Dr Harpreet S Wasan
Consultant & Reader in (Medical) Oncology, Lead for Medical Oncology & Clinical Divisional, Lead for Cancer for N.W London Research Network Department of Cancer Medicine Hammersmith Hospital, Imperial College Healthcare NHS Trust
There were 10,000 pancreatic cancer cases in the UK annually (2018) and increasing in incidence and remains difficult to diagnose, so usually presents late with limited treatment options.1
Typically seen in later life, common symptoms include jaundice, weight loss or severe pain – often mimicking back pain. Early diagnosis is important according to Harpreet S Wasan, Consultant and Reader in Oncology at Hammersmith Hospital, London. “Only about 10% of patients diagnosed with pancreatic cancer can be operated on, even with early diagnosis surgery may not be an option as tumours quickly start attaching to major surrounding blood vessels. In cases where the disease has become advanced, options are limited to systemic chemotherapy.”
Only about 10% of patients diagnosed with pancreatic cancer can be operated on, even with early diagnosis surgery may not be an option.
This bleak outlook has persisted for some time, but a recent clinical trial offers oncologists a potential new addition to their therapeutic toolkit. A pilot study investigated the safety of the OncoSil™ device which allows for the implantation of radioactive microparticles, delivering a high dose of radiotherapy directly into pancreatic tumours. Other advantages of the interventional procedure include speed, efficiency and less risk to organs surrounding the pancreas. The one-day procedure is also convenient for patients.
Although the UK has well-organised cancer networks and specialist pancreatic cancer centres, there is currently no approval of, or funding for, the procedure to be used in the NHS despite its potential and its approval as a device by the BSI (British Standards Institution).
Nuclear medicine is offering innovative therapies for pancreatic cancer
Dr Zarni Win
Consultant Radiologist and Nuclear Medicine Physician, Head of Service Nuclear Medicine,
Imperial College Healthcare NHS Trust
Research and investment into nuclear medicine has been gathering pace over the last decade and is developing some promising options for pancreatic cancer patients.
An alignment of science, research, funding and innovation has resulted in an acceleration of radionuclide therapy for both diagnosis and treatment of cancer, says Zarni Win, Consultant Radiologist at the London Clinic. The potential of harnessing radioactive substances to treat cancer has taken off in the last five years. “Both large and small pharma companies have identified a lack of options for pancreatic cancer and have really got behind it with funding and innovation.”
Pancreatic cancer patients will benefit from these new developments, says Dr Win. “People tend to present too late once the cancer has spread and options for surgery are limited. Chemotherapy and radiotherapy are not targeted in the same way as therapies such as Oncosil ™ which deliver the treatment directly, in a single sitting, without the side effects of conventional treatments.”
People tend to present too late once the cancer has spread and options for surgery are limited.
The desired outcome is that patients become eligible to undergo surgery. A recent clinical trial showed that 33% of participants became candidates for surgery compared to 10% with conventional treatment.
The London Clinic was the first site in the UK to offer the Oncosil ™ procedure and Dr Win is optimistic that this ‘game changing’ therapy will soon be available on the NHS.
Pancreatic cancer: the cancer that has been left behind
Layla Stephen
CEO, PLANETS
Awareness and early diagnosis are vital to improve outcomes for people with pancreatic cancer.
Compared to other cancers, pancreatic cancer presents challenges for both patients and doctors due to its low survival rate and limited treatment options especially if the disease is diagnosed later. Layla Stephen of the cancer charity PLANETS describes it as “the cancer that’s been left behind.” She says: “The speed at which you can lose pancreatic patients is one of the biggest things, particularly nowadays when many other cancers are becoming more treatable.”
No matter what age you are, if you feel unusual pain or something changes you must get it checked out straight away.
Layla describes the treatment journey for pancreatic cancer as fairly straightforward but dependent on the stage at which it is diagnosed. Earlier stage cancer can be treated with surgery, radio or chemotherapy or a combination. Research on detecting pancreatic cancer earlier is key to improving survival as well as discovering new or improved treatment options such as Intra-operative radiotherapy, Radiation therapy and Immunotherapy and which we, as a charity, are actively involved in supporting.
With early diagnosis key to longer term survival, Layla’s advice is to seek help. “No matter what age you are, if you feel unusual pain or something changes you must get it checked out straight away.”
Whilst research into pancreatic cancer moves forwards, it remains a difficult disease to manage and specialist support from health charities is particularly valuable.
The London Clinic is the first hospital in the UK to employ OncoSil™, a breakthrough treatment for locally advanced pancreatic cancer. The treatment is not yet available on the NHS.
[1]. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/pancreatic-cancer [last accessed Nov 21]
