pancreatic

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.

The Glasgow surgeon-scientist who mapped the genomic subtypes of pancreatic cancer and built Precision-Panc, the UK programme that profiled tumours to route patients into the PRIMUS trials.

Liverpool molecular scientist behind the EUROPAC registry's laboratory work and the biomarker analyses of the ESPAC trial samples.

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.

Liverpool pancreatic surgeon who leads EUROPAC, the UK registry and surveillance programme for families with inherited pancreatic cancer risk and hereditary pancreatitis.

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.

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.

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.

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.

Led the MPACT trial of nab-paclitaxel plus gemcitabine and has run more first-in-human cancer trials than almost anyone.

Liverpool medical oncologist, second author of ESPAC-4 and co-lead of ESPAC5, who directs the Liverpool Experimental Cancer Medicine Centre and leads the national GIRFT review of pancreatic cancer services.

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.

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.

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.

The UK's registry and screening programme for families with inherited pancreatic cancer risk, run from Liverpool since 2000; its 2026 outcomes paper shows risk-stratified surveillance finds four times more actionable lesions.

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.

Senior investigator of POLO and a leader in mesothelioma trials, including the ASCO guidelines for the disease.

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.

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.

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.

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.

Dutch surgeon who leads the PREOPANC trials testing chemotherapy or chemoradiation before pancreatic cancer surgery.

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.

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.

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.

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.

A UK charity founded by a pancreatic cancer survivor that works on early diagnosis: symptom awareness campaigns and education for GPs and the public.

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.

The UK's pancreatic cancer charity: a specialist nurse Support Line, the list of NHS specialist centres, the Optimal Care Pathway that GIRFT and the national audit measure against, research funding and the campaign to end PERT shortages.

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.

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.

Liverpool pancreatic surgeon, chief investigator of ESPAC5, the UK trial of short-course neoadjuvant treatment for borderline resectable pancreatic cancer, and a co-author of ESPAC-3 and ESPAC-4.

The UK precision medicine platform for pancreatic cancer, led from Glasgow: profile the tumour at diagnosis, then route the patient to a matching PRIMUS trial.

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.

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.

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.

Led POLO, the first biomarker-driven trial in pancreatic cancer, which brought olaparib to BRCA carriers.

Led the FOLFIRINOX trials that gave pancreatic cancer its most active chemotherapy in both metastatic and adjuvant settings.

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.

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.

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.

Surgeon-scientist whose personalised mRNA vaccine trial showed pancreatic cancer can provoke lasting T-cell immunity.

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.

The University of Glasgow's cancer research centre on the Garscube estate, home to Andrew Biankin's pancreatic cancer genomics group and the Precision-Panc programme that ran the PRIMUS trials through NHS Greater Glasgow and Clyde.

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.

Led NAPOLI 3, the trial that made NALIRIFOX a first-line option for metastatic pancreatic cancer.