Pancreatic Cancer

The hepato-pancreato-biliary (HPB) team provides expert diagnosis, treatment and management of people with suspected liver, biliary tree and pancreatic cancers.

If you come to the hospital you can expect:

Support - every step of the way - You’ll be assigned a specialist nurse who will be with you throughout your treatment journey, from your first clinic appointment to aftercare. The nurse is your key-worker and will help you with any problems or questions you may have.

Experts working together to give you the best treatment - Specialists from different medical areas meet weekly. This is called a multi-disciplinary team meeting (MDT) and is central to the way we work. The MDT advise, support and create treatment plans that are personalised for every patient.

A well-established, experienced team - We are the busiest unit in the country, receiving over 780 referrals and operating on 200 suspected cancer patients each year, with world-renowned consultants.

Total cancer care for Liverpool – and beyond - The team consists of doctors, nurses and other health professionals who manage HPB cancer care in Merseyside, Cheshire, Isle of Man and North Wales. The unit’s excellent reputation means we also take some national and international referrals.

Research-driven care - Our links with the University of Liverpool and Cancer Research UK means that we’re leading research into HPB cancer care. There are currently two professors and two senior lecturers in the team.

You will be referred to the hospital if your doctor (GP) or consultant in your local hospital spots something needing further investigation. We will see you within two weeks if appropriate. We will organise all of the relevant tests if you haven’t had them already in your local hospital.

Testing for pancreatic cancer

It is difficult to test for pancreatic cancer. We use lots of different methods to make sure we get an accurate diagnosis:

• Blood tests: your blood is taken to check your general health and also look for cancer markers. Markers are chemicals that show up in the blood when people have certain types of cancer.
• Ultrasound scan: this is a scan using sound waves to look at your pancreas and liver. The doctor is looking for abnormalities in your pancreas.
• CT scan (computerised tomography scan): a computer is used to build a detailed image of the inside of your body. It does this by joining together a series of X-ray images. The doctor uses the results of this scan to check for any abnormalities, and to assess the size of the tumour in your pancreas.
• MRI scan (magnetic resonance imaging scan): this is a scan using magnetic waves. You may be asked to have an MRI scan of your abdomen.
• Endoscopic ultrasound: this is an internal ultrasound scan that is performed using an endoscope (a thin, flexible tube that allows the specialist to see in side the body).
• ERCP test: ERCP means using an endoscope to help take an X-ray of the pancreas and gall bladder.
• Laparoscopy: a laparoscope is a long tube with a camera at one end and an eye piece at the other. The doctor puts the laparoscope through little cuts (incisions) in the abdomen and examines you from the inside. This usually requires a general anaesthetic - meaning you'll be put to 'sleep'.
• Biopsy: this is the only way of diagnosing cancer 100%. A sample of cells is collected from the lump and then looked at under a microscope for anything abnormal. It is not always necessary to take a biopsy to make a diagnosis.

Test results

Scans and results of the examination are discussed at the weekly regional multi-disciplinary team meeting (MDT). The MDT is held every Wednesday and contains a well-established group of experts

The MDT will make a diagnosis and decide upon a treatment plan that’s best for you. We will then arrange to see you in clinic to discuss your treatment or give advice to your referring doctor if you do not need to be seen. Although the MDT gives advice on treatment options that would benefit you the most, you have the final decision about the type of treatment you receive.

Treatment starts as soon as possible after the cancer is discovered. You are assigned a specialist nurse who stays with you every step of your treatment journey. The nurse is you key-worker and is there to answer any questions you – or your family – may have along the way.

Pancreatic cancer treatment types

The type of treatment depends on the particular type of the pancreas you have, the stage of the cancer, its size, and your general health.

• Surgery: This is a very complex and lengthy procedure which is only suitable for people with early stage pancreatic cancer. It will only be performed if it is possible to remove the cancer and if you are fit enough to have major surgery.
• Chemotherapy: If pancreatic cancer has been completely removed with surgery, chemotherapy may be given afterwards to reduce the chance of the cancer coming back. This is known as adjuvant chemotherapy.If the cancer can’t be removed - but has not yet spread beyond the pancreas – chemotherapy may be used to prevent the cancer from progressing and control it for a time. If the cancer has spread, chemotherapy may be used to try and prevent the cancer from progressing and relieve the symptoms.

Palliative Care

This concentrates on managing cancer symptoms if the disease is not curable. The goal of palliative care is to achieve good quality of life for patients and their families. We have an excellent palliative care unit at the hospital.

Pancreatic cancer research

The Hepato-biliary unit is the largest clinical unit in the United Kingdom. It is internationally-renowned in the treatment and research of pancreatic cancer and is an integral part of the School of Cancer Studies at the University of Liverpool.

The Cancer Research UK Centre at the Royal Liverpool University Hospital is part of a chain of research centres across the UK. It brings together:

• The University of Liverpool
• Royal Liverpool University Hospital
• The Clatterbridge Cancer Centre NHS Foundation Trust
• Liverpool City Council and Cheshire Cancer Task Force

Researchers at the centre aim to develop treatments tailored to individual cancer patients based on understanding the biology of the disease and how it varies among different people.

Dedicated research unit

The Liverpool Pancreatic Biomedical Research Unit (PBRU) is a research unit funded by the NHS National Institute of Heath Research (NIHR) to investigate pancreatic diseases. The PBRU is the first and only NIHR funded specialist unit to undertake translational research into pancreatitis and pancreatic cancer in the UK. PBRU translates basic pancreatic research into a clinical setting - improving the diagnosis and treatment of patients with pancreatitis and pancreatic cancer.

The MDT is held every Wednesday and contains a well-established group of experts, including:

• surgeons
• nurses
• radiologists
• oncologists (specialists in the non-surgical treatment of cancer)
• palliative care specialists

Contact Details for the Cancer Team : 0151 706 2000

Visit the Marie Curie website here

Visit the MacMillan Cancer website here 

Visit the Cancer Research UK website here

Visit the NHS Choices - Cancer website here

Clinical Trials

You may be asked to take part in a clinical trial. Clinical trials help us learn more about the best way to treat specific conditions. You can learn more about the Clinical Research Unit by visiting the website here