[{"id":"adenoma-detection-rate","name":"Adenoma detection rate","tldr":"The adenoma detection rate is the share of screening colonoscopies in which an endoscopist finds at least one adenoma. It is the best single measure of how good a colonoscopy service is, because the patients of endoscopists who find more polyps go on to get fewer cancers and to die of them less often.","route":"/terms/adenoma-detection-rate/","kind":"term","schematic":{"id":"colorectal-screening","sections":["early-detection"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"adenoma-carcinoma-sequence","name":"Adenoma-carcinoma sequence","tldr":"The adenoma-carcinoma sequence is the step-by-step route by which a normal bowel lining becomes a polyp and the polyp becomes a cancer, as genetic faults pile up over years. It is why removing polyps prevents cancer, and it was the first human cancer to be mapped this way.","route":"/terms/adenoma-carcinoma-sequence/","kind":"term","target":{"id":"kras","name":"KRAS","targetClass":"oncogene","tldr":"KRAS is the most commonly mutated cancer gene, called 'undruggable' for 40 years until 2021."},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer","Familial adenomatous polyposis-associated colorectal cancer","Adenoma-like adenocarcinoma of the colon and rectum"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."},{"label":"Familial adenomatous polyposis-associated colorectal cancer","href":"/cancers/fap-associated-colorectal-cancer/","tip":"In familial adenomatous polyposis a person inherits a fault in the APC gene and grows hundreds or thousands of polyps in the large bowel from their teens. Left alone, almost all of them become cancer by about 40, so the bowel is watched from childhood and usually removed before that happens; the cancers that do occur are treated like ordinary bowel cancer."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"colorectal-adenoma-like-adenocarcinoma","name":"Adenoma-like adenocarcinoma of the colon and rectum","tldr":"Adenoma-like adenocarcinoma is a form of bowel cancer whose invasive part still looks like a harmless polyp under the microscope, which is why it is often reported as an adenoma on biopsy and only recognised once the bowel is removed. Despite frequently growing deep into the bowel wall, it spreads to lymph nodes less often than ordinary bowel cancer and does better.","route":"/cancers/colorectal-adenoma-like-adenocarcinoma/","kind":"cancer","cancerIcon":"colorectal-adenoma-like-adenocarcinoma","facets":{"kind":["Cancer"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Cancer","tip":"One page per disease: state of the art, history, and what is coming."},"cancers":[],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."},{"label":"subtype-page","href":"/tagged/subtype-page/","tip":"Every record tagged subtype-page."}]},"sortKeys":{"year":0}},{"id":"pancreatic-adenosquamous-carcinoma","name":"Adenosquamous carcinoma of the pancreas","tldr":"Adenosquamous carcinoma is a rare form of pancreatic cancer in which at least three tenths of the tumour has turned into squamous cells, the flat cells of skin-like linings. It is found more often in the body and tail, tends to be larger and poorly differentiated, and does worse after surgery than ordinary pancreatic cancer, though surgery remains the strongest predictor of survival.","route":"/cancers/pancreatic-adenosquamous-carcinoma/","kind":"cancer","cancerIcon":"pancreatic-adenosquamous-carcinoma","facets":{"kind":["Cancer"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Cancer","tip":"One page per disease: state of the art, history, and what is coming."},"cancers":[],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."},{"label":"subtype-page","href":"/tagged/subtype-page/","tip":"Every record tagged subtype-page."}]},"sortKeys":{"year":0}},{"id":"anti-egfr-rechallenge","name":"Anti-EGFR rechallenge","tldr":"When an EGFR antibody stops working, the resistant cells that caused it fade away once the drug is withdrawn. Rechallenge means giving the same class of drug again later, after a blood test has confirmed those resistant clones have receded, and in small trials about a fifth to a third of patients respond a second time.","route":"/terms/anti-egfr-rechallenge/","kind":"term","target":{"id":"egfr","name":"EGFR","targetClass":"kinase","tldr":"A growth receptor that is mutated in some lung cancers and overproduced in others; the first great success of targeted pills."},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"cholangiocarcinoma","name":"Biliary tract cancer (cholangiocarcinoma)","tldr":"Cholangiocarcinoma is cancer of the bile ducts or gallbladder. It is rare and often found late, but it turned out to carry more targetable mutations than almost any other gastrointestinal cancer, and immunotherapy now adds to chemotherapy from the first treatment.","route":"/cancers/cholangiocarcinoma/","kind":"cancer","cancerIcon":"cholangiocarcinoma","facets":{"kind":["Cancer"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Cancer","tip":"One page per disease: state of the art, history, and what is coming."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"carers-bowel-cancer-uk","name":"Carers: what you can do and UK carer support (bowel cancer)","tldr":"A carer is anyone giving unpaid help to someone with cancer who could not manage without it. You can come to appointments and write down the answers, learn the sepsis, blockage and stoma signs, help with bags and supplies if asked, tell the team you are the carer, ask the council for a free carer's assessment, and use Bowel Cancer UK's nurses, forum and carer pages for yourself.","route":"/terms/carers-bowel-cancer-uk/","kind":"term","term":{"category":"Clinic basics"},"facets":{"kind":["Term"],"cancers":["Colorectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"carers-pancreatic-cancer-uk","name":"Carers: what you can do and UK carer support (pancreatic cancer)","tldr":"A carer is anyone giving unpaid help to someone with cancer who could not manage without it; you can come to appointments, keep the enzyme dose and the medicine list, learn the sepsis, stent, clot and blocked-bowel signs, tell the team you are the carer, ask the council for a free carer's assessment, and use Pancreatic Cancer UK's nurses, carer booklet and Circles community for yourself.","route":"/terms/carers-pancreatic-cancer-uk/","kind":"term","term":{"category":"Clinic basics"},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"circumferential-resection-margin","name":"Circumferential resection margin (rectal cancer)","tldr":"The circumferential resection margin is the side surface of the removed rectum, the plane the surgeon cut along. If cancer cells lie within a millimetre of it, the cancer is much more likely to come back in the pelvis. It is measured on the scan before surgery and on the specimen afterwards, and it is the single reading that most shapes rectal cancer treatment.","route":"/terms/circumferential-resection-margin/","kind":"term","schematic":{"id":"mri","sections":["imaging"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Rectal cancer","Colon cancer","Micropapillary adenocarcinoma of the colon and rectum"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Micropapillary adenocarcinoma of the colon and rectum","href":"/cancers/colorectal-micropapillary-carcinoma/","tip":"Micropapillary adenocarcinoma is bowel cancer in which some of the tumour grows as tiny clusters of cells floating in empty spaces, with the cells turned inside out so the surface that normally faces the bowel faces outwards instead. It is a pattern that goes with heavier invasion of lymph and blood vessels and more involved lymph nodes, and it is graded and treated like ordinary bowel cancer."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"classical-vs-basal-like","name":"Classical versus basal-like (squamous) subtypes of pancreatic cancer, and GATA6","tldr":"Gene expression divides pancreatic ductal adenocarcinoma into two main types: classical, the commoner, which keeps its pancreatic identity and responds better to chemotherapy, and basal-like or squamous, which has lost it and carries a worse outlook. One gene, GATA6, is high in classical and low in basal-like tumours, so it can stand in for the whole test; it is used in trials, not routine care.","route":"/terms/classical-vs-basal-like/","kind":"term","target":{"id":"kras","name":"KRAS","targetClass":"oncogene","tldr":"KRAS is the most commonly mutated cancer gene, called 'undruggable' for 40 years until 2021."},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma","Metastatic pancreatic ductal adenocarcinoma","Resectable pancreatic ductal adenocarcinoma","KRAS wild-type pancreatic ductal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Metastatic pancreatic ductal adenocarcinoma","href":"/cancers/metastatic-pdac/","tip":"Metastatic pancreatic cancer has spread beyond the pancreas, usually to the liver, and is treated with chemotherapy rather than surgery. Three combination regimens lengthen life, a minority of patients qualify for targeted drugs chosen by tumour or inherited mutations, and in 2026 the pan-RAS inhibitor daraxonrasib became the first drug against the KRAS mutation that drives almost every case."},{"label":"Resectable pancreatic ductal adenocarcinoma","href":"/cancers/resectable-pdac/","tip":"Resectable pancreatic cancer is the minority of pancreatic cancer that the surgeon can remove with clear margins because it has not wrapped around the main arteries or spread. Treatment is an operation, usually a Whipple procedure, followed by six months of combination chemotherapy, which is what turns surgery alone into a real chance of cure."},{"label":"KRAS wild-type pancreatic ductal adenocarcinoma","href":"/cancers/kras-wild-type-pdac/","tip":"KRAS wild-type pancreatic cancer is the one in ten pancreatic cancers without the KRAS mutation that drives the rest. Instead many carry a different switched-on gene, often a fusion involving NRG1, NTRK, ALK, ROS1, FGFR2 or RET, or a BRAF change, and several of these have approved pills or antibodies, so these tumours must be sequenced with a test that detects fusions."