognosis for pancreatic cancer.

"With pancreatic cancer predicted to overtake breast cancer as the fourth most common cancer killer by 2026, it is imperative we substantially invest in more research to find the scientific breakthroughs in early diagnosis, and in new and more effective treatments," he said.

"Researchers are exploring how innovative new approaches, such as immunotherapy, that have proven successful in treating other types of cancer could be applied to pancreatic cancer. This approach, which involves reprogramming part of the body’s immune system and helping our natural defences recognise and penetrate the tumour, is the focus of The Pancreatic Cancer UK Grand Challenge Award, our largest ever investment in a single research project.

"The early results from this research are extremely promising but there’s still much more to be done. We won’t stop until we’ve helped transform survival for people affected by this appalling disease.”

Pancreatic Cancer UK have launched a new campaign – Demand Survival Now (show your support here) –to help give future patients a fair chance to beat the disease.

The charity’s petition calls on the next UK Government to produce the first national plan in response to the disease.