‘Cinderella’ cancer in the spotlight

5 minute read

Australia has a novel new national roadmap for navigating pancreatic cancer.

Pancreatic cancer might not be the most common cancer in Australia, but its poor outcomes and early-detection challenges have put it firmly on the national radar.

According to the Australian Institute of Health and Welfare (AIHW), an estimated 4261 cases of pancreatic cancer were diagnosed in 2021, accounting for 2.8% all new cancer diagnoses

It was expected to be the eighth most common cancer diagnosed in 2021, behind breast (20,030 cases), prostate (18,110), melanoma (16,878), colorectal (15,540), lung (13,810), non-Hodgkin lymphoma (6402) and kidney (4377).

AIHW statistics also show that between 2013 and 2017, the five-year relative survival rate was 70% for all cancers combined. For pancreatic cancer between 2013 and 2017, the five-year relative survival rate was just 11.8% for women and 11.2% for men.

Last week the federal government launched a National Pancreatic Cancer Roadmap, which aimed to create a more coordinated approach to tackling the disease, from early detection to treatment and survival.

The interactive roadmap – the first of its kind in Australia – was developed by Cancer Australia.

And the government had also committed $20.3 million to improve outcomes and survival for Australians affected by the disease, said Health Minister Greg Hunt.

“Pancreatic cancer is the third leading cause of cancer death in Australia, and over the past 40 years the number of Australians diagnosed with pancreatic cancer has more than tripled,” he said.

“Pancreatic cancer has significantly poorer outcomes than many other cancers and has a devastating impact on the lives of all those affected.”

The roadmap identified key priority areas and strategies for collective action over the next five years to 2027. These priority areas were developed with stakeholders and covered all aspects of the pancreatic cancer pathway, including prevention, early detection, diagnosis, treatment, supportive and palliative care, and pancreatic cancer research.

Professor Dorothy Keefe, who was also last week reappointed as Cancer Australia’s CEO for a further three years, said the number of pancreatic cancer diagnoses might not be as high as some others, such as breast or prostate cancer, but it was still a risk for all Australians.

The AIHW estimated that in 2021 a person had a one-in-69 risk of being diagnosed with pancreatic cancer by the age of 85. It was also estimated to be the third-most-common cause of death from all cancers in 2021.

“I think it was time that we looked at a cancer that was maybe a Cinderella cancer – it’s not terribly common or as common as the big ones, like breast, lung or colorectal,” she said. “But it’s a big killer. And it has not had the investment that some other cancers have had, because it’s been very difficult to understand how it works and how it develops, and it’s very difficult to find early.

“Couple that with the fact that people die far too soon with it, and you don’t have a huge number of long-term survivors, and of course, survivors make the best advocates. So, it was time to us to focus on one of the lower-volume, higher-impact cancers, and pancreatic ticked all the boxes.”

Professor Keefe said the roadmap was designed to be simple but highly effective, while addressing patient needs as well as the bigger picture of research into early detection and treatment.

Another important consideration of the roadmap was its ability to reach all Australians, especially Aboriginal and Torres Strait Islander people, who were especially at risk, she said.

“We would like to make sure that diagnoses are made sooner to enable treatment and there is a bit of an increase in pancreatic cancer in Aboriginal and Torres Strait Islander people,” she said.

“We’re trying to make sure that everything we do here provides improvements for everybody.”

As part of the $20.3 million in funding, money has been allocated to improve early detection, and management and care of people diagnosed with pancreatic cancer, including $3.3 million to address five priorities outlined in the roadmap, including culturally appropriate models of care.

The Medical Research Future Fund (MRFF) will also fund research aligning with two roadmap priorities including $6 million to progress therapeutic approaches for improving the management of pain and symptoms in individuals with pancreatic cancer through the MRFF Emerging Priorities and Consumer Driven Research Initiative; and $6 million for involvement in international collaborative clinical trials through the MRFF Clinical Trials Activity Initiative.

In addition, $5 million had been provided to support the Pancreatic Centre – located at Epworth HealthCare in Victoria – in its quest to detect pancreatic cancer early and improve treatment options for people affected by the disease. Professor Keefe said this was particularly significant.

“One of the problems with pancreatic cancers is the symptoms are a bit vague, but you put a few things together, create an algorithm and say, well if you present with this particular combination, you should really have a look and make sure there isn’t a pancreatic cancer,” she said.

“The roadmap is for the Australian community,” Professor Keefe said. “Its implementation will be a collective responsibility involving people affected by pancreatic cancer, health professionals, professional colleges, researchers, pancreatic cancer organisations, peak bodies, and non-government and government organisations.”

Cancer In Australia 2021, online 1 December 

National Pancreatic Cancer Roadmap 2022, online 21 March  

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