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"clinical-benefit-response","name":"Clinical benefit response (the gemcitabine trial endpoint)","tldr":"Clinical benefit response was the measure invented for the 1997 trial that got gemcitabine approved for pancreatic cancer: a patient counted as benefiting if pain, painkiller use, day-to-day function or weight improved for at least four weeks without any of the others getting worse. It is a symptom endpoint, and it is why gemcitabine was accepted on a survival gain of about five weeks.","route":"/terms/clinical-benefit-response/","kind":"term","molecule":"gemcitabine","modality":"Nucleoside analogue (deoxycytidine)","facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma","Metastatic pancreatic ductal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Metastatic pancreatic ductal adenocarcinoma","href":"/cancers/metastatic-pdac/","tip":"Metastatic pancreatic cancer has spread beyond the pancreas, usually to the liver, and is treated with chemotherapy rather than surgery. Three combination regimens lengthen life, a minority of patients qualify for targeted drugs chosen by tumour or inherited mutations, and in 2026 the pan-RAS inhibitor daraxonrasib became the first drug against the KRAS mutation that drives almost every case."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"coeliac-plexus-block","name":"Coeliac plexus block for pancreatic cancer pain","tldr":"An injection that deadens the bundle of nerves behind the pancreas, done through the back under X-ray or ultrasound guidance or from inside the stomach during an endoscopic ultrasound; NICE suggests considering it when pancreatic pain is not controlled, opioid side effects are unacceptable or doses keep rising.","route":"/terms/coeliac-plexus-block/","kind":"term","schematic":{"id":"pain-management","sections":["supportive-care"]},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"colibactin","name":"Colibactin","tldr":"Colibactin is a DNA-damaging chemical made by some strains of gut bacteria. It leaves a recognisable pattern of mutations in bowel cancers, that pattern is commoner in people diagnosed young, and it is the strongest current lead on why bowel cancer is rising in the under-50s.","route":"/terms/colibactin/","kind":"term","target":{"id":"apc","name":"APC","targetClass":"tumor-suppressor","tldr":"APC (Adenomatous polyposis coli protein) is a gene whose normal job is to hold cell growth in check. The public catalogues list it as a drug target, an oncogene driver, a tumour suppressor and a biomarker, and an approved or late-stage drug is recorded against it. Tied to Colorectal cancer, Gastric & gastro-oesophageal junction cancer, Hepatocellular carcinoma and 5 more."},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Early-onset colorectal cancer","Colon cancer","Rectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Early-onset colorectal cancer","href":"/cancers/early-onset-colorectal/","tip":"Bowel cancer is rising in people under 50, for reasons that are still not understood, and it is usually found late because neither patients nor doctors expect it. Treatment is the same as in older adults and works as well stage for stage; the changes are earlier screening, genetic testing for everyone diagnosed young, and attention to fertility, work and family."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"pancreatic-colloid-carcinoma","name":"Colloid (mucinous non-cystic) carcinoma of the pancreas","tldr":"Colloid carcinoma is a rare form of pancreatic cancer in which the cancer cells float in large pools of mucus rather than forming glands in dense scar. It usually grows out of an intestinal-type IPMN in the main pancreatic duct, presents as a larger but lower-stage tumour, and has a clearly better outlook after surgery than ordinary pancreatic cancer.","route":"/cancers/pancreatic-colloid-carcinoma/","kind":"cancer","cancerIcon":"pancreatic-colloid-carcinoma","facets":{"kind":["Cancer"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Cancer","tip":"One page per disease: state of the art, history, and what is coming."},"cancers":[],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."},{"label":"subtype-page","href":"/tagged/subtype-page/","tip":"Every record tagged subtype-page."}]},"sortKeys":{"year":0}},{"id":"colorectal","name":"Colorectal cancer","tldr":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on.","route":"/cancers/colorectal/","kind":"cancer","cancerIcon":"colorectal","facets":{"kind":["Cancer"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Cancer","tip":"One page per disease: state of the art, history, and what is coming."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"colorectal-roadmap","name":"Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation","tldr":"Bowel cancer grows from a polyp over years, so removing the polyp prevents it. This roadmap follows the evidence from that discovery through the stool tests and scopes that built the screening programmes, the operation that changed rectal cancer, the chemotherapy and antibody era, immunotherapy that dissolves some tumours without surgery, and the unexplained rise in young adults, to 2032.","route":"/roadmaps/colorectal-roadmap/","kind":"roadmap","cancerIcon":"colorectal","facets":{"kind":["Roadmap"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer","Mismatch-repair deficient (MSI-high) colorectal cancer","BRAF V600E-mutant colorectal cancer","HER2-amplified colorectal cancer","KRAS G12C-mutant colorectal cancer","Early-onset colorectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Roadmap","tip":"Where a technology has been and where it is heading."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."},{"label":"Mismatch-repair deficient (MSI-high) colorectal cancer","href":"/cancers/msi-high-colorectal/","tip":"Mismatch-repair deficient bowel cancer has lost its DNA spell-checker, so it carries thousands of mutations that the immune system can recognise. Immunotherapy alone controls most metastatic cases for years and makes most localised tumours disappear before surgery, sometimes so completely that no surgery is needed."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."},{"label":"roadmap","href":"/tagged/roadmap/","tip":"Every record tagged roadmap."},{"label":"colorectal-evidence","href":"/tagged/colorectal-evidence/","tip":"Every record tagged colorectal-evidence."}]},"sortKeys":{"year":0}},{"id":"conversion-therapy-colorectal","name":"Conversion therapy in bowel cancer","tldr":"Conversion therapy means giving drugs to shrink secondary tumours that cannot be operated on at first, in the hope that they become small enough to remove. It is a different goal from simply controlling the disease: the treatment is chosen for how hard it shrinks the tumour, and the scans are reviewed by a surgeon every couple of months.","route":"/terms/conversion-therapy-colorectal/","kind":"term","target":{"id":"kras","name":"KRAS","targetClass":"oncogene","tldr":"KRAS is the most commonly mutated cancer gene, called 'undruggable' for 40 years until 2021."},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"cimp","name":"CpG island methylator phenotype (CIMP)","tldr":"Some bowel cancers switch off large numbers of genes at once by chemically tagging their control regions rather than by mutating them. That state travels with BRAF mutation, with the serrated route to cancer and with the accidental loss of DNA proofreading, and it is how most bowel cancers with unstable microsatellites arise without an inherited fault.","route":"/terms/cimp/","kind":"term","target":{"id":"braf","name":"BRAF","targetClass":"kinase","tldr":"BRAF is a signalling kinase mutated in half of melanomas; blocking it with two drugs at once became a template for targeted therapy."},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Mismatch-repair deficient (MSI-high) colorectal cancer","BRAF V600E-mutant colorectal cancer","Serrated adenocarcinoma of the colon and rectum","Colon cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Mismatch-repair deficient (MSI-high) colorectal cancer","href":"/cancers/msi-high-colorectal/","tip":"Mismatch-repair deficient bowel cancer has lost its DNA spell-checker, so it carries thousands of mutations that the immune system can recognise. Immunotherapy alone controls most metastatic cases for years and makes most localised tumours disappear before surgery, sometimes so completely that no surgery is needed."},{"label":"BRAF V600E-mutant colorectal cancer","href":"/cancers/braf-v600e-colorectal/","tip":"BRAF V600E bowel cancer carries the same mutation as many melanomas, but BRAF drugs alone did nothing here because the tumour re-routes its growth signal through EGFR. Blocking both with encorafenib and cetuximab, now given with chemotherapy from the start, has doubled survival in a subtype that used to be the worst."},{"label":"Serrated adenocarcinoma of the colon and rectum","href":"/cancers/colorectal-serrated-adenocarcinoma/","tip":"Serrated adenocarcinoma is a form of bowel cancer that grows out of sessile serrated polyps rather than ordinary adenomas, keeping their saw-tooth pattern. Most cases carry a KRAS or BRAF mutation and the BRAF-mutant ones are often mismatch-repair deficient. It is treated like other bowel cancer, with the BRAF and mismatch repair results guiding drugs when it has spread."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"cytoreductive-surgery","name":"Cytoreductive surgery","tldr":"Cytoreductive surgery is an operation that strips every visible tumour deposit from the lining of the abdomen and from the organs it coats, often taking many hours. In bowel cancer that has spread only to that lining, it is the part of treatment that does the work: the heated chemotherapy added at the end of it was tested in a randomised trial and made no difference.","route":"/terms/cytoreductive-surgery/","kind":"term","schematic":{"id":"hipec","sections":["chemotherapy","surgery"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer","Appendiceal adenocarcinoma","Peritoneal mesothelioma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."},{"label":"Appendiceal adenocarcinoma","href":"/cancers/appendiceal-adenocarcinoma/","tip":"Appendiceal adenocarcinoma is the invasive, gland-forming form of appendix cancer that behaves more like bowel cancer than the jelly-producing low-grade tumours, spreading to lymph nodes and the abdominal lining. It is treated with right hemicolectomy and bowel-cancer chemotherapy, and peritoneal spread with cytoreductive surgery and heated intraperitoneal chemotherapy in fit patients."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"distal-pancreatectomy","name":"Distal pancreatectomy (removal of the body and tail of the pancreas, usually with the spleen)","tldr":"Distal pancreatectomy removes the body and tail of the pancreas, the part to the left of the main vessels, usually with the spleen when the cause is cancer. The bile duct and duodenum are left alone, so there is no Whipple-type reconstruction; keyhole and robotic versions recover faster and, in a randomised trial, removed pancreatic cancer as completely as open surgery.","route":"/terms/distal-pancreatectomy/","kind":"term","schematic":{"id":"robotic-surgery","sections":["surgery"]},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma","Resectable pancreatic ductal adenocarcinoma","Mucinous cystic neoplasm of the pancreas with associated invasive carcinoma","Solid pseudopapillary neoplasm of the pancreas","Pancreatic neuroendocrine tumours"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Resectable pancreatic ductal adenocarcinoma","href":"/cancers/resectable-pdac/","tip":"Resectable pancreatic cancer is the minority of pancreatic cancer that the surgeon can remove with clear margins because it has not wrapped around the main arteries or spread. Treatment is an operation, usually a Whipple procedure, followed by six months of combination chemotherapy, which is what turns surgery alone into a real chance of cure."