Pancreatic cancer is the 10th most common cancer in the UK and the 5th biggest cancer killer – according to the Pancreatic Cancer Action charity. It has a reputation as one of the hardest cancers to detect, which makes awareness of the possible symptoms all the more important.
This article is written for both employees and employers to aid pancreatic cancer awareness. We all need to be as well informed as we can be about a cancer that has been described as a ‘silent disease’ – because those that develop it are often completely unaware that they have it.
We are also pleased to support Pancreatic Cancer Awareness Month, now in its 20th year, aiming to raise awareness of the disease and the signs and symptoms, so that people can get a crucial diagnosis, sooner.
For employers, doing their bit to help boost awareness, and supporting their people who are going through treatment might just be lifesaving.
What is the pancreas?
The pancreas is perhaps an organ we’ve heard about but are less sure about what it actually does within the body. It’s a gland that sits at the back of the abdominal cavity, immediately in front of the spine and behind all of the other organs. About 20 cms in length, it has two main functions:
- It’s part of the digestive system, making enzymes which help the body to break down food to a point that it can absorb the nutrients from it.
- It makes hormones that include insulin and glycogen and these help to control our blood sugar levels.
About pancreatic cancer
There are around 11,500 new cases of pancreatic cancer diagnosed in the UK each year (that’s approximately 31 cases every day), according to Cancer Research.
There are two main types, one of which accounts for around 95% of cases. This is known as ‘Pancreatic ductal adenocarcinoma’ and affects the ducts that carry digestive juices containing enzymes. Unfortunately, it’s particularly aggressive, spreading very early on and often way before any symptoms arrive or the diagnosis is made. Hence the ’silent disease’ description.
The second type is known as ‘Neuroendocrine tumours’ which are significantly less common and account for less than 5% of cases. These types of tumours start in the cells that are responsible for making the hormones insulin and glycogen which we need to control bloody sugar.
Who it affects
Pancreatic cancer is generally a later life cancer and nearly half diagnosed in the UK are over the age of 75. However, cases do occur in younger age groups. Like many of those older people who are diagnosed, they may have been living without any idea they have the condition, and may even be unaware that it even exists.
It is not uncommon to attribute many of the symptoms – such as fatigue, belly and back pain to the rigours of busy daily lives. However, there are some more noticeable symptoms, and this is where better awareness can really make a difference.
Symptoms of Pancreatic Cancer
While some of these symptoms might not immediately suggest something is wrong, knowing more about them – and being prepared to raise concerns, could flag the condition early enough to have medical intervention.
In particular, in the case of pancreatic cancer, changes in what we see in the toilet can be a cause for concern. If poo starts to float, changes to a lighter colour and urine goes dark – these are all classic symptoms. Some people with pancreatic cancer have reported having to flush their toilets several times due to their poo floating. It’s easy to dismiss this – and not want to tell others – but this is exactly what we should be doing.
Likewise, jaundice – demonstrated by yellowing of the skin and eyes – is a strong visual indicator that something is wrong.
Symptoms in brief:
- Belly pain that spreads to the sides or back
- Loss of appetite
- Weight loss
- Jaundice (yellowing of the skin and eyes)
- Light-coloured or floating poo
- Dark-coloured urine
- Itching
- Fatigue
- New diagnosis of diabetes or diabetes that’s getting harder to control.
In a small number of cases, when a person makes changes to their diet following a diagnosis of suspected type 2 diabetes (adult-onset diabetes) and loses weight rapidly, this can be a sign of pancreatic cancer.
A family history of pancreatic cancer is also a factor. People who have a breast cancer gene, and a relative with pancreatic cancer are also at increased risk.
Find out more about spotting the signs and symptoms with this resource from Pancreatic Cancer UK.
Lifestyle factors that can increase the risk
Whereas pancreatic cancer appears more in older age groups (and we can’t control our age), there are things we can control – and that may reduce the risk.
Smoking is thought to be a factor that causes around 1 in 5 pancreatic cancer cases. In particular, use of a smokeless tobacco called Snus (Snoose like Moose), usually put under the upper lip to absorb the nicotine, can increase the risk dramatically.
