NHS England - Diabetes and early detection of Pancreatic Cancer Initiative

[martindt1606]

This initiative seems to be a good idea given the link between Diabetes and the Pancreas....

Any initiative that improves early diagnosis has to be applauded.

As someone who lost my Pancreas to a Pancreatic Neuroendocrine Cancer of the Pancreas i don't think the initiative goes far enough as it is only looking to diagnose Pancreatic Cancer. I've had feedback that the project team will incorporate a referral process to a Neuroendocrine Cancer Centre of Excellence if symptoms require further diagnosis. However if its not in the scope will this be the case?

NHS launches new initiative to identify people with diabetes at risk of pancreatic cancer

We're proud to work with the NHS to develop this initiative, which could help improve the early diagnosis of this devastating disease.

www.pancreaticcancer.org.uk

 

[silver minion]

My GP was very proactive and arranged a chest and abdominal CT scan within 10 days of my appointment concerning unplanned weight loss. HbA1c also done which led to diabetes diagnosis. It was reassuring that nothing more serious was found.
I agree that earlier diagnosis of pancreatic cancer needs more priority in the NHS.

 

[JITR]

I don't think the initiative goes far enough as it is only looking to diagnose Pancreatic Cancer.

Soapbox: I agree, annual HbA1c (combined with other) tests should be freely available to everyone (over 30, say).

Aims: to detect prediabetes (and other conditions); avoid future complications.

Message: a 'stitch in time saves nine'.

Method: bookable online; no reference by GP required; user friendly dietary and lifestyle advice online (expert consensus presented by first rate communicators); GP notifications as necessary; annual reminders.

Basis: partnership between the public and the NHS to prevent disease; improved health brings its own rewards and reduces demand on the NHS in the short and long term.

Cost effectiveness: 5/5

 

[Bruce Stephens]

Soapbox: I agree, annual HbA1c (combined with other) tests should be freely available to everyone (over 30, say).

We have a committee specifically for judging such screening proposals, the UK National Screening Committee. It's not at all the case that more screening is always better, and I'm not sure where a population-level HbA1c annual test would lie.

 

[Leadinglights]

I am always encouraged by those here who are survivors of pancreatic cancer as my allotment neighbour was not so lucky, he had felt unwell for a couple of months and was then diagnosed and passed away 3 days later, it was such a shock to everyone.

 

[Martin.A]

My GP was very proactive and arranged a chest and abdominal CT scan

Same here, and thankfully everything looked normal. I'd also had an inconclusive bowel cancer screening result and had to do another, which came back normal, and then one more, which also came back normal. Just the T2, then. It could have been a lot worse.

 

[Deb_l]

Excellent initiative. Having lost a very good friend to pancreatic cancer recently, anything that supports the early detection of this killer is fantastic.

My friend was still waiting for the results of her initial tests to come through when she died - she went that quickly.

 

[Proud to be erratic]

Like you, @martindt1606, I also wholly applaud the initiative. I am also, like you, nervous about whether early diagnosis will ultimately lead to a referral to the right (=best) place. But perhaps that is something that needs more focus, once this pilot scheme gets established and widened across all of NHS England.

 

[JITR]

We have a committee specifically for judging such screening proposals, the UK National Screening Committee. It's not at all the case that more screening is always better, and I'm not sure where a population-level HbA1c annual test would lie.

Thank you for pointing to the UK National Screening Committee.

Actually, my proposal is not a screening programme delivered by the government and/or the NHS. Quite the reverse it is part of a programme to help us all look after ourselves.

The Government wants to the country to focus on prevention rather than cure. They need to enlist the support of the population for that policy to succeed. Making self help information and diagnostic facilities available to everyone is part of bargain.

Many of the principles of the UK National Screening Committee will carry over but some need turning on their head. The Government, the NHS and the food companies cannot deliver a healthy nation, but we the population can.

 

[silver minion]

I applaud your sentiment and optimism @JITR but as a population we are often happy to ignore the potential long term effects of poor health decisions. For instance smoking.

I remember receiving information and education about the dangers of smoking in the late 1960s before I was a teenager. Along with my classmates I was shown a preserved lung of a 30 year smoker and it was pretty shocking. Nevertheless most of my peers and my relatives smoked by the time they left school. I was considered odd because I never smoked although both my parents smoked.
My husband smoked for over 35 years before he quit around 2010.
Now it is quite rare to see someone smoking although vaping is very popular. It has taken decades to get this far with a mix of public education, financial disincentives and legislation.

 

[silver minion]

Might want to do a quick edit on that last para 🙂

Thanks Eddy. Damned autocorrect 😡. Not helped by my dodgy eyesight at the moment. Hope nobody was offended.😱

 

[tesser raggy]

But which test conclusively diagnoses Pancreatic Cancer? CT scan, blood test or something else?
Judging from some of the comments on here, it seems to be going undetected.

 

[trophywench]

It goes undetected because there isn't a definitive symptom of it. You may know 'I don't feel 100% right, but can't put my finger on it' so you don't go to the surgery. Then when you eventually do feel bad enough it's often too late. And blokes are far worse than ladies at 'getting themselves checked out' which is why so many are found to have Stage 4 Prostate Cancer before anyone knew they had Stage 1.

 

[eggyg]

@tesser raggy I am one of the lucky ones ie my tumour was pre cancerous but only because I already had had acute pancreatitis due to gall stones. Six years after having gall bladder removed and pancreatic pseudo cysts drained I got the dreaded pain again whilst on holiday in Majorca. Luckily it was towards the end. Got a GP appointment soon as we got home. The young locum GP told me I couldn’t get pancreatitis again as I’d had my gall bladder removed! Less feisty folks may have just said “ok” and went home until the next attack. I burst into tears and said to her she was wrong, the pancreas is a different organ and once you’ve had pancreatitis you never ever forget the pain. She left to discuss it with another GP. When she returned she apologised and referred me for an ultrasound. They were quite quick, they looked worried and went to get a consultant who explained there were worrying areas. Next I had an endoscopy, then MRI, then an ultrasound endoscopy in another hospital. That’s when they discovered the tumour. Apple sized. Three weeks later I was getting it removed along with most of my pancreas and all of my spleen. This still all took six months from the attack in Majorca to the op. It really isn’t an easy organ to see, and the symptoms could be lots of things, they always start with the most common things. ie gall stones, ulcer, GERD etc. I may not have still been here if I hadn’t burst into tears and challenged that locum GP. Sometimes we have to be our own advocates.