Prince Philip's Hidden Battle with Pancreatic Cancer: A Disease with One of the Lowest Survival Rates

Prince Philip quietly lived with pancreatic cancer for nearly eight years before his death, it has been claimed. The revelation, published in a forthcoming biography about his wife, Queen Elizabeth II, is surprising on two counts. Firstly, it was never made public that the Duke had cancer, and secondly, pancreatic cancer is notoriously difficult to detect and has one of the lowest survival rates of any form of the disease, with many people dying just six months after diagnosis. Prince Philip's story highlights the key risk factors that can increase the likelihood of developing the disease, from age and family history to lifestyle choices such as smoking, obesity, alcohol consumption and diet.

Biographer Hugo Vickers, in *Queen Elizabeth II*, serialised exclusively in the *Mail on Sunday*, reveals that the Duke of Edinburgh was diagnosed with inoperable pancreatic cancer in June 2013 during an 11-day hospital stay. He passed away at Windsor Castle in April 2021, just two months short of his 100th birthday, with 'old age' recorded on his death certificate. Vickers describes how, on the night before his death, Prince Philip quietly moved along a corridor with his Zimmer frame to pour himself a beer in the Oak Room. The following morning, he reportedly had a bath, said he did not feel well and died peacefully.

By that time, he had already survived far longer than the average prognosis for pancreatic cancer, which typically has a five-year survival rate of around 12 per cent in the UK. His story demonstrates why awareness of the disease and its risk factors is so important, as early recognition can sometimes improve outcomes. However, the lack of public disclosure about his condition raises broader questions about transparency in medical diagnoses, particularly among high-profile individuals, and whether such secrecy inadvertently delays public engagement with health education campaigns.

Pancreatic cancer can run in families. Around five to 10 per cent of pancreatic cancer cases occur in people with a family history of the disease. Risk is higher if a first-degree relative is affected or if a close relative was diagnosed at a young age. Some inherited gene faults, including BRCA1, BRCA2, and PALB2, also increase risk. These genes are better known for raising the chance of breast, ovarian, and prostate cancers. Famously, actress Angelina Jolie underwent a preventative double mastectomy after testing positive for BRCA1 in 2013; her mother, Marcheline Bertrand, died from ovarian cancer at 56. Other rare inherited conditions, such as Peutz–Jeghers syndrome, familial atypical multiple mole melanoma (FAMMM) syndrome, and Lynch syndrome, are also linked to pancreatic cancer. However, most cases are sporadic and do not run in families.

Age and rising cases in younger people. Getting older is one of the biggest risk factors. Almost half of pancreatic cancer cases are diagnosed in people over 75, and the disease is rare in those under 40. Despite this, pancreatic cancer incidence is rising more rapidly in younger age groups, particularly among women. This increase appears to be driven by pancreatic ductal adenocarcinoma, the most common and aggressive type. Other, less common types include neuroendocrine tumours, which generally have a better prognosis. Experts suggest rising rates may reflect both improved detection of early-stage tumours and increases in obesity, type 2 diabetes, and smoking. Overall, men still have a slightly higher incidence than women.

Smoking and nicotine products. Around one in five pancreatic cancers is linked to smoking. Cigarettes, cigars, pipes, and chewing tobacco all increase risk. Research is ongoing into snus—nicotine pouches popular with young men—which may also raise risk. Quitting smoking is the most effective protection; after 20 years, a former smoker's risk returns to that of someone who has never smoked. Government regulations on tobacco products, such as plain packaging laws and bans on advertising, have played a critical role in reducing smoking rates across many populations. However, the rise of alternative nicotine delivery systems like vaping and snus presents new challenges for public health authorities seeking to curb preventable disease.

Obesity and weight-related risk factors. Roughly one in ten pancreatic cancers is linked to being overweight or obese. Excess body fat, particularly around the abdomen, can make tissues resistant to insulin, prompting the pancreas to work harder. This may contribute to cancer development, though more research is needed. Obesity also raises the risk of type 2 diabetes, and pancreatic cancer is more common in people with the condition. Other obesity-related issues, such as gallstones, may also increase risk. Government initiatives aimed at combating obesity—such as food labeling laws, sugar taxes, and urban planning that encourages physical activity—have been implemented globally, though their long-term impact on reducing pancreatic cancer incidence remains to be seen.

