Top tips for healthcare professionals

Pancreatic Cancer Diagnosis

Nearly 80% diagnosed with pancreatic cancer will currently have late stage disease at the point of their diagnosis. 

The challenge for you, the GP is in the detective work required to identify patients who are displaying symptoms at a stage when pancreatic cancer is operable.

Common Problems with Diagnosis

Misdiagnosis

Misdiagnosis is common, with men and women presenting with the signs and symptoms of pancreatic cancer to initially receive a diagnosis of another more common illness that affects the gastro-intestinal system (gut).

These include: heartburn, pancreatitis, gallstones and irritable bowel syndrome (IBS).

IBS is the most common misdiagnosis. With most pancreatic cancer patients being over the age of 50, it is important to remember that new-onset IBS signs and symptoms in patients over the age of 45 is considered a red flag for cancer.

Pancreatic cancer diagnosis.

For me, my early diagnosis was a product of both persistence and circumstance. Persistent by my frequent visits to my GP, out of hour’s doctor service and to A&E as my instinct told me something was wrong, and I was not reassured by diagnoses of irritable bowel syndrome and indigestion for my symptoms.

Ali Stunt, Founder and Chief Executive, Pancreatic Cancer Action

 

Delay in diagnosis

Patients not returning to their GPs, and lack of follow up in patients where signs and symptoms are persisting is a common problem. GPs should encourage patients to book a follow up consultation within one to two weeks if signs and symptoms persist.

Suggesting that patients keep a record of symptom frequency and persistency may help a follow up appointment, patients can download a copy of our symptoms diary to help them.

Other causes for delays in diagnosis

  • Investigation of weight loss and steatorrhea as a colorectal condition.
  • Over-reliance on ultrasound tests. Ultrasound scans are routinely used, however, it is important to be aware that a normal ultrasound will often produce a false negative, which will not necessarily rule out PC. Sensitivity is compromised due to the location of the gland, in a larger patient and/or in the presence of gas and falls to about 30% for tumours <2cm in diameter. Multi-slice contrast enhanced CT scans, which have a sensitivity of 97% are therefore the most useful investigation to diagnose and stage pancreatic tumours[i] and, where specific symptoms exist, referral for a CT scan should be the first action.
  • Lack of adequate follow-up in patients where symptoms are persisting.
  • Not associating new onset Type II diabetes with possible pancreatic cancer.

GP Diagnosis Reconstruction Videos

The following videos, featuring actors, show examples of how a patient might present themselves in primary.

They set out an approach that GPs can take to ensure appropriate and timely investigation and how follow-up in cases of diagnostic uncertainty.

Pancreatic Cancer Action GP Consultation Reconstruction Scenario One

Pancreatic Cancer Action GP Consultation Reconstruction Scenario Two

Pancreatic Cancer Action GP Consultation Reconstruction Scenario Three

Pancreatic Cancer Action GP Consultation Reconstruction Scenario Four

Pancreatic Cancer Action GP Consultation Reconstruction Scenario Five

Diagnostic guide for GPs

Our A4 poster for GPs gives a summary of the key signs and symptoms, and NICE guidelines. You can download or order a hard copy to display in your surgery by emailing .

Diagnosis Guidelines

Get In Touch

If you would like to get in touch, please fill our contact form or contact the Pancreatic Cancer Action office on 0303 040 1770.