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Diabetes… or the first sign of killer pancreatic cancer?

 

Screening newly diagnosed type 2 diabetes patients for pancreatic cancer could slash the number of deaths from the killer disease. 

Experts are issuing the advice as they believe that the blood sugar condition suffered by four million Britons may be an early warning sign of the aggressive tumours, which are typically discovered too late to treat.

Research suggests that three per cent of pancreatic cancer sufferers will have been diagnosed with type 2 diabetes in the 18 months before their cancer diagnosis.

Survivor: Ali Stunt’s cancer was caught early and could be treated, thanks to a CT scan

Ross Carter, consultant pancreatic surgeon at Glasgow Royal Infirmary, said: ‘Type 2 diabetes is generally age- and obesity-related. But when type 2 is found in patients who do not fit the profile, it should be considered a red flag.’

One pioneering Hampshire GP is now offering CT scans – the only reliable test for pancreatic cancer – to these patients to ensure it is not the first symptom of the much more serious problem.

Dr Paul Bennett, of the Westlands Medical Centre in Portchester, examined the records of his practice’s 10,000 patients after watching an educational film three years ago produced by UK charity Pancreatic Cancer Action (PCA) highlighting the link between the disease and diabetes.

His own research suggests that as many as one in ten atypical type 2 diabetes cases – those not linked to weight gain – could be an early warning sign of the devastating cancer, which kills more than 8,800 Britons a year.

Backing this drive is PCA founder Ali Stunt, who discovered she had pancreatic cancer a year after being diagnosed with type 2 diabetes, despite being a healthy size 10.

This year Ali, now 51, celebrated an astonishing ten years’ survival.

Fewer than one per cent of pancreatic cancer patients live for this long. The disease has the worst survival rate of any cancer, with 80 per cent of sufferers diagnosed too late for lifesaving treatment.

Ali said: ‘Even though it was picked up relatively early, its proximity to major blood vessels would soon have rendered the cancer inoperable.

Experts are issuing the advice as they believe that the blood sugar condition suffered by four million Britons may be an early warning sign of the aggressive tumours, which are typically discovered too late to treat

‘Research has shown that pancreatic cancer patients will have visited their GP four times on average before being referred to a specialist for a scan. I saw mine more than that. But type 2 diabetes not associated with weight gain is often one of the earliest signs of pancreatic cancer, as it was in my case. If GPs began routinely screening these patients, it may lead to the disease being picked up earlier.’

Ali, a mother-of-two who lives with financier husband Phil, 53, in Haslemere, Surrey, was diagnosed after being referred to a pancreatic specialist who immediately admitted her to hospital for a CT scan. 

Within five days, she was having a five-hour operation to remove a large tumour. After six months of chemotherapy and radiotherapy, she quit her job studying meteorites to set up PCA with the aim of improving early detection and therefore survival rates.

Dr Bennett now wants GPs across Britain to carry out audits on their patient records to identify those recently diagnosed with type 2 diabetes but whose weight falls within healthy guidelines. 

They would then be contacted to ask if they would like to be referred for a CT scan that examines the abdominal area, to rule out pancreatic cancer.

Research suggests that three per cent of pancreatic cancer sufferers will have been diagnosed with type 2 diabetes in the 18 months before their cancer diagnosis

Diabetes is a condition in which the body does not produce enough insulin, the hormone responsible for moving sugars digested from food from the bloodstream and into the cells where it can be used for energy.

Without enough insulin, sugar builds up in the blood and causes a raft of symptoms and damage to numerous organs.

The primary organ responsible for making insulin is the pancreas. However, it is not known whether diabetes contributes to the development of pancreatic cancer or is a potential consequence.

Dr Bennett said: ‘There are two critical problems with pancreatic cancer. The first is that it is incredibly difficult to pick up because symptoms are so vague: tiredness, loss of appetite, stomach pain.

‘The second is that it is therefore usually diagnosed too late to treat successfully, with devastating consequences.

‘If my approach was replicated at surgeries throughout the UK, we’d be on our way to making an impact on a dreadful disease with the worst prognosis of all cancers.’

Of the 9,000 people diagnosed with pancreatic cancer annually, fewer than five per cent will survive beyond five years – and those statistics have not improved in 40 years. There are currently more than four million people in the UK with type 2 diabetes.

Mr Carter added: ‘If patients with diabetes are complaining of losing appetite, pain after eating, persistent indigestion and weight loss, they should be referred for a CT scan.

‘I’m entirely supportive of practices undertaking a systematic review of their patients in this structured way, as early diagnosis is key to improving outcomes. It would be a major step forward.’

 Health comment: Dr Ellie Cannon

The symptoms of pancreatic cancer – pain in the upper abdomen, jaundice and sudden weight loss – occur only when the disease is at an advanced stage. Before this, it is hard to spot, and later detection means that it is often far too late for curative treatment.

Ali Stunt is one of a tiny number of the lucky ones who survive.

The more that GPs like myself and Dr Bennett can do, the more we will change these terrible odds and the more survivors there will be, like Ali.

We are diagnosing type 2 diabetes on almost a daily basis in general practice as the obesity epidemic fuels a huge rise in cases. Of course, the vast majority will not have extra complications. But all GPs need to be aware that when type 2 diabetes is found unexpectedly in a patient of normal weight, they must think of pancreatic cancer and send the patient for a scan.

Dr Bennett has already shown the effect this could have on detection and therefore survival rates. It’s a simple thing to do and could mean the difference between life and death. 

Article source: http://healthmedicinet.com/i2/diabetes-or-the-first-sign-of-killer-pancreatic-cancer/