Pancreatic cancer trial: Early surgery boosts success rates

In In The News by Barbara Jacoby


Speeding up access to surgery for pancreatic cancer patients diagnosed early enough increased success rates by a third, a pilot scheme has shown.

The Birmingham team said it had saved the NHS £3,200 per patient and could help hundreds of patients UK-wide.

The trial involved cutting average time to surgery for 32 patients from two months to just over two weeks – 31 had their tumours removed successfully.

But it will be two years before doctors know if operating earlier extends life.

About 9,600 people are diagnosed with pancreatic cancer in the UK each year, and fewer than 7% live beyond five years. Very little progress has been made in treating the disease since the early 1970s.

Currently, just 8% of pancreatic cancer patients in the UK have surgery to successfully remove their tumour, because the majority are diagnosed at an advanced stage, when surgery is not an option.

Even if a patient is eligible for surgery, the chances of that surgery being a success are linked to how quickly it takes place.

The team at University Hospitals Birmingham NHS Foundation Trust, led by pancreatic surgeon Keith Roberts, worked with hospitals to speed up referrals for patients and reorganised the way surgery was carried out.

They also cut out a treatment generally given to jaundiced patients before surgery, which was thought to reduce the risk of post-operative complications.

This involves putting a stent into the bile duct to relieve symptoms.

Speeding up time to surgery saw 31 out of 32 patients eligible for surgery go on to have successful treatment – a 97% success rate, compared with a current average of 75%.

Complications and hospital readmissions after surgery were also reduced.

Mr Roberts said: “We have shown that it is possible to create a much faster path to surgery for pancreatic cancer patients within the NHS, which could have a significant impact on survival.

“We carried out surgery earlier, avoided unpleasant and costly pre-surgery treatment, and yet there was no significant increase in complications post-surgery.”

Alex Ford, of Pancreatic Cancer UK, which funded the study, said: “These results are incredibly exciting. Surgery is the only treatment for pancreatic cancer that can save lives. If we can ensure that hundreds more patients have their tumour successfully removed each year, it could be a huge breakthrough in treatment.”

She said savings would be used to fund specialist nurses, who could help speed up the time to surgery still further.

Kate Rigby, 69, from Minsterley, near Shrewsbury, was fast-tracked to surgery as part of the pilot. She had surgery seven days after being diagnosed.

“Within a week of receiving my diagnosis, I had surgery to have my tumour removed. I barely had time to worry about undergoing such an extensive operation,” she said.

“I had jaundice, but this wasn’t treated prior to surgery and this hasn’t caused me problems. People, including friends in the medical profession, have been astounded about how quickly I’ve been able to receive my treatment and how well I’ve recovered.”