A recent investigation by the Scottish Public Services Ombudsman (SPSO) has highlighted a critical failure by a general practitioner to identify and escalate the symptoms of pancreatic cancer, resulting in a patient's death weeks after their initial diagnosis of diabetes. The report criticizes the family doctor for missing 'red flag symptoms' from the patient's first contact with the practice, leading to an "unreasonable delay" in diagnosis and inadequate end-of-life care.
Pancreatic cancer, known for its high mortality rate and often vague early symptoms, poses a significant diagnostic challenge. The SPSO report identified missed opportunities to recognize the severity of the patient's condition, which included unexplained weight loss, a key indicator that GPs have been warned to pay close attention to. Despite ongoing symptoms, the patient was initially treated for diabetes, a misdiagnosis that persisted for months.
The patient eventually requested to be tested for pancreatic cancer, prompting a referral to gastroenterology specialists. Subsequent blood tests confirmed the diagnosis, but the patient died just six weeks later. The watchdog specifically criticized the GP's "unreasonable reliance on telephone consultations," suggesting this method may have exacerbated the diagnostic delay.
Pancreatic cancer has seen a steady increase in cases over the past 30 years, with rising rates particularly noted among younger patients and women, though it predominantly affects older individuals. Factors such as smoking, obesity, processed meat consumption, and alcohol are known to increase the risk. While approximately 10,500 people are diagnosed with the disease annually in the UK, more than half die within three months due to late-stage detection.
Recent advancements in treatment offer some hope. A drug called daraxonrasib has shown potential in clinical trials to double the life expectancy of patients with advanced pancreatic cancer, with findings submitted to U.S. regulators and an application expected for UK approval. This development marks a potential shift in managing a disease with historically limited treatment options, which until recently, largely consisted of highly toxic chemotherapy.