The ‘silent killer’ on the rise in Australia

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Elvis Govic describes pancreatic cancer as “the silent killer”.

“You’re not even aware that you’ve got it … and if it goes too far, there’s no chance of surviving it.”

By the time Elvis Govic was diagnosed with pancreatic cancer in 2020, it had progressed to stage 3.Credit: Simon Schluter

The painter, business owner and football coach first developed worrying symptoms in 2020.

“Everything I put in my mouth, it came straight out,” said the 61-year-old Melbourne grandfather, who was initially prescribed antibiotics by his GP.

“It sort of helped a little bit, but three weeks later, I started looking jaundiced.”

By the time he was diagnosed with pancreatic cancer, the disease had progressed to stage 3, which means the cancer has grown outside the pancreas and into nearby major blood vessels or lymph nodes.

Govic’s description of pancreatic cancer as the silent killer is fitting because most cases do not produce symptoms until the advanced stage. About 30 per cent of cases are detected at stage 3 and 50 per cent at stage 4, meaning it has spread to other parts of the body.

When they do emerge, symptoms can include weight loss, pain in the back and abdomen, fatigue, dark urine and yellow skin and eyes.

Just 12.5 per cent of Australians with the disease survive past five years, an increase from about 5 per cent in 2003 to 2007, but it is still the lowest survival rate for a cancer type in this country bar mesothelioma, an aggressive tissue cancer that attacks multiple organs.

In contrast, prostate cancer has a five-year survival rate of more than 95 per cent, and breast cancer 92 per cent.

The low survival rates for pancreatic cancer sit alongside another worrying statistic: increasing prevalence. Between 2001 and 2021, the risk of Australians developing pancreatic cancer before the age of 85 jumped from one in 102 to one in 69.

As a result, pancreatic cancer was redefined from being a “less common” to a “common” cancer in an Australian Institute of Health and Welfare report updated last month.

It vaulted from being the sixth-leading cause of cancer death in Australia to the third between 2001 and 2021. It now takes about 3400 Australian lives each year, behind bowel cancer and lung cancer.

The increase in cases can be partly put down to Australia’s ageing population. Pancreatic cancer is more common as people get older. However, age-adjusted rates of the disease have also been on the rise since 2002, meaning other factors are at play.

Diabetes and obesity are among the risk factors for pancreatic cancer, and these have also been increasing at the same time. Other risk factors include smoking (smokers are about twice as likely to develop pancreatic cancer as non-smokers), workplace exposure to certain pesticides, dyes or chemicals, a family history of pancreatic cancer and other inherited conditions.

Michelle Stewart, the chief executive of PanKind, the Australian Pancreatic Cancer Foundation, is concerned the cancer has flown under the radar for fundraising and research investment, partly because “the speed at which this disease moves means that there are not a large number of advocates who are able to raise awareness of this disease”.

The foundation believes the best way to improve survival rates is to invest in earlier detection.

“This could be in the form of a liquid biopsy, improved imaging or other innovative approaches that could identify the cancer before the patient becomes symptomatic,” Stewart said.

“There is significant work to do before we can implement any population-based screening tests, but we are hoping we can leapfrog ahead using the learnings gained from other cancers.”

Govic’s cancer is now considered terminal, but the father of two has been determined to stay optimistic and live life to the fullest. He is taking a short break from his treatment to attend the AFL Masters National Carnival next week, as the coach of the Victorian over-60s team.

Samm Honeysett being treated for pancreatic cancer.

“You just have to keep pushing on,” he said.

Sydney oncologist Professor David Goldstein said 80 per cent of pancreatic cancer patients he treats are “inoperable and incurable” by the time they present, but he and his colleagues have occasionally had patients who have done “exceptionally well”.

“The exceptional responders [to treatment] are in many ways the most interesting to study … We can learn from them to adapt our treatments.”

Dubbo resident Samm Honeysett is one of those people. She was diagnosed with stage 3 pancreatic cancer just after she had her third child in October 2018, and was told the chance of survival after five years was about 3 per cent. She did 10 rounds of chemotherapy while looking after her own three children, and two others, all aged under 10.

Today, there is no sign of her cancer, although she requires scans every three months and constantly fears it might return.

“I didn’t used to think I would be around to see my son turn five,” the 34-year-old said. “I used to cry all the time when I looked at him as a baby … I didn’t imagine that I would be able to get him ready for school, or pick his shoes or his school bag. But I get to do that next year.”

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