Alcohol and chronic pancreatitis. Long-term inflammation of the pancreas, known as chronic pancreatitis, is a known risk factor. Alcohol consumption, particularly in excess, can lead to this condition, which in turn raises the likelihood of developing pancreatic cancer. While alcohol regulations vary by country, some governments have introduced measures such as minimum pricing for alcoholic beverages and restrictions on advertising to reduce consumption. These policies aim to mitigate the public health burden associated with alcohol-related diseases, including pancreatic cancer, though their effectiveness continues to be evaluated.

Prince Philip's case underscores the complex interplay between individual health choices, genetic predispositions, and societal factors. While his longevity with the disease may be attributed to a combination of personal resilience and medical care, it also highlights the gaps in public awareness and early detection systems. As governments grapple with rising cancer rates, the need for targeted education, improved screening technologies, and robust regulatory frameworks becomes increasingly urgent—factors that could ultimately shape the trajectory of public health outcomes for diseases like pancreatic cancer.

Sustained heavy drinking—defined as consuming around three or more units of alcohol daily—has long been associated with a heightened risk of pancreatitis, a condition that can progress to pancreatic cancer. Three units equate roughly to one pint of lager or a large glass of wine, highlighting how common this threshold might be for many drinkers. Recent data from the UK's Medicines and Healthcare Products Regulatory Agency (MHRA) has reignited concerns about alcohol's role in pancreatic health, though the focus now extends beyond drinking to include weight-loss medications.

In late 2023, the MHRA issued updated guidance following reports linking GLP-1 receptor agonists—popular injectable drugs for obesity and diabetes—to rare but serious cases of pancreatitis. These medications, including semaglutide and liraglutide, have been widely prescribed, with millions of patients globally relying on them for weight management. "We're seeing a small but significant increase in pancreatitis reports among users," said Dr. Emily Carter, a pharmacovigilance officer at the MHRA. "While no direct link to pancreatic cancer has been established, we're urging healthcare providers to monitor patients closely and consider alternative treatments for those with a history of pancreatic issues."

The connection between diet and pancreatic cancer remains a complex puzzle. Some studies suggest that high consumption of red and processed meats may marginally elevate cancer risk, particularly in men. Researchers point to compounds formed during high-temperature cooking methods like grilling or barbecuing. For example, charring meat at temperatures above 150°C can produce heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs), both classified as potential carcinogens by the International Agency for Research on Cancer (IARC). "These chemicals are like invisible toxins," explained Dr. Raj Patel, a nutritional epidemiologist at University College London. "They bind to DNA and can cause mutations that lead to cancer over time."

Processed meats, such as sausages, bacon, and deli meats, add another layer of risk. Curing methods involving nitrates and nitrites, along with smoking, may introduce additional harmful substances. A 2022 meta-analysis published in *The Lancet* found that individuals who consumed more than 50 grams of processed meat daily had a 19% higher risk of pancreatic cancer compared to those who ate less. However, the evidence is not definitive. "We're still trying to untangle whether it's the meat itself, the additives, or the cooking methods that are most damaging," said Dr. Sarah Lin, a gastroenterologist specializing in pancreatic diseases.

The MHRA's warnings and ongoing research underscore a broader challenge: balancing the benefits of weight-loss drugs with their potential risks. Similarly, dietary guidelines must navigate the nuances of meat consumption without causing undue alarm. Public health officials emphasize moderation, recommending that individuals limit alcohol intake to no more than 14 units per week and reduce reliance on processed meats. "We're not saying to stop eating meat entirely," Dr. Carter clarified. "But awareness of how we prepare and consume it is crucial."

As scientists continue to investigate these links, the message remains clear: lifestyle choices—whether through alcohol, medication, or diet—play a pivotal role in pancreatic health. While no single factor guarantees cancer prevention, understanding these risks empowers individuals to make informed decisions. For now, the focus is on vigilance, further research, and ensuring that medical advancements do not inadvertently create new health challenges.