It is one of the most brutal cancers, killing around three-quarters of those diagnosed within a year. And, perhaps even more worryingly, it is on the rise.
Pancreatic cancer has become steadily more common over the past 30 years, with cases increasing fastest among younger patients and women – though the disease, which led to actor Alan Rickman’s death aged 69, still overwhelmingly affects older people.
So there was huge excitement last week when new research suggested a treatment that could reduce the risk of the disease.
The study, unveiled at the American Society for Clinical Oncology (Asco) annual conference in Chicago, found that GLP-1 drugs – including weight-loss jabs Mounjaro and Ozempic – were linked to a roughly 50 per cent lower risk of developing pancreatic cancer over a five-year period.
The researchers analysed the health records of around 90,000 patients in the US, focusing on those with chronic pancreatitis – long-term inflammation of the pancreas – and type 2 diabetes. Both conditions are known to increase the risk of pancreatic cancer.
Experts behind the study said the drugs may have a protective effect because they reduce inflammation and improve metabolism and blood sugar control.
Early laboratory evidence suggests they could slow cancer-related cell processes, although this has yet to be proven in people.
The findings raise the possibility that GLP-1 jabs could one day be offered to those at higher risk of pancreatic cancer – even if they are not overweight.
Pancreatic cancer claimed the life of actor Alan Rickman in 2016 at the age of 69
Dr Rachna Shroff, a gastrointestinal cancers expert at the University of Arizona Cancer Center who was not involved in the study, said: ‘Chronic pancreatitis is a major risk factor for pancreatic cancer. So to see such a significant drop in cancer incidence among people using GLP‑1 drugs is remarkable.’
These results are even more surprising given concerns that GLP-1 drugs might trigger pancreatitis – so much so that patient information leaflets list it as a rare potential side-effect.
But recent large-scale analyses have found no clear evidence of a meaningful increase in pancreatitis among users.
The pancreas is a palm-sized, pear-shaped gland that sits behind the stomach and plays a vital role in digestion.
When it becomes inflamed, this can lead to acute pancreatitis – which can cause severe abdominal pain, nausea and fever. In most cases, the underlying cause is gallstones or excessive alcohol consumption, although obesity is also a risk factor.
Acute pancreatitis usually settles within days or weeks. But if inflammation persists or keeps returning, it can develop into chronic pancreatitis – a long-term condition known to increase the risk of pancreatic cancer.
A recent study found that GLP-1 drugs – including weight-loss jabs Mounjaro and Ozempic – were linked to a roughly 50 per cent lower risk of developing pancreatic cancer over a five-year period
Around 10,500 people in the UK are diagnosed with pancreatic cancer every year, and more than half die within three months of diagnosis because most cases are detected only at an advanced stage.
Scientists are now working to understand why these GLP-1 drugs might have an effect on pancreatic cancer specifically.
‘The thinking around pancreatitis is that GLP‑1s slow the movement of bile and digestive enzymes to make users feel fuller for longer without having to eat more,’ Dr Shroff explained.
‘But if that process slows down too much, problems can occur.’
Bile is a thin, detergent-like fluid that flows from the liver, through the gallbladder and into the small intestine to help digest fat.
When digestion slows, components of bile – such as cholesterol, salts and microscopic gallstone fragments – can clump together, block the ducts close to the pancreas and trigger inflammation. Or at least that had been the concern with GLP-1s.
Dr Shroff said: ‘So far, there isn’t any real-world data that suggests the average GLP-1 patient is at increased risk of pancreatitis or pancreatic cancer.
‘In fact, we are seeing the opposite. There’s now data emerging suggesting the jabs may be protective. If this is the case… that’s a really big deal for a disease that is often diagnosed at a late stage and is notoriously difficult to treat.
‘But this is just the tip of the iceberg and we need more research to back up these claims.’
Another study presented at the Asco conference suggested the jabs could slow the progression of seven types of cancer – including lung, liver, breast and bowel – and improve survival outcomes.
The team believe the drugs may work by reducing inflammation and fat around tumours, which can act as fuel for cancer cells to grow and spread.
Dr Brian Wolpin, from the Dana-Farber Cancer Institute, said: ‘There could be some trade-off if there is a higher risk of pancreatitis. But the data I have seen so far has not shown an increase in pancreatic cancer risk among users, giving us hope that these drugs could one day help in the fight against this deadly disease.’