I’m a pancreatic cancer expert… this is why the crisis may be getting worse, the risk factors everyone needs to know – and what you can change right now

It is often described by doctors as one of the most merciless diseases – difficult to detect, fast-moving and, although few will say it publicly, often hopeless. 

Pancreatic cancer typically develops silently, with few clear warning signs, and is all too often only discovered once it has already spread, and prognosis is bleak.

Just last week it was alleged that Prince Philip was diagnosed with it eight years before his death in 2021. For most, however, the outlook is far bleaker.

The most optimistic estimates suggest just 12 per cent of patients survive more than five years after diagnosis.

And high-profile cases have underlined just how brutal it can be. Harry Potter star Alan Rickman died in 2016, aged 69, just months after learning he had the disease, while action hero Patrick Swayze died in 2009 within 20 months of diagnosis.

Although nearly half of cases occur in the over-75s, there is growing evidence rates may be rising in younger people – particularly women – with the most aggressive form, pancreatic ductal adenocarcinoma, driving the increase.

Experts say part of this may reflect better detection of smaller tumours. But there is also increasing concern that modern lifestyles are playing a role.

Smoking, obesity, alcohol use and poor diet are all known to increase the risk – largely by driving chronic inflammation, disrupting insulin levels and placing sustained stress on the pancreas. And the picture could yet worsen.

Scientists are now examining whether newer trends – including the surge in weight-loss injections and the rise of nicotine pouches such as snus – could also be affecting pancreatic health, though the evidence remains under investigation.

With concern growing, experts say understanding the risk factors – and acting on those we can change – is becoming increasingly important.

Consultant surgeon and trustee of Pancreatic Cancer Action, Mr Neville Menezes, says: ‘Survival rates for pancreatic cancer have improved slightly since I began in the medical profession, but fewer than 10 per cent of patients are eligible for surgery because the disease is diagnosed too late.

‘Symptoms can be mistaken for something as simple as indigestion.‘

The reason it is so often missed lies partly in the biology of the disease.

The pancreas – a small gland hidden deep behind the stomach – plays a vital role in digestion and blood sugar control. But because of its position, tumours can grow silently for months or even years without causing obvious symptoms.

By the time signs such as weight loss, abdominal pain or jaundice appear, the cancer has often already spread, limiting the chances of curative treatment.

So what is it that drives this disease – and who is most at risk?

How the rise of snus could drive pancreatic cancer

Around one in five pancreatic cancer cases in the UK is linked to smoking, according to Cancer Research UK. Cigarettes, cigars and pipes all increase the risk – as does chewing tobacco.

‘We know smoking is a risk factor for many cancers – but studies also show smokers are about twice as likely to develop pancreatic cancer compared to non-smokers,’ says Ade Williams, Pharmacist Ambassador for Pancreatic Cancer Action.

Smoking is often tied to alcohol use – a combination experts warn can be particularly damaging. 

‘Smoking and drinking often go hand in hand, which can inflame the pancreas and, over time, damage the organ,’ Mr Williams explains.

Alcohol can also directly harm the pancreas. It can trigger digestive enzymes prematurely – inside the organ itself – causing it to begin digesting its own tissue. Over time, this can lead to chronic pancreatitis, which raises cancer risk.

‘Years of smoking and drinking can damage pancreatic cells and lead to chronic pancreatitis,’ says Mr Menezes. ‘This can set off a chain reaction that increases the risk of cancer.’

Questions are now being asked about newer nicotine products – particularly snus, the small pouches placed under the lip that have surged in popularity among younger people.

Some studies have raised concern. A 2007 study of Swedish construction workers found snus users had roughly double the risk of pancreatic cancer compared to non-tobacco users, while a 2005 Norwegian study reported a 67 per cent increased risk among current users.

However, the evidence is not conclusive, and researchers say more data is needed.

There is also no clear evidence linking e-cigarettes to pancreatic cancer, although early lab studies suggest some compounds may affect pancreatic cells.

For now, experts say the safest approach remains avoiding tobacco in all its forms.

Excess weight and poor diet may be fuelling pancreatic cancer

Around 64 per cent of adults in England are estimated to be overweight or living with obesity. Excess weight is a major risk factor for chronic diseases, contributing to type 2 diabetes, heart disease, stroke, and certain cancers – including pancreatic cancer.

Mr Williams says: ‘Excess visceral fat – the fat stored around internal organs – places stress on the pancreas. Losing just five to 10 per cent of your body weight can significantly reduce this strain.’

Experts say maintaining a healthy weight starts with a balanced diet, including plenty of fruit, vegetables, fibre, and protein, while limiting ultra-processed foods, sugary drinks, and saturated fats. Poor diet can trigger blood sugar spikes, forcing the pancreas to work harder to produce insulin.

Some studies suggest vegetarians may have a lower risk of certain cancers, although more research is needed. High consumption of red and processed meat has also been linked to increased risk.

Mr Menezes adds: ‘Saturated fats found in meat – particularly heavily processed products – can negatively affect pancreatic health. Processed red meats, such as bacon and burgers, are linked to digestive issues and harmful changes at a cellular level.

‘These effects are driven by high fat and protein content, chemical preservatives, and the formation of toxic compounds during digestion and high-temperature cooking – all of which can lead to inflammation and increase chronic disease risk.’

Exercise is equally important. ‘When you exercise, you improve insulin sensitivity, which reduces strain on the pancreas.

‘Even short bursts of activity can be beneficial. Do what you can, set realistic targets, and remember physical activity improves overall metabolic health,’ says Mr Williams.