},{"label":"Mucinous cystic neoplasm of the pancreas with associated invasive carcinoma","href":"/cancers/mcn-associated-carcinoma/","tip":"MCN-associated carcinoma is pancreatic cancer that has developed inside a mucinous cystic neoplasm, a thick-walled cyst with ovary-like tissue in its wall that occurs almost only in women, usually in the tail of the pancreas. Most such cysts are benign when removed; the minority with invasive cancer are larger, carry nodules and occur in older women, and about six in ten survive five years."},{"label":"Solid pseudopapillary neoplasm of the pancreas","href":"/cancers/solid-pseudopapillary-neoplasm/","tip":"Solid pseudopapillary neoplasm is a rare, slow-growing pancreatic tumour of young women that is classed as a low-grade cancer. It is driven by a fault in the beta-catenin gene rather than the KRAS mutation of ordinary pancreatic cancer, is often found by chance as a large mass, and surgery cures more than nineteen in twenty patients, although it can recur years later."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"eating-after-whipple","name":"Eating after a Whipple operation: slow stomach emptying, dumping and bowel changes","tldr":"After a Whipple operation the stomach can be slow to empty for days or weeks, meals feel full quickly, and pale, oily stools mean enzymes are needed; small frequent meals, enzyme capsules with everything, a dietitian's review and patience over several months are the pattern most people describe.","route":"/terms/eating-after-whipple/","kind":"term","schematic":{"id":"oncology-nutrition","sections":["supportive-care","nutrition-lifestyle"]},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"emergency-presentation","name":"Emergency presentation (route to diagnosis)","tldr":"An emergency presentation means a cancer was diagnosed after the person arrived as an emergency, through A&E or an urgent admission, rather than through a GP referral or screening. It is the route with the worst survival because the cancer is usually advanced by then. Almost half of pancreatic cancers in England are diagnosed this way, more than for almost any other common cancer.","route":"/terms/emergency-presentation/","kind":"term","schematic":{"id":"ct","sections":["imaging"]},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma","Metastatic pancreatic ductal adenocarcinoma","Cancer of unknown primary"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Metastatic pancreatic ductal adenocarcinoma","href":"/cancers/metastatic-pdac/","tip":"Metastatic pancreatic cancer has spread beyond the pancreas, usually to the liver, and is treated with chemotherapy rather than surgery. Three combination regimens lengthen life, a minority of patients qualify for targeted drugs chosen by tumour or inherited mutations, and in 2026 the pan-RAS inhibitor daraxonrasib became the first drug against the KRAS mutation that drives almost every case."},{"label":"Cancer of unknown primary","href":"/cancers/cancer-of-unknown-primary/","tip":"Cancer found already spread, where doctors cannot find where it started. Genomic profiling finds a drug target in about a third of cases and tumour-agnostic approvals apply directly; the rest still rely on general-purpose chemotherapy, which is what those tests are changing."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"extended-ras-testing","name":"Extended RAS testing","tldr":"Extended RAS testing looks for mutations across KRAS and NRAS, not just the one spot that was tested first. It decides who can have an EGFR antibody: the drugs work only when every one of those spots is normal, and testing the wider set moved about one patient in six out of the group offered them.","route":"/terms/extended-ras-testing/","kind":"term","target":{"id":"kras","name":"KRAS","targetClass":"oncogene","tldr":"KRAS is the most commonly mutated cancer gene, called 'undruggable' for 40 years until 2021."},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer","KRAS G12C-mutant colorectal cancer","BRAF V600E-mutant colorectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."},{"label":"KRAS G12C-mutant colorectal cancer","href":"/cancers/kras-g12c-colorectal/","tip":"KRAS G12C bowel cancer carries a mutation that was undruggable for forty years. The first KRAS drugs work only weakly on their own in the bowel, because the tumour switches EGFR back on, so they are given with an anti-EGFR antibody: sotorasib with panitumumab and adagrasib with cetuximab are both approved after chemotherapy."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"faecal-occult-blood-test","name":"Faecal occult blood test (guaiac)","tldr":"The guaiac faecal occult blood test was the first stool test used for bowel screening: six smears from three separate stools, read by a colour change when blood is present. It is the test that proved in randomised trials that bowel screening saves lives, and England replaced it with the more accurate and easier faecal immunochemical test in 2019.","route":"/terms/faecal-occult-blood-test/","kind":"term","schematic":{"id":"colorectal-screening","sections":["early-detection"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"fap-associated-colorectal-cancer","name":"Familial adenomatous polyposis-associated colorectal cancer","tldr":"In familial adenomatous polyposis a person inherits a fault in the APC gene and grows hundreds or thousands of polyps in the large bowel from their teens. Left alone, almost all of them become cancer by about 40, so the bowel is watched from childhood and usually removed before that happens; the cancers that do occur are treated like ordinary bowel cancer.","route":"/cancers/fap-associated-colorectal-cancer/","kind":"cancer","cancerIcon":"fap-associated-colorectal-cancer","facets":{"kind":["Cancer"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Cancer","tip":"One page per disease: state of the art, history, and what is coming."},"cancers":[],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."},{"label":"subtype-page","href":"/tagged/subtype-page/","tip":"Every record tagged subtype-page."}]},"sortKeys":{"year":0}},{"id":"familial-pancreatic-cancer","name":"Familial pancreatic cancer and inherited risk (who qualifies for surveillance)","tldr":"Familial pancreatic cancer means at least two close relatives on the same side of the family have had the disease without a known gene fault to explain it. Members of such families have several times the usual risk, rising steeply with the number of relatives affected. With carriers of certain gene faults, they are the people offered yearly MRI or endoscopic ultrasound in surveillance programmes.","route":"/terms/familial-pancreatic-cancer/","kind":"term","target":{"id":"brca","name":"BRCA1 / BRCA2 (HRD)","targetClass":"tumor-suppressor","tldr":"DNA repair genes. Inheriting a broken copy raises breast and ovarian cancer risk, but tumours that lose them become uniquely vulnerable to PARP inhibitors and platinum."},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma","BRCA or PALB2-mutant pancreatic ductal adenocarcinoma","Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"BRCA or PALB2-mutant pancreatic ductal adenocarcinoma","href":"/cancers/brca-palb2-pdac/","tip":"BRCA or PALB2-mutant pancreatic cancer is pancreatic cancer in someone who inherited a faulty copy of a gene that repairs broken DNA. These tumours respond better to platinum chemotherapy, and the POLO trial showed that the PARP inhibitor olaparib, taken after platinum has held the disease, delays its return; that made it the first targeted drug approved for a pancreatic cancer subgroup."},{"label":"Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors","href":"/cancers/ipmn-cystic-precursors/","tip":"Intraductal papillary mucinous neoplasms are fluid-filled growths in the pancreatic ducts that make mucus and can slowly turn into pancreatic cancer, one of the few chances to catch pancreatic cancer before it starts. Most are watched with scans for years, and surgery is reserved for the ones with warning signs such as a widened main duct, a solid nodule inside the cyst or jaundice."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"gastric","name":"Gastric & gastro-oesophageal junction cancer","tldr":"A cancer with three new targets in five years: Claudin 18.2, FGFR2b, and HER2 with new ADCs, plus immunotherapy in first line.","route":"/cancers/gastric/","kind":"cancer","cancerIcon":"gastric","facets":{"kind":["Cancer"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Cancer","tip":"One page per disease: state of the art, history, and what is coming."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"hcc","name":"Hepatocellular carcinoma","tldr":"Liver cancer almost always grows in a liver already damaged by hepatitis, alcohol or fatty liver disease. It is one of the most preventable cancers, and since 2020 immunotherapy combinations have roughly doubled how long people with advanced disease live.","route":"/cancers/hcc/","kind":"cancer","cancerIcon":"hcc","facets":{"kind":["Cancer"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Cancer","tip":"One page per disease: state of the art, history, and what is coming."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"heracles-criteria","name":"HERACLES criteria (HER2 in bowel cancer)","tldr":"Bowel cancer needed its own rule for calling a tumour HER2-positive, because the rules written for breast and stomach cancer did not transfer. The HERACLES criteria are that rule: intense membrane staining in more than half the cells, confirmed by gene amplification, which finds about one in twenty RAS wild-type bowel cancers.","route":"/terms/heracles-criteria/","kind":"term","target":{"id":"her2","name":"HER2","targetClass":"surface-antigen","tldr":"A growth-signal receptor. Some cancers make far too much of it, and drugs that block it or use it as a docking site have transformed those cancers."