The best bit about my job

Pancreatic cancer is one of the most deadly forms of cancer and a diagnosis of this disease usually means a short life expectancy of a few months. The 5-year survival rate even for people with operable disease, treated with surgery and chemotherapy is only 20 per cent and only one percent of those diagnosed at late stage 4 are alive four years later. So when someone is told they have late-stage pancreatic cancer – not that uncommon since it doesn’t cause symptoms like jaundice abdominal pain and weight loss until well advanced –  they usually go home to get their affairs in order.

This is exactly what an 80-year-old gentleman did when he was diagnosed with the disease having presented with acute jaundice and loss of weight. In fact, he went home and organised his funeral with the loving help of his distraught family.

Except that he didn’t have pancreatic cancer at all. He had gallstones which had blocked his bile duct and like many older people, he put up with the pain until he was close to collapse.

When I saw him, he was simply getting a scan to show how long he had. The blood tests had already showed positive for a pancreatic cancer tumour marker and his GP had informed him of his terminal disease.

But a CT scan showed no such thing. Neither did the biopsies. There was no cancer, but his bile duct was full of gallstones, hard stones comprised of calcium and bile, that had caused the flow of bile to stop.

In this man’s case the raised tumour marker was simply due to the jaundice….what’s known as a “false positive”, which essentially means that no single test is perfect.

It was my job to send the tests back to his GP and inform him that there may have to be a change of plan when it came to his imminent demise. This has to be the best bit about my job.

Mr Tim Worthington

Mr Worthington is a Consultant Surgeon, Royal Surrey County Hospital, Guildford. Laparoscopic Tutor, Minimal Access Therapy and Training Unit,
University of Surrey. Mr Worthington trained at the Hammersmith Hospital, Imperial College London.

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