At Home Christian Jessen 2014 - 85

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A CT scan will
detect if there
is a pancreatic
mass present

chronic pancreatitis. Other risk factors include
smoking and obesity, and a recent onset of
diabetes may also be a warning sign.
When the disease first develops, it often
doesn't cause many symptoms, so people can
have pancreatic cancer for some time without
being aware of it. Any symptoms people do
have can be quite vague and may also be a
sign of other more common illnesses that affect
the gastrointestinal system. These symptoms
include jaundice, persistent unexplained
abdominal or back pain and rapid weight
-loss, and are an indication to see your doctor.

Managing the condition

which is insulin, which helps to regulate the
amount of sugar present in the blood.

Pancreatic cancer - the facts

Pancreatic cancer is one of the top 10 leading
causes of cancer deaths within the UK, and
approximately 8,000 people are diagnosed
with the disease each year. The options

Pancreatic cancer has a very poor outlook
and treatment options are limited. While
rapid weight-loss and jaundice clearly require
urgent investigation, adult-onset diabetes and
persistent abdominal or back pain may
also be presenting features. A computerised
tomography (CT) scan is a first-line investigation
and, if a pancreatic mass is suspected, urgent
hospital referral is subsequently indicated for
further tests and treatment planning, too.
A minority of patients will be eligible for
resection surgery while in patients with more
advanced disease there are a number of
treatments available to them which can prolong
life expectancy and improve symptoms as well.

Acute and chronic pancreatitis
Acute pancreatitis is a serious and painful
medical condition in which the pancreas

'Pancreatic cancer is one of the toP 10
leading causes of cancer deaths in the
uK, and aPProximately 8,000 PeoPle are
diagnosed with the disease each year'

problems, such as pancreatic, gallbladder
and liver conditions, indigestion and change in
bowel habit. Dr Pereira has a special interest
in endoscopy, including colonoscopy and
endoscopic ultrasound, and undertakes
minimally invasive endoscopic treatments of the
bile duct and pancreas, called an endoscopic
retrograde cholangiopancreatograph (ERCP).

What is the pancreas?

The pancreas is a large gland situated deep in
the abdomen, between the stomach and the
spine. It has two main functions: firstly to make
pancreatic juice, containing enzymes that help
to break down food in the small bowel, so that
it can be absorbed, and secondly to produce
a number of hormones, the most important of

available for treatment include surgical
removal, which is possible in about one in
10 people diagnosed with the condition and
is the only chance of cure from the disease,
and life-prolonging treatments including
chemotherapy and radiotherapy.
Despite improvements in the quality of
imaging by CT scanning, surgical approaches
and the choice of chemotherapy drugs, overall
survival has not improved much within the last
few decades. These concerns, along with the
lack of major progress, have lead to efforts
to identify patients with early cancers or pre
-cancerous changes in the pancreas earlier, so
that more patients can have successful surgery.

Risk factors and symptoms

People who have two or more relatives with
pancreatic cancer carry a slightly increased
risk of pancreatic cancer, as do patients with

becomes inflamed. This condition can develop
quickly. According to the NHS, around one in
2,500 people develop acute pancreatitis each
year in England. Symptoms include severe pain
in the centre of the abdomen, nausea, vomiting,
diarrhoea, fever, loss of appetite and jaundice.
It is usually diagnosed after an emergency
hospital admission. Treatment will deal with
pain, preventing dehydration and assessing any
underlying cause, such as gallstones or alcohol.

FOR MORE INFORMATION
Dr Steve Pereira, BSc, MBBS, PhD, FRCP
(London) FRCPE (Edinburgh).
Email suemcalinden@btconnect.com
call 020 7935 4849 or fax 020 7935 6826.
Alternatively, write to
110 Harley Street, London W1G 7JG.



At Home Christian Jessen 2014

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