‘Obesity is often linked to wider lifestyle factors – poor diet, excess calories, and lack of exercise. High abdominal fat places extra strain on organs such as the liver and pancreas, affecting long-term cell health,’ adds Mr Menezes.

Finally, evidence suggests high consumption of red and processed meats may increase pancreatic cancer risk by 12–38 per cent, particularly in men.

Cooking meat at high temperatures – such as grilling, barbecuing, or pan-frying – can produce potentially harmful chemicals, while processed meats may carry additional risks due to curing and smoking. Experts stress that moderation is key.

Why dehydration may put hidden strain on the pancreas

Water makes up roughly 60 per cent of the human body, but many people fail to drink the recommended six to eight glasses a day.

‘Dehydration can affect pancreatic enzyme production, slowing digestion and nutrient absorption,’ explains Mr Williams.

‘Think of your body as an engine – drinking water keeps it running efficiently. Even if you’re active and eat well, insufficient hydration puts extra strain on your body.’

Experts suggest keeping a reusable water bottle with you, drinking water with meals, and choosing water or unsweetened herbal teas over sugary drinks.

Early signs of dehydration include fatigue, headaches, dark urine, and dry skin.

Maintaining hydration supports not only overall health but also the pancreas, helping it produce enzymes and manage blood sugar effectively.

Could weight-loss jabs trigger pancreatic cancer?

Weight-loss injections have surged in popularity, but experts warn patients to follow medical advice.

Early studies raised concerns that GLP-1 receptor agonists – including semaglutide, liraglutide, and tirzepatide – could affect the pancreas and increase the risk of pancreatitis.

Recent large-scale studies are more reassuring, suggesting these medications – better known by their brand names, such as Wegovy, Ozempic, and Mounjaro – do not significantly increase the risk of pancreatic cancer, with some evidence of a potential reduced risk. 

However, long-term data is still needed. 

‘We may have to wait a few more years to fully understand whether other mechanisms in these injections affect the pancreas,’ says Mr Menezes.

The MHRA has issued guidance on a small risk of pancreatitis – a sudden and potentially life-threatening inflammation of the pancreas. 

Symptoms include severe stomach or back pain, fever, and vomiting, and patients are urged to seek immediate medical attention.

While rare, severe cases can lead to infection, organ failure, or death. One reported case involved a 58-year-old nurse who died after tirzepatide injections – a death investigated as potentially linked to the drug. 

Regulators say the benefits outweigh the risks when used appropriately.

Mr Williams advises: ‘Some medicines can put extra strain on the pancreas if not taken properly. Always follow instructions and speak to a doctor before making changes. GLP-1 drugs are effective, but carry rare risks – seek urgent medical help if you feel unwell.’

The hidden genetic risks that can run in families

Around five to 10 per cent of pancreatic cancer cases are linked to family history.

Risk is higher if first-degree relatives were diagnosed, especially at a young age. Genes such as BRCA1, BRCA2, and PALB2 can increase risk, as can inherited syndromes like Peutz-Jeghers, FAMMM and Lynch.

However, most pancreatic cancers are sporadic.

Experts recommend that people with a strong family history consider genetic testing, which can be carried out by the NHS – speaking to a GP is the first port of call. Identifying a harmful gene variant can allow closer monitoring and, in some cases, earlier intervention.

For example, high-risk individuals may undergo regular imaging or endoscopic screening to detect tumours at an earlier stage.

Lifestyle changes – such as maintaining a healthy weight, not smoking, and limiting alcohol – are also particularly important for those with a hereditary risk.

Breakthrough scientists hope could change survival rates

A recent study by Spanish researchers generated huge excitement in the world of pancreatic cancer treatment. 

It found that a combination of three existing drugs completely wiped out pancreatic tumours in lab mice. The drugs work by simultaneously blocking multiple survival pathways pancreatic cancers use, making it harder for tumour cells to grow and adapt.

While promising, this approach has so far only been tested in animals, and human clinical trials will be needed to determine whether it can benefit patients.

There are, however, other areas of progress offering cautious hope.

Targeted treatments such as PARP inhibitors – including olaparib – are already being used in a small subset of patients with inherited BRCA mutations. These drugs work by blocking cancer cells’ ability to repair damaged DNA, effectively pushing them towards self-destruction.

In selected patients, they have been shown to delay disease progression and are now approved in some settings.

Immunotherapy, which has transformed treatment for several other cancers, has so far had limited success in pancreatic cancer. 

A drug called pembrolizumab has been approved for patients with advanced pancreatic cancer whose tumors show what’s known as high microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR). 

These markers indicate the tumor has many mutations, making it easier for the immune system to spot and attack. 

Another drug, nivolumab, has also shown promise in treating MSI-H and dMMR forms of the disease. 

However these represent just one to three per cent of all pancreatic cancers.  

Researchers are now exploring new approaches, including combination therapies designed to make tumours more visible to the immune system.

At the same time, advances in chemotherapy combinations and more personalised treatment strategies are helping some patients live longer, particularly when the disease is caught earlier.

Mr Menezes says: ‘Pancreatic cancer has affected many celebrities over the years, helping bring awareness of the disease to the public. Charities are increasing awareness and training for GPs. 

‘Being cured is rare, but it is possible.’

Meanwhile, scientists are developing new ways to detect the disease sooner. Emerging blood and urine tests – including multi-marker panels – are showing promise in identifying pancreatic cancer at an earlier, more treatable stage.

While pancreatic cancer remains one of the most challenging diagnoses, advances in targeted treatments, earlier detection and better awareness are beginning to shift the outlook – even if only gradually.