Pancreatic cancer patients should be offered early scans to improve diagnosis and to avoid unnecessary surgery

Patients with pancreatic cancer should receive an early scan to determine the stage of their disease so unnecessary surgery is avoided, new guidance suggests.

NICE – the National Institute for Health and Care Excellence (NICE) – has published guidance, which was led by Professor John Primrose from the University of Southampton, aiming to improve care for people with pancreatic cancer by ensuring faster, more accurate diagnosis and staging.

Surgery to remove the cancer is the only potential cure. However this is not possible if, as in the large majority of cases, the cancer has already spread at the time of diagnosis. Therefore it is vital that the stage of the disease is accurately determined, so patients are not subjected to surgery that will not benefit them. This will limit the damaging side effects for patients and ensure those with inoperable cancer can get earlier access to chemotherapy.

NICE recommends the use of the PET-CT* scan and estimates that using this scan in the diagnosis and staging of pancreatic cancer will result in a 20% reduction in operations, meaning theatre time is freed up for other patients.

This is a different type of computed tomography (CT) scan. It ensures the extent of the cancer is found promptly and accurately, more so than existing scans, such as MRIs and standard CT.

Overall, improving the staging process will result in the correct management of the disease, reducing the impact on patients and the NHS of inappropriate, expensive surgery and giving them earlier access to chemotherapy.

Professor Primrose, chair of the NICE guideline committee and Professor of Surgery at the University of Southampton, said: “Pancreatic cancer is a devastating disease.  It is important that patients have the best possible standard of treatment available even if cure is not feasible. By obtaining the best information about pancreatic cancers at the earliest possible stage we hope to improve the management of the disease. If we can better identify which patients will benefit from surgery and chemotherapy, we can improve the support provided to patients and families through their surgery or end of life care.”

Professor Mark Baker, director of the centre for guidelines at NICE, said: “The PET-CT scan could have a significant impact on the treatment of patients with pancreatic cancer. It will mean that the staging process is more effective so that patients stand a better chance of getting the right treatment, at the right time.”

Pancreatic cancer is the fifth leading cause of cancer death in the UK. There are more than 9,500 new cases diagnosed each year**. Once diagnosed, life expectancy is on average four to six months.

This guidance also recommends surveillance for people who have two or more close relatives, such as siblings, children or parents with pancreatic cancer or Lynch syndrome due to their inherited higher risk of the disease.

NICE recommends increased support for the psychological impact that the cancer can have on patients, including anxiety and depression.

NHS organisations should compare their current practice with these recommendations and consider what changes may need to be made to put them into practice. In considering any changes, they will need to take into account any extra costs and savings involved. The speed at which these recommendations are adopted by local NHS services will depend on the resources they have available and the other priorities they are dealing with.