},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","HER2-amplified colorectal cancer","Colon cancer","Rectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"HER2-amplified colorectal cancer","href":"/cancers/her2-amplified-colorectal/","tip":"A few bowel cancers make too much of the HER2 protein, the same target as in HER2-positive breast cancer. Two HER2 drugs together, tucatinib and trastuzumab, shrink about four in ten of these tumours after chemotherapy has failed, and the antibody-drug conjugate trastuzumab deruxtecan works even when other HER2 drugs have stopped."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"pancreatic-cyst-high-risk-stigmata","name":"High-risk stigmata and worrisome features of pancreatic cysts (IPMN and MCN surgical criteria)","tldr":"Most pancreatic cysts never become cancer, so doctors watch them and operate only when warning signs appear. The strongest signs, the high-risk stigmata, are jaundice from a cyst in the head of the pancreas, a solid lump inside the cyst that lights up with dye, or a main duct widened to a centimetre or more. Lesser signs, the worrisome features, prompt a closer look with endoscopic ultrasound.","route":"/terms/pancreatic-cyst-high-risk-stigmata/","kind":"term","schematic":{"id":"mri","sections":["imaging"]},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma","Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors","Invasive carcinoma arising in an intraductal papillary mucinous neoplasm","Mucinous cystic neoplasm of the pancreas with associated invasive carcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors","href":"/cancers/ipmn-cystic-precursors/","tip":"Intraductal papillary mucinous neoplasms are fluid-filled growths in the pancreatic ducts that make mucus and can slowly turn into pancreatic cancer, one of the few chances to catch pancreatic cancer before it starts. Most are watched with scans for years, and surgery is reserved for the ones with warning signs such as a widened main duct, a solid nodule inside the cyst or jaundice."},{"label":"Invasive carcinoma arising in an intraductal papillary mucinous neoplasm","href":"/cancers/ipmn-associated-carcinoma/","tip":"IPMN-associated carcinoma is pancreatic cancer that has grown out of a mucus-producing cyst in the pancreatic duct. Because the cyst is often being watched, the cancer is found smaller and earlier, and about four in ten patients are alive five years after surgery against two in ten for ordinary pancreatic cancer; the advantage belongs to the colloid type, not the tubular type."},{"label":"Mucinous cystic neoplasm of the pancreas with associated invasive carcinoma","href":"/cancers/mcn-associated-carcinoma/","tip":"MCN-associated carcinoma is pancreatic cancer that has developed inside a mucinous cystic neoplasm, a thick-walled cyst with ovary-like tissue in its wall that occurs almost only in women, usually in the tail of the pancreas. Most such cysts are benign when removed; the minority with invasive cancer are larger, carry nodules and occur in older women, and about six in ten survive five years."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"immunoscore","name":"Immunoscore","tldr":"The Immunoscore counts the immune cells inside a bowel tumour and at its invading edge and turns the density into a single score. People with a high score relapse far less often than people with a low one, whatever their stage, and the score adds information the stage does not.","route":"/terms/immunoscore/","kind":"term","schematic":{"id":"histopathology-ihc","sections":["diagnostics"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer","Mismatch-repair deficient (MSI-high) colorectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."},{"label":"Mismatch-repair deficient (MSI-high) colorectal cancer","href":"/cancers/msi-high-colorectal/","tip":"Mismatch-repair deficient bowel cancer has lost its DNA spell-checker, so it carries thousands of mutations that the immune system can recognise. Immunotherapy alone controls most metastatic cases for years and makes most localised tumours disappear before surgery, sometimes so completely that no surgery is needed."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"interval-cancer","name":"Interval cancer","tldr":"An interval cancer is one diagnosed after a screening test or a colonoscopy that found nothing, and before the next test was due. Every screening programme has them. Counting them honestly is how a programme finds out what it is missing, and in the bowel most of them come from lesions that were there and were not seen.","route":"/terms/interval-cancer/","kind":"term","schematic":{"id":"colorectal-screening","sections":["early-detection"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"ipmn-associated-carcinoma","name":"Invasive carcinoma arising in an intraductal papillary mucinous neoplasm (IPMN-associated carcinoma)","tldr":"IPMN-associated carcinoma is pancreatic cancer that has grown out of a mucus-producing cyst in the pancreatic duct. Because the cyst is often being watched, the cancer is found smaller and earlier, and about four in ten patients are alive five years after surgery against two in ten for ordinary pancreatic cancer; the advantage belongs to the colloid type, not the tubular type.","route":"/cancers/ipmn-associated-carcinoma/","kind":"cancer","cancerIcon":"ipmn-associated-carcinoma","facets":{"kind":["Cancer"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Cancer","tip":"One page per disease: state of the art, history, and what is coming."},"cancers":[],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."},{"label":"subtype-page","href":"/tagged/subtype-page/","tip":"Every record tagged subtype-page."}]},"sortKeys":{"year":0}},{"id":"lewis-negative","name":"Lewis-negative (Lewis antigen-negative, CA 19-9 non-secretor) status","tldr":"About one person in ten to twenty cannot make the sugar that the CA 19-9 blood test measures, because they lack a working copy of the Lewis blood-group gene. In these Lewis-negative people the test stays low however large the cancer, so a normal CA 19-9 does not rule pancreatic cancer out, and their cancers appear to behave more aggressively.","route":"/terms/lewis-negative/","kind":"term","schematic":{"id":"liquid-biopsy","sections":["diagnostics"]},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma","Metastatic pancreatic ductal adenocarcinoma","Biliary tract cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Metastatic pancreatic ductal adenocarcinoma","href":"/cancers/metastatic-pdac/","tip":"Metastatic pancreatic cancer has spread beyond the pancreas, usually to the liver, and is treated with chemotherapy rather than surgery. Three combination regimens lengthen life, a minority of patients qualify for targeted drugs chosen by tumour or inherited mutations, and in 2026 the pan-RAS inhibitor daraxonrasib became the first drug against the KRAS mutation that drives almost every case."},{"label":"Biliary tract cancer","href":"/cancers/cholangiocarcinoma/","tip":"Cholangiocarcinoma is cancer of the bile ducts or gallbladder. It is rare and often found late, but it turned out to carry more targetable mutations than almost any other gastrointestinal cancer, and immunotherapy now adds to chemotherapy from the first treatment."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"liver-limited-metastatic-colorectal","name":"Liver-limited metastatic bowel cancer","tldr":"Bowel cancer that has spread only to the liver, and sometimes only to the lung, is one of the few forms of secondary cancer treated with the aim of cure. If the deposits can be removed or destroyed, with chemotherapy before and after, a substantial minority of people are alive five years later.","route":"/terms/liver-limited-metastatic-colorectal/","kind":"term","schematic":{"id":"thermal-ablation","sections":["surgery"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"living-with-a-stoma-bowel-cancer","name":"Living with a stoma after bowel cancer surgery","tldr":"A colostomy or ileostomy after bowel cancer surgery may be temporary, to let a join heal, or permanent. Recovery takes about eight weeks, bags come as one-piece or two-piece and drainable or closed, permanent colostomy supplies are free on prescription, and the emergencies to know are a blockage (nothing coming out, cramps, sickness, swelling), heavy bleeding, dehydration and signs of infection.","route":"/terms/living-with-a-stoma-bowel-cancer/","kind":"term","term":{"category":"Procedures"},"facets":{"kind":["Term"],"cancers":["Colorectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"chemotherapy-side-effects-pancreatic","name":"Living with FOLFIRINOX, NALIRIFOX and gemcitabine with nab-paclitaxel","tldr":"The three main regimens share low blood counts, tiredness, sickness and sore mouth; FOLFIRINOX and NALIRIFOX add irinotecan diarrhoea and oxaliplatin's cold-triggered tingling and rare throat spasm, gemcitabine with nab-paclitaxel adds hair loss and neuropathy, and every regimen comes with the same temperature rule for ringing the 24-hour line.","route":"/terms/chemotherapy-side-effects-pancreatic/","kind":"term","molecule":"folfirinox","modality":"Cytotoxic regimen","facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"chemotherapy-side-effects-colorectal","name":"Living with FOLFOX, CAPOX, FOLFIRI and the EGFR antibodies","tldr":"The bowel cancer regimens share low blood counts, tiredness, sickness and a sore mouth. Oxaliplatin adds cold-triggered tingling, irinotecan adds early and late diarrhoea, capecitabine adds hand-foot syndrome and needs a DPD test first, and cetuximab or panitumumab add an acne-like rash and low magnesium. The rule for all of them: ring the 24-hour number rather than wait.","route":"/terms/chemotherapy-side-effects-colorectal/","kind":"term","molecule":"folfox","modality":"Cytotoxic regimen","facets":{"kind":["Term"],"cancers":["Colorectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"low-anterior-resection-syndrome","name":"Low anterior resection syndrome (LARS)","tldr":"The group of bowel problems that can follow sphincter-preserving surgery for rectal cancer: going more often, urgency with or without leaking, feeling the bowel is not empty, passing small amounts little and often, and not being able to tell wind from stool. NICE asks teams to warn people before surgery, to measure it with the LARS score and to treat it in primary care.","route":"/terms/low-anterior-resection-syndrome/","kind":"term","schematic":{"id":"survivorship-care-plan","sections":["supportive-care","rejuvenation"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"lynch-syndrome-testing-uk","name":"Lynch syndrome testing after bowel cancer, and what it means for the family","tldr":"Every bowel cancer should be tested for mismatch repair loss, and where it is found, for whether that loss is inherited. A Lynch syndrome result changes your treatment options, gives each of your children and siblings a one in two chance of carrying it, and puts you into regular colonoscopy; NICE also says to consider daily aspirin for more than two years.","route":"/terms/lynch-syndrome-testing-uk/","kind":"term","schematic":{"id":"germline-testing","sections":["diagnostics","prevention"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"lynch-associated-colorectal-cancer","name":"Lynch syndrome-associated colorectal cancer","tldr":"Lynch syndrome-associated bowel cancer is bowel cancer in someone born with a fault in one of the genes that proofread DNA copying errors. The tumours tend to arise younger and on the right side, they carry the mismatch repair defect that makes immunotherapy work, and the diagnosis changes the care of the whole family as well as the care of the patient.","route":"/cancers/lynch-associated-colorectal-cancer/","kind":"cancer","cancerIcon":"lynch-associated-colorectal-cancer","facets":{"kind":["Cancer"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Cancer","tip":"One page per disease: state of the art, history, and what is coming."