Simple tests could help diagnose pancreatic cancer earlier

A Southampton-led study has shown two simple tests could potentially be used to diagnose pancreatic cancer at an earlier stage.

The DEPEND study has been published in the journal Cancers.

It could pave the way for faster detection of the disease, helping to improve life expectancy for patients in the future.

The study was led by Declan McDonnell and Zaed Hamady at University Hospital Southampton (UHS). It was funded by Cancer Research UK and coordinated by the CRUK Southampton Clinical Trials Unit (CTU).

The need for early detection

Around 10,500 people in the UK are diagnosed with pancreatic cancer each year. It is the 10th most common cancer in the UK, but the fifth most common cause of cancer death, according to Cancer Research UK. This is because there are very few symptoms in the early stages of the disease meaning it is often not picked up straight away.

“Pancreatic cancer is often diagnosed when it is too late for the cancer to be removed with surgery, and options for treatment are very limited,” says Principal Investigator, Mr McDonnell.

“There is therefore a real need for better ways of detecting the disease earlier before the more obvious symptoms such as jaundice occur.”

Patients with pancreatic cancer often have problems digesting food and drink. This is due to reduced pancreatic enzymes, which aid normal digestion.

This reduction in enzymes is known as pancreatic exocrine insufficiency (PEI). It often leads to early, vague symptoms such as indigestion and changes in bowel habits.

The study aimed to find out if PEI happens in earlier stages of the disease, allowing it to be used as a diagnostic tool.

Simple tests

The study recruited patients at UHS with pancreatic cancer, diagnosed at an early enough stage to be treatable with surgery. It was led by Mr Hamady, pancreatic surgeon and Chief Investigator.

Healthy volunteers and a control group with chronic pancreatitis also took part. This is a condition where the pancreas has become permanently damaged and stops working properly.

All the participants underwent a simple breath test and a stool sample test, both of which have already been shown to pick up PEI.

These simple, cost-effective tests can be carried out in primary care settings such as GP surgeries and health centres. The researchers hope they could one day provide a way to test for pancreatic cancer in its early stages, when surgery is still an option.

“What we found is that the tests did show that PEI was detectable in the patients with surgically treatable pancreatic cancer compared to the healthy controls,” says Mr Hamady. “The hope is that these tests could therefore be potential diagnostic tools to aid earlier detection of the disease.”

Next stage

However, the results also showed that the tests were similarly positive in patients with chronic pancreatitis. Further research is therefore needed to see if there are ways to show which patients who test positive for PEI may be at risk of pancreatic cancer.

“We are now working on the next stage of this vital research with the development of the DEPEND2 study, to further our knowledge in this area,” says Sam Wilding, senior statistician for the Early Diagnosis team at the CRUK Southampton CTU. “The more people we can diagnose early, the better the chances of successful treatment and survival.”