Ali Stunt's Blog

Celebrating rising survival rates

To see an increase in 5-year survival to almost 8% is just so heartening. When I was diagnosed, the survival rate was only 3% and it had not changed at all in the 30/40 years before my own diagnosis. To be diagnosed with a disease with such a low survival rate was a traumatic experience and the numbers were so low that it seemed almost impossible that I would be one of the ones to survive.

But survive I have, and I am very lucky to have done so as I was diagnosed early, in time for surgery to be an option. Seeing a rising trend in pancreatic cancer survival rates will give hope to many, but we still have a long way to go before the majority of patients will survive long-term with this disease.

Me and my team at Pancreatic Cancer Action will continue our work to improve early diagnosis of pancreatic cancer and ultimately improve survival rates.

Here are my thoughts on this latest news:

Survival rates have, until recently, barely moved since the early 1970’s when they were a mere 2%. However, we have seen an encouraging increase in five-year survival up to 7.9% in 2015. While not a major uplift, the trend is positive and has come about for several reasons;

Firstly, the introduction of pancreatic cancer specific referral guidelines for GPs to use when considering referring a patient for the disease. These guidelines include a list of key “red flag” symptoms that could be due to pancreatic cancer. The guidelines prompt GPs to urgently refer patients for testing. This can help reduce the number of visits patients make to GPs with symptoms and increase confidence in making referrals for the disease.

Improvements have also been made for patients once they are diagnosed. Treating patients in specialist centres has helped the development of better surgical techniques. The introduction of new chemotherapies such as FOLFIRINOX and the use of multiple chemotherapy drugs together has helped many patients live longer with a better quality of life.

Some patients have benefited in clinical trials from the use of neoadjuvant treatment. This is usually chemotherapy that takes place before surgery to attempt to shrink a tumour and increase the chances of it being successfully removed. In trials with patients who are borderline operable, up to 30% more patients were able to have surgery after this neoadjuvant treatment.

Other trials have focused on precision medicine, looking at the genetic makeup of tumours and developing personalised treatments for patients. This is an area of cancer treatment that is expected to grow and benefit more patients over the coming years.

Finally, survival can only be improved if health care professionals and the public are aware of pancreatic cancer. Pancreatic Cancer Action works to increase the publics knowledge of pancreatic cancer and its symptoms through awareness campaigns. We also work closely with GPs, pharmacists and hospital doctors providing awareness materials and free educational resources.

However, despite improvements in survival, pancreatic cancer continues to be diagnosed late. The UK is lagging behind many other countries in terms of survival. Only 10-20% of pancreatic cancer cases are diagnosed at a stage when curative surgery remains an option and only eight per cent of patients actually receive the surgery in the UK. One study in 2018, found that the UK comes 47th out of 56 high income countries for 5-year pancreatic cancer survival. This is something that we urgently need to address.

We need to understand why UK survival is so low and what we can do to catch up. Countries with better survival such as Australia have more CT and other diagnostic scanners available and GPs can refer directly for scans, minimising delay. Other countries like Denmark allow GPs to refer patients with vague but potentially serious symptoms to rapid assessment clinics where they receive a number of urgent tests to diagnose cancer. This is the model that new rapid diagnostic centres in the UK will be based on. However, the UK also has its own specific issues that can’t be compared with other countries, cancer waiting times have been repeatedly missed and there are staff vacancies in many cancer related specialities.

To have 5-year survival rates that are as good as, if not better than, the best in countries with higher incomes is a target we would like to see achieved in the next 10 years.

With your support, we will continue to take action’ to make the 2020s the #DecadeofChange for pancreatic cancer.