},"cancers":[],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."},{"label":"subtype-page","href":"/tagged/subtype-page/","tip":"Every record tagged subtype-page."}]},"sortKeys":{"year":0}},{"id":"colorectal-micropapillary-carcinoma","name":"Micropapillary adenocarcinoma of the colon and rectum","tldr":"Micropapillary adenocarcinoma is bowel cancer in which some of the tumour grows as tiny clusters of cells floating in empty spaces, with the cells turned inside out so the surface that normally faces the bowel faces outwards instead. It is a pattern that goes with heavier invasion of lymph and blood vessels and more involved lymph nodes, and it is graded and treated like ordinary bowel cancer.","route":"/cancers/colorectal-micropapillary-carcinoma/","kind":"cancer","cancerIcon":"colorectal-micropapillary-carcinoma","facets":{"kind":["Cancer"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Cancer","tip":"One page per disease: state of the art, history, and what is coming."},"cancers":[],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."},{"label":"subtype-page","href":"/tagged/subtype-page/","tip":"Every record tagged subtype-page."}]},"sortKeys":{"year":0}},{"id":"mcn-associated-carcinoma","name":"Mucinous cystic neoplasm of the pancreas with associated invasive carcinoma (MCN-associated carcinoma)","tldr":"MCN-associated carcinoma is pancreatic cancer that has developed inside a mucinous cystic neoplasm, a thick-walled cyst with ovary-like tissue in its wall that occurs almost only in women, usually in the tail of the pancreas. Most such cysts are benign when removed; the minority with invasive cancer are larger, carry nodules and occur in older women, and about six in ten survive five years.","route":"/cancers/mcn-associated-carcinoma/","kind":"cancer","cancerIcon":"mcn-associated-carcinoma","facets":{"kind":["Cancer"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Cancer","tip":"One page per disease: state of the art, history, and what is coming."},"cancers":[],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."},{"label":"subtype-page","href":"/tagged/subtype-page/","tip":"Every record tagged subtype-page."}]},"sortKeys":{"year":0}},{"id":"neoadjuvant-versus-upfront-surgery-pancreatic","name":"Neoadjuvant therapy versus surgery first for resectable and borderline resectable pancreatic cancer","tldr":"For pancreatic cancers that look removable, doctors debate whether to operate at once and give chemotherapy afterwards, or to give chemotherapy first. Trials show chemotherapy first helps when the tumour is borderline, touching the big vessels, but it is not yet proven better for clearly removable tumours, where the largest trial found no gain and a US trial is still running.","route":"/terms/neoadjuvant-versus-upfront-surgery-pancreatic/","kind":"term","molecule":"folfirinox","modality":"Cytotoxic regimen","facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma","Resectable pancreatic ductal adenocarcinoma","Borderline resectable pancreatic ductal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Resectable pancreatic ductal adenocarcinoma","href":"/cancers/resectable-pdac/","tip":"Resectable pancreatic cancer is the minority of pancreatic cancer that the surgeon can remove with clear margins because it has not wrapped around the main arteries or spread. Treatment is an operation, usually a Whipple procedure, followed by six months of combination chemotherapy, which is what turns surgery alone into a real chance of cure."},{"label":"Borderline resectable pancreatic ductal adenocarcinoma","href":"/cancers/borderline-resectable-pdac/","tip":"Borderline resectable pancreatic cancer touches the big blood vessels behind the pancreas, so an operation straight away would probably leave cancer behind. Chemotherapy first, usually FOLFIRINOX for several months and sometimes radiotherapy, shrinks the edge of the tumour, and patients whose disease has not spread go on to surgery with a better chance of a clean removal."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"new-onset-diabetes-pancreatic-cancer","name":"New-onset diabetes as a signal of pancreatic cancer (and the ENDPAC score)","tldr":"A pancreatic cancer can cause diabetes before any other symptom, so new diabetes after the age of 50, especially with weight loss rather than weight gain, is a recognised warning sign. About one in a hundred such people is found to have pancreatic cancer within three years; a simple score using weight change, blood sugar change and age picks out the smaller group who should have a scan.","route":"/terms/new-onset-diabetes-pancreatic-cancer/","kind":"term","schematic":{"id":"mced","sections":["early-detection","diagnostics"]},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma","Resectable pancreatic ductal adenocarcinoma","Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Resectable pancreatic ductal adenocarcinoma","href":"/cancers/resectable-pdac/","tip":"Resectable pancreatic cancer is the minority of pancreatic cancer that the surgeon can remove with clear margins because it has not wrapped around the main arteries or spread. Treatment is an operation, usually a Whipple procedure, followed by six months of combination chemotherapy, which is what turns surgery alone into a real chance of cure."},{"label":"Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors","href":"/cancers/ipmn-cystic-precursors/","tip":"Intraductal papillary mucinous neoplasms are fluid-filled growths in the pancreatic ducts that make mucus and can slowly turn into pancreatic cancer, one of the few chances to catch pancreatic cancer before it starts. Most are watched with scans for years, and surgery is reserved for the ones with warning signs such as a widened main duct, a solid nodule inside the cyst or jaundice."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"bowel-cancer-screening-uk","name":"NHS bowel cancer screening programme","tldr":"The NHS posts a home test for hidden blood in the poo to everyone aged 50 to 74 in England every two years. Most people are told no further tests are needed; if blood is found they are offered a colonoscopy. It is the only NHS cancer screening programme that can prevent the cancer as well as find it early, because the colonoscopy removes the polyps.","route":"/terms/bowel-cancer-screening-uk/","kind":"term","schematic":{"id":"colorectal-screening","sections":["early-detection"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"obstructing-colorectal-cancer","name":"Obstruction and T4 disease in bowel cancer","tldr":"Sometimes a bowel cancer is found only when it blocks the bowel or has grown through its outer wall into the peritoneum or a neighbouring organ. Both change the plan: a blockage may be relieved with a stent so that surgery can be done calmly a few weeks later, and a tumour that has grown outside the bowel may be given chemotherapy first.","route":"/terms/obstructing-colorectal-cancer/","kind":"term","schematic":{"id":"ct","sections":["imaging"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"esophageal","name":"Oesophageal cancer","tldr":"Oesophageal cancer is really two diseases sharing one organ: squamous cell carcinoma, which dominates in Asia, and adenocarcinoma, which dominates in the West and is treated like gastric cancer. Immunotherapy is now standard, and the bispecific ADC iza-bren posted a positive phase 3 in the squamous type in 2026.","route":"/cancers/esophageal/","kind":"cancer","cancerIcon":"esophageal","facets":{"kind":["Cancer"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Cancer","tip":"One page per disease: state of the art, history, and what is coming."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"pancreas-protocol-ct","name":"Pancreas protocol CT (pancreatic protocol CT, dual-phase thin-slice CT with structured reporting)","tldr":"A pancreas protocol CT is a scan tuned for the pancreas: thin slices taken at two timed moments after contrast dye so that the tumour, the arteries and the veins all show up sharply. It is the first test NICE asks for when pancreatic cancer is suspected, before any stent is placed, and the report follows a template that lists every vessel the tumour touches and by how many degrees.","route":"/terms/pancreas-protocol-ct/","kind":"term","schematic":{"id":"ct","sections":["imaging"]},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma","Resectable pancreatic ductal adenocarcinoma","Borderline resectable pancreatic ductal adenocarcinoma","Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Resectable pancreatic ductal adenocarcinoma","href":"/cancers/resectable-pdac/","tip":"Resectable pancreatic cancer is the minority of pancreatic cancer that the surgeon can remove with clear margins because it has not wrapped around the main arteries or spread. Treatment is an operation, usually a Whipple procedure, followed by six months of combination chemotherapy, which is what turns surgery alone into a real chance of cure."},{"label":"Borderline resectable pancreatic ductal adenocarcinoma","href":"/cancers/borderline-resectable-pdac/","tip":"Borderline resectable pancreatic cancer touches the big blood vessels behind the pancreas, so an operation straight away would probably leave cancer behind. Chemotherapy first, usually FOLFIRINOX for several months and sometimes radiotherapy, shrinks the edge of the tumour, and patients whose disease has not spread go on to surgery with a better chance of a clean removal."