Early diagnosis of pancreatic cancer in a nurse-led, one-stop jaundice service

Abstract

UK cancer survival rates are below the European average, owing to frequent late diagnosis. Pancreatic cancer is particularly difficult to diagnose early, due to limited initial symptoms. As the surgical window is small, this makes it particularly deadly, with a 6-month average survival. The public is less aware of the symptoms of pancreatic cancer than of other cancers. Many patients either avoid presenting at the GP for a long time or first present at an accident and emergency ward, which is expensive and has poor outcomes. As jaundice is the most reliable indicator of pancreatic cancer, a nurse-led one-stop jaundice service was set up to diagnose and refer cases as early as possible. The service provides biliary drainage via percutaneous transhepatic cholangiogram (PTC) for patients with bilirubin over 250 mumol/l. Initial outcomes measurements have been positive.