Simple tests could help diagnose pancreatic cancer at an earlier stage

A Southampton-led study has shown that 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 Mr Declan McDonnell and Mr Zaed Hamady at University Hospital Southampton. It was funded by Cancer Research UK and coordinated by the CRUK Southampton Clinical Trials Unit.

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 5th most common cause of cancer death*. 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 Declan 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 and this is due to reduced pancreatic enzymes which aid normal digestion. This reduction in enzymes often leads to early vague symptoms such as dyspepsia (indigestion) and changes in bowel habits.

The aim of the DEPEND study was to find out whether this impaired enzyme function, called pancreatic exocrine insufficiency (PEI), is present in earlier stages of the disease and could therefore be used as an additional diagnostic tool.

Utilising simple tests

The study recruited patients at University Hospital Southampton with pancreatic cancer, but crucially which had been diagnosed at an early enough stage that it was still treatable with surgery.

The study also involved healthy volunteers, as well as a control group with chronic pancreatitis, 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.

“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 Zaed Hamady, pancreatic surgeon and Chief Investigator of the DEPEND study. “The hope is that these tests could therefore be potential diagnostic tools to aid earlier detection of the disease.”

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 Clinical Trials Unit. “The more people we can diagnose early, the better the chances of successful treatment and survival. “

Mr McDonnell concludes: “The hope is that in the future these simple, cost-effective tests, which can be carried out routinely in primary care settings such as GP surgeries and health centres, could provide a way to test for pancreatic cancer in its early stages, when curative surgery is still an option.”