},{"label":"Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors","href":"/cancers/ipmn-cystic-precursors/","tip":"Intraductal papillary mucinous neoplasms are fluid-filled growths in the pancreatic ducts that make mucus and can slowly turn into pancreatic cancer, one of the few chances to catch pancreatic cancer before it starts. Most are watched with scans for years, and surgery is reserved for the ones with warning signs such as a widened main duct, a solid nodule inside the cyst or jaundice."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"pancreatic-roadmap","name":"Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question","tldr":"Pancreatic cancer has had one operation since 1935 and a handful of chemotherapy drugs since 1997. This roadmap follows the evidence through FOLFIRINOX, chemotherapy before and after surgery, the first inherited-gene drug, the first drugs against the KRAS protein that drives nearly every tumour, personalised vaccines, and the surveillance and blood tests that might catch it earlier, to 2031.","route":"/roadmaps/pancreatic-roadmap/","kind":"roadmap","cancerIcon":"pancreatic","facets":{"kind":["Roadmap"],"cancers":["Pancreatic ductal adenocarcinoma","Resectable pancreatic ductal adenocarcinoma","Borderline resectable pancreatic ductal adenocarcinoma","Metastatic pancreatic ductal adenocarcinoma","BRCA or PALB2-mutant pancreatic ductal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Roadmap","tip":"Where a technology has been and where it is heading."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Resectable pancreatic ductal adenocarcinoma","href":"/cancers/resectable-pdac/","tip":"Resectable pancreatic cancer is the minority of pancreatic cancer that the surgeon can remove with clear margins because it has not wrapped around the main arteries or spread. Treatment is an operation, usually a Whipple procedure, followed by six months of combination chemotherapy, which is what turns surgery alone into a real chance of cure."},{"label":"Borderline resectable pancreatic ductal adenocarcinoma","href":"/cancers/borderline-resectable-pdac/","tip":"Borderline resectable pancreatic cancer touches the big blood vessels behind the pancreas, so an operation straight away would probably leave cancer behind. Chemotherapy first, usually FOLFIRINOX for several months and sometimes radiotherapy, shrinks the edge of the tumour, and patients whose disease has not spread go on to surgery with a better chance of a clean removal."},{"label":"Metastatic pancreatic ductal adenocarcinoma","href":"/cancers/metastatic-pdac/","tip":"Metastatic pancreatic cancer has spread beyond the pancreas, usually to the liver, and is treated with chemotherapy rather than surgery. Three combination regimens lengthen life, a minority of patients qualify for targeted drugs chosen by tumour or inherited mutations, and in 2026 the pan-RAS inhibitor daraxonrasib became the first drug against the KRAS mutation that drives almost every case."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."},{"label":"roadmap","href":"/tagged/roadmap/","tip":"Every record tagged roadmap."}]},"sortKeys":{"year":0}},{"id":"pancreatic","name":"Pancreatic ductal adenocarcinoma","tldr":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change.","route":"/cancers/pancreatic/","kind":"cancer","cancerIcon":"pancreatic","facets":{"kind":["Cancer"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Cancer","tip":"One page per disease: state of the art, history, and what is coming."},"cancers":[],"tags":[]},"sortKeys":{"year":0}},{"id":"pancreatic-enzyme-replacement","name":"Pancreatic enzyme replacement therapy (PERT, pancreatin, Creon) for pancreatic exocrine insufficiency: why and how to take it","tldr":"Most pancreatic cancers stop the gland's digestive enzymes reaching the gut, so fat passes through undigested and weight falls. Enzyme capsules taken with every meal and snack replace what is missing. NICE says everyone whose cancer cannot be removed should have them and that they should be considered before and after surgery, yet in UK records only about one patient in five was prescribed them.","route":"/terms/pancreatic-enzyme-replacement/","kind":"term","schematic":{"id":"oncology-nutrition","sections":["supportive-care","nutrition-lifestyle"]},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma","Locally advanced unresectable pancreatic ductal adenocarcinoma","Metastatic pancreatic ductal adenocarcinoma","Resectable pancreatic ductal adenocarcinoma","Pancreatoblastoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Locally advanced unresectable pancreatic ductal adenocarcinoma","href":"/cancers/locally-advanced-pdac/","tip":"Locally advanced pancreatic cancer has grown around the arteries or veins behind the pancreas so that it cannot be removed, but it has not spread to other organs. Chemotherapy is the main treatment, joined in 2026 by a device that delivers electric fields to the tumour; radiotherapy controls pain and local growth, and a minority of tumours shrink enough to be operated on after all."},{"label":"Metastatic pancreatic ductal adenocarcinoma","href":"/cancers/metastatic-pdac/","tip":"Metastatic pancreatic cancer has spread beyond the pancreas, usually to the liver, and is treated with chemotherapy rather than surgery. Three combination regimens lengthen life, a minority of patients qualify for targeted drugs chosen by tumour or inherited mutations, and in 2026 the pan-RAS inhibitor daraxonrasib became the first drug against the KRAS mutation that drives almost every case."},{"label":"Resectable pancreatic ductal adenocarcinoma","href":"/cancers/resectable-pdac/","tip":"Resectable pancreatic cancer is the minority of pancreatic cancer that the surgeon can remove with clear margins because it has not wrapped around the main arteries or spread. Treatment is an operation, usually a Whipple procedure, followed by six months of combination chemotherapy, which is what turns surgery alone into a real chance of cure."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"panin","name":"Pancreatic intraepithelial neoplasia (PanIN), the microscopic precursor of pancreatic cancer","tldr":"PanIN is the name for abnormal cells lining the small pancreatic ducts that can, over years, turn into pancreatic cancer. It is too small to see on any scan and is found only under the microscope, so it cannot be screened for directly. Pathologists now grade it as low or high grade, and high-grade PanIN was found in about one in twenty-five older people who died without pancreatic cancer.","route":"/terms/panin/","kind":"term","target":{"id":"kras","name":"KRAS","targetClass":"oncogene","tldr":"KRAS is the most commonly mutated cancer gene, called 'undruggable' for 40 years until 2021."},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma","Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors","Invasive carcinoma arising in an intraductal papillary mucinous neoplasm"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors","href":"/cancers/ipmn-cystic-precursors/","tip":"Intraductal papillary mucinous neoplasms are fluid-filled growths in the pancreatic ducts that make mucus and can slowly turn into pancreatic cancer, one of the few chances to catch pancreatic cancer before it starts. Most are watched with scans for years, and surgery is reserved for the ones with warning signs such as a widened main duct, a solid nodule inside the cyst or jaundice."},{"label":"Invasive carcinoma arising in an intraductal papillary mucinous neoplasm","href":"/cancers/ipmn-associated-carcinoma/","tip":"IPMN-associated carcinoma is pancreatic cancer that has grown out of a mucus-producing cyst in the pancreatic duct. Because the cyst is often being watched, the cancer is found smaller and earlier, and about four in ten patients are alive five years after surgery against two in ten for ordinary pancreatic cancer; the advantage belongs to the colloid type, not the tubular type."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"peritoneal-carcinomatosis-index","name":"Peritoneal cancer index","tldr":"The peritoneal cancer index is the score a surgeon gives the abdomen at operation, region by region, for how much tumour is on its lining. It decides whether stripping the disease out is worth attempting, and it is the number quoted when a specialist centre says a person is or is not a candidate.","route":"/terms/peritoneal-carcinomatosis-index/","kind":"term","schematic":{"id":"hipec","sections":["chemotherapy","surgery"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer","Appendiceal adenocarcinoma","Peritoneal mesothelioma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."},{"label":"Appendiceal adenocarcinoma","href":"/cancers/appendiceal-adenocarcinoma/","tip":"Appendiceal adenocarcinoma is the invasive, gland-forming form of appendix cancer that behaves more like bowel cancer than the jelly-producing low-grade tumours, spreading to lymph nodes and the abdominal lining. It is treated with right hemicolectomy and bowel-cancer chemotherapy, and peritoneal spread with cytoreductive surgery and heated intraperitoneal chemotherapy in fit patients."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"colorectal-peritoneal-metastases","name":"Peritoneal metastases from bowel cancer","tldr":"Bowel cancer can seed the lining of the abdomen rather than travel to the liver or lungs. Where the deposits are confined to that lining and can all be removed, specialist centres offer an operation to strip them out. Adding heated chemotherapy into the abdomen at the end of that operation was tested in a randomised trial and did not help.","route":"/terms/colorectal-peritoneal-metastases/","kind":"term","schematic":{"id":"hipec","sections":["chemotherapy","surgery"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer","Appendiceal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."},{"label":"Appendiceal adenocarcinoma","href":"/cancers/appendiceal-adenocarcinoma/","tip":"Appendiceal adenocarcinoma is the invasive, gland-forming form of appendix cancer that behaves more like bowel cancer than the jelly-producing low-grade tumours, spreading to lymph nodes and the abdominal lining. It is treated with right hemicolectomy and bowel-cancer chemotherapy, and peritoneal spread with cytoreductive surgery and heated intraperitoneal chemotherapy in fit patients."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"colorectal-polyp-types","name":"Polyp types in the bowel","tldr":"A polyp is a growth on the lining of the bowel. Most are harmless, but two families can turn into cancer: adenomas, the classic route, and serrated lesions, the flatter and easier-to-miss route. Which kind you had, how many, how big and whether the cells looked abnormal decide when you are asked back.","route":"/terms/colorectal-polyp-types/","kind":"term","schematic":{"id":"colorectal-screening","sections":["early-detection"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer","Familial adenomatous polyposis-associated colorectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."