Karmactive Staff
24 Doctor Visits. 12 Days to Live. One Missed Diagnosis.
The story of Nigel Williams — and what it reveals about pancreatic cancer’s deadliest trait: silence in its early stages.
In early 2023, Nigel Williams, a 61-year-old father of three in the UK, began experiencing persistent lower back and leg pain. Over the next year, he visited healthcare professionals 24 times. Each time, he was sent away — with painkillers, indigestion medication, or nothing at all. On February 9, 2024, he died, just 12 days after doctors told him he had advanced, metastatic cancer. His wife, Liv Williams, shared the family’s experience publicly to support awareness of the wider crisis in pancreatic cancer care — and to advocate for a breath test clinical trial that could improve detection for future patients.
Tap each event to read what happened — and what was missed.
Why each of Nigel’s symptoms was misread — tap a card to see the clinical picture.
Tap any card to reveal the clinical picture · Full NHS symptom guide →
Data from Cancer Research UK, NCI SEER and NHS England.
“Nigel saw a healthcare professional 24 times, and even then, we didn’t know it was pancreatic cancer. If something like the breath test had been available, maybe Nigel could have had treatment to give him more time with us.”
— Liv Williams, Nigel’s wife, in an essay for Metro.co.ukA national clinical study at Imperial College London investigating whether a non-invasive breathalyser can detect pancreatic cancer early — currently enrolling patients across NHS sites.
How the Breath Test Works
Led by Professor George Hanna · Imperial College London · Targeting recruitment of at least 8,000 symptomatic patients across 40 NHS sites
The trial is registered with the NHS Health Research Authority and is led by the Hanna Group at Imperial College London. Liv Williams has publicly named this trial as the type of tool that could have made a difference for Nigel. Broader early-detection research — including liquid biopsy and AI-assisted imaging — is also being evaluated; registered studies can be found at ClinicalTrials.gov. Pancreatic Cancer UK, the leading UK charity, is also funding and supporting early detection research.
Aligned with NHS guidance and American Cancer Society clinical criteria.
Red-Flag Symptom Combinations
Individual symptoms are often benign. These combinations warrant urgent investigation.
- Back or abdominal pain that worsens over weeks and is not explained by imaging
- Unexplained weight loss of 5% or more bodyweight within 2–3 months
- New-onset persistent indigestion in someone over 50, with no prior history
- Back pain combined with unexplained weight loss — doctors are advised to consider an abdominal cause, not just musculoskeletal issues
- Jaundice (yellowing of skin or eyes), dark urine, or pale, greasy stools at any point
- New-onset diabetes without obvious risk factors, especially in those over 50
- Persistent fatigue unrelated to lifestyle, combined with any of the above
Per Cancer Research UK and the National Cancer Institute.
Practical steps backed by NHS and Cancer Research UK guidance.
Steps worth knowing
- If symptoms have lasted more than four weeks without clear explanation, return to your GP and ask specifically whether further diagnostic tests — including blood work or abdominal imaging — are appropriate.
- Ask your GP about the NHS 28-Day Faster Diagnosis Standard if you have been referred with unexplained symptoms and are still awaiting a clear outcome.
- Request a second opinion if you are repeatedly sent away without a diagnostic pathway or clear explanation.
- Tell your doctor when symptoms appear together — particularly back pain alongside unexplained weight loss or appetite changes, which together carry more clinical significance than either does alone.
- Check whether any Cancer Research UK clinical trials are open for early detection if you are at elevated risk due to family history, chronic pancreatitis, or new-onset diabetes.
The account shared by Liv Williams described 24 medical consultations over approximately one year for symptoms including back pain, indigestion, weight loss, and muscle wasting. The eventual diagnosis of advanced, metastatic pancreatic cancer was made in January 2024, with the primary cancer site confirmed only after Nigel’s death on February 9, 2024. The PANACEA clinical trial, registered with the NHS Health Research Authority and led by the Hanna Group at Imperial College London, is investigating VOC breath analysis as a triage tool for symptomatic patients. The NHS diagnostic standards, clinical symptom guidance, and survival statistics relevant to pancreatic cancer were covered in this piece.
