Vague symptoms, late diagnosis — and two specific patterns that should never be watched and waited on.
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Pancreatic cancer has among the worst outcomes of any common cancer in the UK, and the reason is almost entirely late diagnosis.
The pancreas sits deep in the abdomen. Tumours there can grow for a long time producing nothing more than vague discomfort, indigestion, or a bit of weight loss — symptoms that describe a great many ordinary things.
Painless jaundice — yellowing of the skin or eyes without pain — needs assessment the same day. It is one of the few genuinely specific signs.
New diabetes in someone over 50 who is also losing weight. Diabetes normally comes with weight gain or stable weight. New diabetes alongside unexplained weight loss is a recognised presentation and it is frequently missed.
We do not diagnose or treat pancreatic cancer. Diagnosis needs CT and specialist assessment.
What twenty minutes can do is join up symptoms that have been seen separately — which, for this cancer, is often the whole problem.
This is worth knowing because people rarely mention it. Stools that are pale, oily, float and smell strongly suggest fat is not being absorbed — which happens when the pancreatic duct is blocked.
It is embarrassing to describe and therefore frequently not described. Say it anyway.
Gallstones, indigestion, IBS and coeliac disease are all far commoner causes. The point is not to be frightened by any single symptom, but to act when several persist together.
This confuses people, and it is worth being clear. Long-standing type 2 diabetes modestly raises pancreatic cancer risk.
But new-onset diabetes can be an early sign of the cancer itself, because the tumour disrupts insulin production before it causes anything else.
Which is why new diabetes plus weight loss in an older adult is a pattern that warrants looking further, rather than simply starting metformin and moving on.
Stopping smoking is the single largest lever, and free NHS support works considerably better than trying alone.
Liver function tests often show a characteristic obstructive pattern where the bile duct is blocked. HbA1c may reveal new diabetes.
CA 19-9 is a tumour marker used in pancreatic cancer — but it is not a screening test. It is raised by gallstones, pancreatitis and jaundice itself, and it can be normal in early cancer. It is used to monitor known disease, not to find it.
Ultrasound is often first and can show a blocked bile duct — but bowel gas obscures the pancreas in a substantial proportion of people, so a normal ultrasound does not exclude anything.
CT with contrast is the key test, and a specific pancreatic protocol is used where this is suspected.
Endoscopic ultrasound gives the most detailed views and allows biopsy. MRI and PET-CT are used for further assessment.
If symptoms persist after a normal ultrasound, that is not the end of the investigation. The pancreas is genuinely difficult to see, and CT is the test that answers the question.
We do not diagnose or treat pancreatic cancer, and we cannot examine your abdomen or arrange a CT scan quickly enough to be the right route for an urgent symptom.
This is a cancer where the individual symptoms have usually all been mentioned to someone — just never at the same time.
Indigestion mentioned in January, weight loss in March, tiredness in May — each unremarkable alone, and a pattern when set side by side. Twenty minutes is enough to set them side by side.
If you are jaundiced, do not book with us. Contact your GP the same day or go to A&E — that needs assessing today, not in a consultation slot.
Ask specifically for liver function tests and an urgent referral, and mention every symptom together — the pattern is what matters here, not any one of them.
Go back. Ultrasound frequently cannot see the pancreas properly, and persistent symptoms warrant a CT.
Stopping smoking. It is the largest avoidable cause of pancreatic cancer, and risk falls after quitting.
Free NHS stop-smoking support is several times more effective than willpower alone, and it costs nothing.
No screening test exists for pancreatic cancer in the general population, and CA 19-9 is not one — despite occasionally being sold as though it were.
Which makes recognising the symptom patterns the entire early-detection strategy.
Several affected relatives, or a known BRCA2 or Lynch syndrome in the family, can qualify for specialist surveillance — free, through NHS genetics.
That is a genuine exception to there being no screening, and it is worth asking about if it applies to you.
Pancreatic cancer is difficult, and it would be dishonest to suggest a private consultation changes the outlook much. The symptoms are vague and late, there is no screening test, and by the time it declares itself the options are often limited. We would rather say that than sell hope.
What genuinely matters is recognising the two patterns that should not be waited on. Painless jaundice — yellow eyes or skin, dark urine, pale stools, itching — requires same-day assessment, not an appointment next week. And new-onset diabetes in someone over 60 with unexplained weight loss is a recognised presentation that is very frequently attributed to the diabetes itself.
NHS care is free, and the urgent pathway is the right route. There is no useful private alternative for diagnosis — CT is what is needed and the NHS provides it quickly on the urgent pathway.
What we can do is arrange urgent referral or direct you to A&E the same day, and take vague symptoms seriously rather than treating them as dyspepsia.
Where money is genuinely wasted: private “full body” scans and multi-cancer blood tests marketed to worried people. The UK National Screening Committee does not recommend pancreatic cancer screening, and these tests produce false alarms and incidental findings far more often than early diagnoses.
NICE NG12, Suspected cancer: recognition and referral, is the governing guideline. It recommends an urgent direct-access CT scan for people aged 60 and over with weight loss and any of diarrhoea, back pain, abdominal pain, nausea, vomiting, constipation or new-onset diabetes.
NG12 recommends immediate referral for people with jaundice, which is the basis for the same-day advice above.
NICE NG85, Pancreatic cancer in adults, covers diagnosis, staging and management within specialist services, including the role of endoscopic ultrasound and the importance of pancreatic enzyme replacement.
The UK National Screening Committee does not recommend population screening for pancreatic cancer, which underpins the position on private scans and multi-cancer tests.
NG85 also addresses hereditary risk, where surveillance may be offered through specialist genetics services to defined high-risk groups.
Because the pancreas is deep in the abdomen and early symptoms are genuinely unremarkable.
Indigestion, tiredness, a bit of weight loss — each of those describes hundreds of harmless things. It is the combination, persisting, that matters.
Painless jaundice. Yellow skin or eyes without pain, often with dark urine and pale stools.
That needs same-day assessment, not a routine appointment.
Usually not — type 2 diabetes is common and is almost always just type 2 diabetes.
The pattern that warrants a second look is new diabetes over 50 alongside unexplained weight loss, because diabetes usually comes with stable or increasing weight.
If that describes you, say so specifically. It is a recognised presentation and it is frequently missed.
Not necessarily. Bowel gas obscures the pancreas in a substantial proportion of people, so a normal ultrasound often means the pancreas was not properly seen rather than that it was seen and was normal.
If symptoms persist, ask about a CT.
No — CA 19-9 is not a screening test, though it is sometimes sold as one.
It is raised by gallstones, pancreatitis and jaundice itself, and can be normal in early cancer. Its role is monitoring known disease.
They suggest fat is not being absorbed, which happens when the pancreatic duct is blocked.
Most people never mention it because it is embarrassing. It is one of the more useful things you can describe, so describe it.
Stopping smoking is by far the largest thing. Alcohol within limits, a healthy weight and well-managed diabetes all help.
There is no supplement, diet or detox that prevents pancreatic cancer, and this is a condition where such claims are aggressively marketed.
It can. Where there is a strong family history, or a known BRCA2 or Lynch syndrome, specialist surveillance may be available on the NHS.
Ask your GP about a genetics referral — it is free and it is one of the few situations where monitoring is offered.
August 30, 2026
Ongoing
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Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
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Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
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Typically 10 minutes
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Usually
Free
Same day
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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