},{"label":"Familial adenomatous polyposis-associated colorectal cancer","href":"/cancers/fap-associated-colorectal-cancer/","tip":"In familial adenomatous polyposis a person inherits a fault in the APC gene and grows hundreds or thousands of polyps in the large bowel from their teens. Left alone, almost all of them become cancer by about 40, so the bowel is watched from childhood and usually removed before that happens; the cancers that do occur are treated like ordinary bowel cancer."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"rspo-fusion","name":"R-spondin fusion","tldr":"R-spondin fusions are rearrangements that make a bowel tumour overproduce a protein which turns the Wnt growth pathway up from outside the cell. They occur in about one colon tumour in ten and almost never alongside the usual APC fault, so they look like an alternative way into the same pathway.","route":"/terms/rspo-fusion/","kind":"term","schematic":{"id":"cgp","sections":["diagnostics"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"r0-r1-margin-pancreatic","name":"R0 and R1 margins in pancreatic cancer: the 1 mm rule and standardised specimen reporting","tldr":"After a pancreatic cancer is removed, the pathologist checks whether cancer reaches the cut edges of the specimen. In the UK, cancer within one millimetre of an edge counts as an incomplete (R1) resection even if it does not touch it. Reported this way most operations are R1, because the tumour creeps along nerves behind the gland; cancer touching the edge carries a worse outlook.","route":"/terms/r0-r1-margin-pancreatic/","kind":"term","schematic":{"id":"histopathology-ihc","sections":["diagnostics"]},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma","Resectable pancreatic ductal adenocarcinoma","Borderline resectable pancreatic ductal adenocarcinoma","Invasive carcinoma arising in an intraductal papillary mucinous neoplasm"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Resectable pancreatic ductal adenocarcinoma","href":"/cancers/resectable-pdac/","tip":"Resectable pancreatic cancer is the minority of pancreatic cancer that the surgeon can remove with clear margins because it has not wrapped around the main arteries or spread. Treatment is an operation, usually a Whipple procedure, followed by six months of combination chemotherapy, which is what turns surgery alone into a real chance of cure."},{"label":"Borderline resectable pancreatic ductal adenocarcinoma","href":"/cancers/borderline-resectable-pdac/","tip":"Borderline resectable pancreatic cancer touches the big blood vessels behind the pancreas, so an operation straight away would probably leave cancer behind. Chemotherapy first, usually FOLFIRINOX for several months and sometimes radiotherapy, shrinks the edge of the tumour, and patients whose disease has not spread go on to surgery with a better chance of a clean removal."},{"label":"Invasive carcinoma arising in an intraductal papillary mucinous neoplasm","href":"/cancers/ipmn-associated-carcinoma/","tip":"IPMN-associated carcinoma is pancreatic cancer that has grown out of a mucus-producing cyst in the pancreatic duct. Because the cyst is often being watched, the cancer is found smaller and earlier, and about four in ten patients are alive five years after surgery against two in ten for ordinary pancreatic cancer; the advantage belongs to the colloid type, not the tubular type."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"nccn-resectability-criteria-pancreatic","name":"Resectability classes for pancreatic cancer (NCCN anatomical criteria and the 2017 international consensus)","tldr":"Surgeons class a pancreatic cancer as resectable, borderline resectable or locally advanced by how far it wraps around the arteries and veins behind the pancreas on the CT scan, measured in degrees of contact. Less than half way round an artery, or a vein the surgeon can rebuild, is borderline; more is locally advanced. A very high CA 19-9 or poor fitness can also make a tumour borderline.","route":"/terms/nccn-resectability-criteria-pancreatic/","kind":"term","schematic":{"id":"ct","sections":["imaging"]},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma","Resectable pancreatic ductal adenocarcinoma","Borderline resectable pancreatic ductal adenocarcinoma","Locally advanced unresectable pancreatic ductal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Resectable pancreatic ductal adenocarcinoma","href":"/cancers/resectable-pdac/","tip":"Resectable pancreatic cancer is the minority of pancreatic cancer that the surgeon can remove with clear margins because it has not wrapped around the main arteries or spread. Treatment is an operation, usually a Whipple procedure, followed by six months of combination chemotherapy, which is what turns surgery alone into a real chance of cure."},{"label":"Borderline resectable pancreatic ductal adenocarcinoma","href":"/cancers/borderline-resectable-pdac/","tip":"Borderline resectable pancreatic cancer touches the big blood vessels behind the pancreas, so an operation straight away would probably leave cancer behind. Chemotherapy first, usually FOLFIRINOX for several months and sometimes radiotherapy, shrinks the edge of the tumour, and patients whose disease has not spread go on to surgery with a better chance of a clean removal."},{"label":"Locally advanced unresectable pancreatic ductal adenocarcinoma","href":"/cancers/locally-advanced-pdac/","tip":"Locally advanced pancreatic cancer has grown around the arteries or veins behind the pancreas so that it cannot be removed, but it has not spread to other organs. Chemotherapy is the main treatment, joined in 2026 by a device that delivers electric fields to the tumour; radiotherapy controls pain and local growth, and a minority of tumours shrink enough to be operated on after all."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"screening-uptake","name":"Screening uptake","tldr":"Uptake is the share of people invited to screening who actually take the test. It decides how much good a programme does, because a test nobody returns prevents nothing, and it is lower in more deprived areas, which turns a programme meant to close a gap in outcomes into one that can widen it.","route":"/terms/screening-uptake/","kind":"term","schematic":{"id":"colorectal-screening","sections":["early-detection"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"serrated-pathway","name":"Serrated pathway","tldr":"The serrated pathway is the second route to bowel cancer, running not through the familiar mushroom-shaped polyp but through flat, pale, saw-toothed lesions that are easy to miss at colonoscopy and rarely bleed. It accounts for about three in ten bowel cancers and for most of the ones whose DNA proofreading has broken down by accident rather than by inheritance.","route":"/terms/serrated-pathway/","kind":"term","target":{"id":"braf","name":"BRAF","targetClass":"kinase","tldr":"BRAF is a signalling kinase mutated in half of melanomas; blocking it with two drugs at once became a template for targeted therapy."},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Serrated adenocarcinoma of the colon and rectum","Mismatch-repair deficient (MSI-high) colorectal cancer","BRAF V600E-mutant colorectal cancer","Colon cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Serrated adenocarcinoma of the colon and rectum","href":"/cancers/colorectal-serrated-adenocarcinoma/","tip":"Serrated adenocarcinoma is a form of bowel cancer that grows out of sessile serrated polyps rather than ordinary adenomas, keeping their saw-tooth pattern. Most cases carry a KRAS or BRAF mutation and the BRAF-mutant ones are often mismatch-repair deficient. It is treated like other bowel cancer, with the BRAF and mismatch repair results guiding drugs when it has spread."},{"label":"Mismatch-repair deficient (MSI-high) colorectal cancer","href":"/cancers/msi-high-colorectal/","tip":"Mismatch-repair deficient bowel cancer has lost its DNA spell-checker, so it carries thousands of mutations that the immune system can recognise. Immunotherapy alone controls most metastatic cases for years and makes most localised tumours disappear before surgery, sometimes so completely that no surgery is needed."},{"label":"BRAF V600E-mutant colorectal cancer","href":"/cancers/braf-v600e-colorectal/","tip":"BRAF V600E bowel cancer carries the same mutation as many melanomas, but BRAF drugs alone did nothing here because the tumour re-routes its growth signal through EGFR. Blocking both with encorafenib and cetuximab, now given with chemotherapy from the start, has doubled survival in a subtype that used to be the worst."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"sex-fertility-after-bowel-cancer","name":"Sexual function, fertility and body image after bowel cancer","tldr":"Pelvic surgery and radiotherapy can affect the nerves and tissues that control erections, ejaculation, vaginal comfort and sensation, and pelvic radiotherapy often causes infertility and an early menopause. NICE asks teams to raise altered sexual function before treatment, and a fertility referral belongs before treatment starts, not after.","route":"/terms/sex-fertility-after-bowel-cancer/","kind":"term","schematic":{"id":"fertility-preservation","sections":["supportive-care","rejuvenation"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"solid-pseudopapillary-neoplasm","name":"Solid pseudopapillary neoplasm of the pancreas","tldr":"Solid pseudopapillary neoplasm is a rare, slow-growing pancreatic tumour of young women that is classed as a low-grade cancer. It is driven by a fault in the beta-catenin gene rather than the KRAS mutation of ordinary pancreatic cancer, is often found by chance as a large mass, and surgery cures more than nineteen in twenty patients, although it can recur years later.","route":"/cancers/solid-pseudopapillary-neoplasm/","kind":"cancer","cancerIcon":"solid-pseudopapillary-neoplasm","facets":{"kind":["Cancer"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Cancer","tip":"One page per disease: state of the art, history, and what is coming."},"cancers":[],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."},{"label":"subtype-page","href":"/tagged/subtype-page/","tip":"Every record tagged subtype-page."