Obesity is also thought to be a contributory factor, with around 12% or 1 in 8 pancreatic cancer cases in the UK linked to being overweight or obese. And as we have covered, there’s a higher risk in those who have diabetes, specifically type 1. What’s more, alcohol consumption of more than 3 units a day increases the risk by 15-19% compared to someone who only drinks occasionally or doesn’t drink at all.
So, stopping smoking, losing weight and reducing alcohol may all have a benefit in reducing the likelihood of developing pancreatic cancer.
Work-related risk factors
Employers need to be aware that the workplace, namely through exposure to solvents and chemicals, can be a contributor to pancreatic cancer. Exposure to common workshop materials such as degreasers, paints, and dry cleaning fluids increase risks. And agricultural work, through the use of pesticides – in particular DDT – also carries risks.
Likewise, exposure to nickel chloride and nickel acetate, typically centred around electroplating, manufacturing textiles, chemical synthesis, and metal surface treatments can also be a risk factor.
This is why it’s always recommended to have workplace health surveillance that includes biological monitoring so that any signs of work-related ill-health are caught and monitored as early as possible.
Can pancreatic cancer be treated?
Pancreatic cancer can be difficult to treat and depends on whether the tumour is early-stage and removable or advanced and spread to nearby blood vessels or organs.
Treatment may include surgery, chemotherapy, radiotherapy and supportive care. Surgery is the only potentially curative option, but it is usually only possible if the tumour is confined to the pancreas and has not invaded major blood vessels. Common surgery procedures include the Whipple procedure (removing the head of the pancreas, part of the small intestine, gallbladder, and bile duct).
The main treatments are explained in more detail on the NHS page ‘Main treatments for pancreatic cancer’.
How can employers support better awareness?
Employers can improve awareness of pancreatic cancer and support early detection by using the educational and awareness campaigns run by pancreatic cancer charities, and training management teams in how to listen and support employees – see the next section for more on this.
For workplace awareness, charities like Pancreatic Cancer Action or Pancreatic Cancer UK offer free educational resources, fact sheets, toolkits, and workplace support guidance. And Cancer Research UK run a Cancer Awareness in the Workplace programme which could offer broader training and awareness to include other cancers.
As early identification is so critical to pancreatic cancer survival, employers could consider highlighting the warning signs in high traffic areas such as staff rooms, kitchens and toilets via posters warning about symptoms like indigestion, back pain, unexplained weight loss, and jaundice.
How can employers offer employee support?
In many ways, the support needed is no different to other cancers affecting employees. What they need is a combination of listening, empathy and workplace adjustments. A good line manager will want to offer to listen but also know to read the signs when they may prefer to have some space and privacy.
Likewise, colleagues may not know what to say but letting the person going through cancer know that they are there for them and being willing to help with workload can be a powerful way to reduce their anxiety about the impact their diagnosis might cause. They will be going through a rollercoaster of emotions from fear, anger, anxiety, sadness, uncertainty and a supportive manager and team can make the world of difference.
Employers should be aware that someone who has cancer is protected as disabled under the Equality Act 2010 from the point that they’re diagnosed. This means it’s the employers duty to think about reasonable adjustments so that person isn’t substantially disadvantaged.
Practical adjustments will be needed alongside emotional support and these may include:
- Flexible working hours
- More regular breaks in the day
- Discussing hybrid or home based working
- Time off for medical appointments – recorded separately from sickness absence
Finally, respecting confidentiality is essential. Going through cancer diagnosis and treatment and recovery is a very personal and sensitive journey and it’s not appropriate to share this information without the persons consent to do so.
Final thoughts
While pancreatic cancer is largely diagnosed in older age groups, it does also affect younger age groups who may attribute the symptoms to the stresses of every day life. The biggest challenge is knowing enough about the symptoms to spot the possibility of having it early enough to have a surgical intervention. Sadly, the hard to spot symptoms are often overlooked or not addressed until it is too late. Employers can play a vital role in awareness that could save lives, as well as supporting those going through diagnosis and treatment with compassion and adjustments.
