It is known as the silent killer, sneaking up with little warning, and seldom sparing its victims from a premature death.
In the UK, only 7 per cent of those who are diagnosed with pancreatic cancer will live for five years; a higher death rate than almost any other cancer.
Last month the former England football manager Sven-Goran Eriksson, 76, went public with the news that he has pancreatic cancer and is likely to die within a year.
With characteristic single-mindedness, he said he is determined to live a life ‘as normal as possible. I refuse to give up’.
For me, Sven’s words had a chilling resonance. Last summer I, too, was diagnosed with pancreatic cancer.
I feel blessed that I survived at all, writes Mark Edmonds, pictured. His pancreatic cancer was discovered by chance
The disease, as is its wont, arrived with scant fanfare — most symptoms, perhaps an innocuous-seeming back pain or simple indigestion often don’t appear until the disease is almost highly advanced.
I was tremendously fortunate. My pancreatic cancer was only discovered coincidentally as I was undergoing a post-treatment check-up after being diagnosed with unrelated prostate cancer — an ‘easy’ cancer, common in men, and which is often eminently treatable with surgery or radiotherapy.
Last week Buckingham Palace revealed that the King had been diagnosed with a ‘coincidental’ cancer after he was treated for an enlarged prostate.
Part of my own treatment last year involved what I thought would be a routine hospital scan.
Yet within a matter of days I found myself staring death in the face.
It had all started in the autumn of 2022. Most mornings before starting work I take my much-loved dog, Roxy, for a brisk couple of circuits of Regent’s Park in London, near to where I live.
The four-mile walk tends to keep both of us reasonably fit; we normally spend an hour or so in the park before we repair to a local cafe.
Charles and Camilla wave after attending a service at St Mary Magdalene Church on the Sandringham Estate at the weekend
That October I began to notice that after just one cup of coffee, I was experiencing what doctors refer to as ‘urinary urgency’ — those leisurely strolls around the park would often be followed by an undignified sprint home.
Something, it seemed, was not right and, given my age (I’m in my early 60s), it made sense to see my GP.
Within less than a fortnight, I was diagnosed with prostate cancer. I had raised PSA levels (a measure of prostate specific antigen, a protein linked to cancer) and a scan revealed two small tumours, each — thankfully — slow growing.
The seriousness of prostate cancer is determined by its Gleason score (what the cancer cells look like in relation to normal cells). My two tumours were ‘intermediate’ prostate cancer — serious, but treatable.
However, my oncologist was confident that a month of radiotherapy would zap the tumours completely, without the need for surgery.
Prostate cancer, if diagnosed early enough, can easily be treated. Many men die from other causes in old age, without even knowing they have the disease.
After radiotherapy, my PSA levels went right down. In common with thousands of other men my age, I appeared to have beaten the disease.
The mild discomfort of the radiotherapy suite in the basement of University College London Hospital (UCLH) — where I was treated by a team, most of whom I got to know on first-name terms — was soon forgotten as I contemplated a long and lazy summer.
But less than a week later, when I was at home one lunchtime, the phone call came.
It was my UCLH oncologist. His demeanour had always been urbane and unflappable. But now he seemed unusually agitated, alarmed by some abnormalities in my liver.
His question was clipped and to the point: ‘How much alcohol are you drinking?’
‘Something, it seemed, was not right and, given my age (I’m in my early 60s), it made sense to see my GP.’ Pictured: Mark with friend Hanna
When I first met him, I made him aware of my former life as a well-lubricated and gregarious newspaper journalist with a passion for expansive lunches with ‘contacts’ — that said, I would not say I was a heavy drinker, and I’d barely touched a drop since my diagnosis.
‘Your drinking has got to stop right now,’ my oncologist insisted, clearly irritated by what he believed was my irresponsible and cavalier approach to my health.