}]},"sortKeys":{"year":0}},{"id":"colonoscopy-surveillance-intervals","name":"Surveillance intervals after polypectomy","tldr":"After polyps are removed, the date of your next colonoscopy is set by what was found, not by habit. In the UK, most people go back to routine screening; only those with several premalignant polyps or one advanced one are brought back at three years, and people who have had bowel cancer removed have a clearance test at one year.","route":"/terms/colonoscopy-surveillance-intervals/","kind":"term","schematic":{"id":"colorectal-screening","sections":["early-detection"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Colon cancer","Rectal cancer","Lynch syndrome-associated colorectal cancer","Familial adenomatous polyposis-associated colorectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Colon cancer","href":"/cancers/colon-cancer/","tip":"Colon cancer is bowel cancer arising in the large bowel above the rectum. It shares its biology with colorectal cancer but is treated differently from rectal cancer: surgery comes first without radiotherapy, chemotherapy afterwards is decided by stage and increasingly by a blood test for leftover tumour DNA, and the side the tumour started on changes which drugs work once it has spread."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."},{"label":"Lynch syndrome-associated colorectal cancer","href":"/cancers/lynch-associated-colorectal-cancer/","tip":"Lynch syndrome-associated bowel cancer is bowel cancer in someone born with a fault in one of the genes that proofread DNA copying errors. The tumours tend to arise younger and on the right side, they carry the mismatch repair defect that makes immunotherapy work, and the diagnosis changes the care of the whole family as well as the care of the patient."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"type-3c-diabetes-pancreatic-cancer","name":"Type 3c diabetes with pancreatic cancer","tldr":"Pancreatic cancer or surgery to remove part or all of the pancreas can stop it making enough insulin and glucagon; the result is type 3c diabetes, which behaves differently from type 1 and type 2, usually needs tablets or insulin, and is best managed by a diabetes nurse and a specialist dietitian who know you have pancreatic cancer.","route":"/terms/type-3c-diabetes-pancreatic-cancer/","kind":"term","term":{"category":"Side effects"},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"pancreatic-undifferentiated-carcinoma-ogc","name":"Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells","tldr":"Undifferentiated carcinoma with osteoclast-like giant cells is a rare form of pancreatic cancer studded with large bone-eating-type cells that are not themselves cancerous. It grows as a big, well-circumscribed mass, often within a cyst, spreads to nerves and lymph nodes far less often than ordinary pancreatic cancer, and about six in ten patients are alive five years after surgery.","route":"/cancers/pancreatic-undifferentiated-carcinoma-ogc/","kind":"cancer","cancerIcon":"pancreatic-undifferentiated-carcinoma-ogc","facets":{"kind":["Cancer"],"cancers":[],"year":[]},"cols":{"kind":{"facet":"kind","value":"Cancer","tip":"One page per disease: state of the art, history, and what is coming."},"cancers":[],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."},{"label":"subtype-page","href":"/tagged/subtype-page/","tip":"Every record tagged subtype-page."}]},"sortKeys":{"year":0}},{"id":"vascular-resection-pancreatic","name":"Vascular resection in pancreatic cancer surgery (portal and superior mesenteric vein resection; arterial resection)","tldr":"When a pancreatic cancer touches or narrows the big vein behind the pancreas, surgeons can cut out that segment of vein and rebuild it during the operation, which turns a borderline tumour into a removable one. Removing and rebuilding an artery is far riskier and is done only in selected patients in specialist centres, usually after chemotherapy has shrunk the tumour.","route":"/terms/vascular-resection-pancreatic/","kind":"term","schematic":{"id":"robotic-surgery","sections":["surgery"]},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma","Borderline resectable pancreatic ductal adenocarcinoma","Locally advanced unresectable pancreatic ductal adenocarcinoma","Resectable pancreatic ductal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."},{"label":"Borderline resectable pancreatic ductal adenocarcinoma","href":"/cancers/borderline-resectable-pdac/","tip":"Borderline resectable pancreatic cancer touches the big blood vessels behind the pancreas, so an operation straight away would probably leave cancer behind. Chemotherapy first, usually FOLFIRINOX for several months and sometimes radiotherapy, shrinks the edge of the tumour, and patients whose disease has not spread go on to surgery with a better chance of a clean removal."},{"label":"Locally advanced unresectable pancreatic ductal adenocarcinoma","href":"/cancers/locally-advanced-pdac/","tip":"Locally advanced pancreatic cancer has grown around the arteries or veins behind the pancreas so that it cannot be removed, but it has not spread to other organs. Chemotherapy is the main treatment, joined in 2026 by a device that delivers electric fields to the tumour; radiotherapy controls pain and local growth, and a minority of tumours shrink enough to be operated on after all."},{"label":"Resectable pancreatic ductal adenocarcinoma","href":"/cancers/resectable-pdac/","tip":"Resectable pancreatic cancer is the minority of pancreatic cancer that the surgeon can remove with clear margins because it has not wrapped around the main arteries or spread. Treatment is an operation, usually a Whipple procedure, followed by six months of combination chemotherapy, which is what turns surgery alone into a real chance of cure."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"watch-and-wait-rectal-cancer","name":"Watch and wait after chemoradiotherapy for rectal cancer","tldr":"In some people the rectal tumour disappears completely after chemotherapy and radiotherapy. Watch and wait means keeping the rectum and checking it closely instead of removing it, and operating only if the tumour comes back. About a quarter of regrowths happen, almost all within two years, and almost all can still be operated on.","route":"/terms/watch-and-wait-rectal-cancer/","kind":"term","schematic":{"id":"mri","sections":["imaging"]},"facets":{"kind":["Term"],"cancers":["Colorectal cancer","Rectal cancer","Mismatch-repair deficient (MSI-high) colorectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."},{"label":"Rectal cancer","href":"/cancers/rectal-cancer/","tip":"Rectal cancer is bowel cancer in the last part of the large intestine, where surgery can mean a permanent stoma. Treatment now usually gives all the chemotherapy and radiotherapy first, and about half of people whose tumour disappears completely can keep their rectum and avoid surgery altogether."},{"label":"Mismatch-repair deficient (MSI-high) colorectal cancer","href":"/cancers/msi-high-colorectal/","tip":"Mismatch-repair deficient bowel cancer has lost its DNA spell-checker, so it carries thousands of mutations that the immune system can recognise. Immunotherapy alone controls most metastatic cases for years and makes most localised tumours disappear before surgery, sometimes so completely that no surgery is needed."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"urgent-help-bowel-cancer","name":"When to seek urgent help with bowel cancer (NHS 111 and 999)","tldr":"Call 999 for signs of sepsis, non-stop bleeding from the bottom or large blood clots, or sudden severe tummy pain with green vomit. Ring the hospital's 24-hour line at once for a temperature outside your team's range, shivering, diarrhoea that has not settled within 24 hours, or a stoma that has stopped working. Use 111 for black or dark red poo and bloody diarrhoea.","route":"/terms/urgent-help-bowel-cancer/","kind":"term","cancerIcon":"colorectal","facets":{"kind":["Term"],"cancers":["Colorectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"urgent-help-pancreatic-cancer","name":"When to seek urgent help with pancreatic cancer (NHS 111 and 999)","tldr":"Call 999 for signs of sepsis, vomiting blood with feeling faint, or a swollen painful leg with breathlessness or chest pain. Ring the hospital's 24-hour line at once for a temperature over 37.5 C or below 36 C, shivering with a stent or jaundice, vomiting large amounts, heavy diarrhoea or uncontrolled pain. Ask for an urgent GP appointment or use 111 for returning yellow eyes or skin.","route":"/terms/urgent-help-pancreatic-cancer/","kind":"term","cancerIcon":"pancreatic","facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}},{"id":"work-and-money-bowel-cancer-uk","name":"Work and money with bowel cancer (UK)","tldr":"From diagnosis you are protected from discrimination at work by the Equality Act 2010, and your employer must consider reasonable adjustments such as different hours, time off for appointments, changed duties or a phased return. Access to Work can fund equipment, benefits such as Personal Independence Payment may apply, and permanent stoma supplies are free on prescription.","route":"/terms/work-and-money-bowel-cancer-uk/","kind":"term","term":{"category":"Clinic basics"},"facets":{"kind":["Term"],"cancers":["Colorectal cancer"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Colorectal cancer","href":"/cancers/colorectal/","tip":"The cancer where screening works best and where immunotherapy can make some tumours disappear entirely; chemotherapy still carries most metastatic disease, now with antibodies and targeted combinations chosen by RAS, BRAF, mismatch repair and which side of the bowel the tumour started on."}],"tags":[{"label":"colorectal","href":"/tagged/colorectal/","tip":"Every record tagged colorectal."}]},"sortKeys":{"year":0}},{"id":"work-and-money-pancreatic-cancer-uk","name":"Work and money with pancreatic cancer (UK)","tldr":"Cancer counts as a disability, so your employer must consider reasonable adjustments; benefits such as PIP, Attendance Allowance and Carer's Allowance may apply, an SR1 form from your doctor speeds claims where the cancer cannot be cured, prescriptions are free in England with an FP92A certificate, and Macmillan's advisers and calculator work out what you can claim.","route":"/terms/work-and-money-pancreatic-cancer-uk/","kind":"term","term":{"category":"Clinic basics"},"facets":{"kind":["Term"],"cancers":["Pancreatic ductal adenocarcinoma"],"year":[]},"cols":{"kind":{"facet":"kind","value":"Term","tip":"Glossary with plain-English TL;DRs and Wikipedia links."},"cancers":[{"label":"Pancreatic ductal adenocarcinoma","href":"/cancers/pancreatic/","tip":"Almost every pancreatic tumour carries a KRAS mutation, and for the first time drugs against it work: daraxonrasib nearly doubled survival in previously treated disease in 2026. Pancreatic cancer has been the hardest common cancer to treat once advanced; that is what is starting to change."}],"tags":[{"label":"pancreatic","href":"/tagged/pancreatic/","tip":"Every record tagged pancreatic."}]},"sortKeys":{"year":0}}]