A new study — in collaboration with a range of Midland-based NHS trusts, and a team from the University of Birmingham — found almost half of people diagnosed with inoperable pancreatic cancer, were not prescribed Pancreatic Enzyme Replacement Therapy (PERT) tablets. The tablets are considered essential in helping patients digest food properly, and remain healthy enough to tolerate pancreatic cancer treatments.
The study — due to be published in the Pancreatology journal — utilised an audit of the records of 1,350 patients with pancreatic cancer, between April and August 2018 in the UK.
The research found huge variations in prescription rates for PERT across 84 NHS hospitals (59 non-specialist and 25 specialist surgical hospitals). The study showed that of the patients who were diagnosed too late to have surgery, just 45% were prescribed PERT tablets. But those whose cancer was considered operable, 74% were prescribed PERT.
Richard Wilkin, Clinical Lecturer at the University of Birmingham and corresponding author of the research, said: “Our important research has highlighted that, despite national guidance, there is a wide variation and under-treatment with Pancreatic Enzyme Replacement Therapy.
“This is a very simple tablet that allows patients with pancreatic cancer to absorb their food and is a vitally important part of their treatment.
“Given that most patients with pancreatic cancer cannot be treated with surgery and are treated in non-surgical hospitals — where prescribing is lowest — strategies to disseminate best practice and overcome barriers to prescribing are urgently required.”
In response to the latest findings, the Pancreatic Cancer UK charity launched its ‘Transform Lives: Prescribe’ campaign on Wednesday, urging the NHS to ensure everyone who could benefit from the tablets, are prescribed them when diagnosed.
PERT is already recommended for people with pancreatic cancer by NICE, but there appears to be a lack of awareness around the medication, which research shows is the main reason they are not prescribed more often.
Keith Roberts, Pancreatic Subspecialty Lead, at the Royal College of Surgeons of England, said: “People with heart, lung or kidney failure would not be left untreated, but far too often pancreas failure is. This leads to very predictable problems namely weight loss, abdominal cramps and lack of ability to undergo treatment. Pancreas enzyme replacement therapy is simple and corrects this.”
Diana Jupp, CEO of Pancreatic Cancer UK, said: “Nobody should have to watch someone they love waste away from pancreatic cancer when proven, inexpensive medication is available to stop that from happening. It needs to become second nature to see people with pancreatic cancer prescribed PERT tablets.
“We need targeted action now across the NHS to raise awareness of PERT tablets and ensure everyone who needs them is prescribed them – regardless of whether or not their cancer is curable. A simple prescription could give so many people with pancreatic cancer more – and better quality – time with their loved ones.”