It is difficult, I reminded him, to stop what you haven’t started. Once he had calmed down he arranged for me to have, on a Friday three days later, a specialised MRI scan (known as an MRCP) which targets the liver, gall bladder, bile duct and pancreas.
To me, it seemed like another routine scan — and I’d had quite a few in the previous few months.
But within half an hour of this MRI, as I was on the bus home, I received another urgent call. This time from the registrar in the A&E department who had conducted the MRCP scan.
‘You’d better come back in,’ he said. ‘Would Monday be OK?’ I asked. ‘No, you need to come in now.’ This was serious.
I suddenly found myself in a daze and for the first time felt fear. Fear of serious illness and, ultimately, fear of death.
I went back to the hospital. The registrar sat me down in a small cupboard of a room, only just removed from the organised chaos of A&E.
‘We have found a tumour on your pancreas,’ he said. ‘And it does not look good. You need to come back immediately — early next week.’
It was a shock. And I was well aware that a diagnosis of pancreatic cancer is invariably a death sentence.
An old, dear friend of mine had died of it a few years previously. In his case, unusually, it was a long, painful and drawn-out affair over two years as the cancer spread tortuously throughout his body.
Prostate cancer, if diagnosed early enough, can easily be treated. Many men die from other causes in old age, without even knowing they have the disease
At his funeral I remember seeing his body, scrubbed and polished up by the dutiful undertaker, lying in repose in his open coffin in a smart new shirt.
As I accepted my diagnosis, I couldn’t stop thinking about what had happened to him.
The following week I saw my GP. She seemed more shaken than me.
On learning that I had been diagnosed with pancreatic cancer, she suggested this might be the time to decide whether I wanted to die at home or in a hospice.
A little premature, but these questions have to be considered at some point. Such a dilemma had never previously entered my head. Most people only give death a thought when it taps us on the shoulder.
Strangely, by that point the fear had gone. I was left only with a determination to do all I could to beat the disease.
Many experts — including some of those treating me — have since told me that an aggressive mindset is half the battle against any cancer, or at least successful recovery from the disease during and after treatment.
‘You are fit and have a curmudgeonly attitude which will help you over the next months and years,’ my surgeon told me. It wasn’t entirely intended as a compliment.
The shocking death rate among people with pancreatic cancer is partly explained by the fact that the only cure is surgery, principally the Whipple procedure, which was developed in the U.S. in the 1930s.
But it only works if the cancer is caught early and the tumour is in the head (i.e. at the top) of the pancreas.
‘We desperately need more treatment options for pancreatic cancer,’ Dr Chris Macdonald, head of research at the charity Pancreatic Cancer UK, told me.
‘But detecting the disease in its early stages is very difficult — only 10 per cent of people can go on to have surgery.’
Dr Macdonald explained that if scans show a person’s tumour has grown very close to the major blood vessels near the pancreas, patients may be given chemotherapy first to try to shrink the tumour to make surgery possible.
The Whipple procedure remains an effective treatment but, as I found, is incredibly invasive and it can be a year or two before you get back to normal.
The operation involves the removal of the head of the pancreas — where most pancreatic tumours are found — and the duodenum (the first bit of the small intestine), the gallbladder and in some cases part of the stomach.
Last summer I was told that under the NHS I would have to wait at least a month for the op (to be followed by chemotherapy to mop up any remaining cancer cells).
‘Within a few weeks following my diagnosis, I began to present classic symptoms of the disease: jaundice, itchy skin and darkened urine.’ Pictured: Mark in hospital
Given the speed with which the tumour had appeared — the scan had revealed that it was already 3cm in diameter, yet at a scan three months earlier there had been no sign of it — I wasn’t willing to take any chances.
Within a few weeks following my diagnosis, I began to present classic symptoms of the disease: jaundice, itchy skin and darkened urine.
Time was running out, whatever the NHS might say. So I opted instead to have the procedure carried out privately — at a jaw-dropping cost of £35,000.
I was fortunate to have the money — or at least access to it via my private pension, but I am well aware that not everyone can afford to go outside the NHS.
NHS England statistics insist that more than 93 per cent of patients diagnosed with pancreatic cancer and similar cancers are treated within one month.
But a lack of an early diagnosis is still the main problem.
My operation took about nine hours — a long time for anyone to be under the knife.
Until the Seventies, the death rate of patients during the Whipple procedure amounted to around 20 per cent — nowadays outcomes are much improved and only about 2 per cent die in the operating theatre.
Immediately before I was wheeled into the theatre at the swanky new Cleveland Clinic in London, my surgeon Charles Imber appeared in his scrubs for a brief chat.
He was upbeat and optimistic but did warn me that if they found any cancer had spread outside the pancreas they would not be able to operate — and he would sew me up and send me on my way. Probably to an early death — but he was too discreet to mention that.
Palliative chemotherapy, which might control the cancer for a few months, would then be my only option.
When I came round later that night, the first question I asked was ‘did you get all of the cancer?’. Mercifully he did.
As a private patient, I was lucky enough to be operated on within a week — in a gleaming new private hospital, just round the corner from Buckingham Palace. It felt like a five-star hotel.
Since my surgeon had comprehensively reorganised a large section of my insides, I can’t say I was craving a slap-up meal from the extensive menu. For four nights I was allowed to consume only consommé for lunch and dinner.
Much of my bill was for the operation itself — around £27,000 — though my surgeon’s ‘professional fees’ amounted to a relatively modest £3,160 for a long day’s work.
But I have no regrets — six months on, I feel blessed that I survived at all. A huge scar, running the length of my abdomen, is testament to the sheer complexity of the surgery.
Against all the odds, I had made it. As the oncologist at UCLH, who is supervising my chemotherapy, put it to me: ‘You came close to death. You were lucky to have that surgeon. And you were lucky to have the operation when you did.’
He says there is every chance of a full recovery. Had I not been diagnosed coincidentally with prostate cancer, the pancreatic tumour would almost certainly have killed me — very quickly.
Without a doubt, I was lucky on all counts.
I am now in recovery — having lost nearly three stone as a result of the surgery. I am doing my best to build up muscles again and get back to my normal life, though at times the chemo has been punishing.
I still suffer chronic fatigue and I’m too tired to go out in the evening. But I am one of the fortunate ones.
There are some positive signs in terms of diagnosis and treatment. In the U.S., vaccines are being tested as a treatment for pancreatic cancer, while in this country a research project, led by Pancreatic Cancer UK, is looking at a revolutionary ‘breath test’ which GPs will administer to identify people with the disease.
Researchers are optimistic it will be rolled out within four years.
Dr Macdonald said: ‘With this test, we hope GPs will be able to identify people who are likely to have pancreatic cancer with high levels of accuracy, so they can be quickly sent for further tests.’ The breath test will cost the NHS only about £15 per patient.
But outcomes for the vast majority in the UK who get pancreatic cancers remain bleak — our survival rates for the worst cancers (pancreatic is number two in the league table of horrors, with lung cancer at number one) are much worse than many countries in Europe and elsewhere.
We rank just 26th of the ‘wealthy’ countries for survival rates for pancreatic cancer.
Dr Macdonald blames ‘decades of underfunding and inaction from successive governments that have made tackling pancreatic cancer a cancer emergency like no other.
‘The huge strides which have been made in improving survival for other cancers here, and in other countries, are proof that the UK can do so much better,’ he says.
‘Currently seven in ten people with pancreatic cancer in the UK receive no treatment at all — not even chemotherapy. That’s completely unacceptable.
‘Other countries have access to the same diagnostic techniques and treatments that we do. If everyone could get the best care currently available, more people could survive this devastating disease.’
And they might do so without having to raid their pensions or crack open their savings.
For more information visit pancreaticcancer.org.uk
